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The recent news about the harmful effects of hormone replacement was
played in the media as a health story, but it is much more than that. In
fact, it may be the hot-flashiest corporate scandal to date: Let's call
it Estron.

If other corporate scandals have been about fudging figures, this one
is about fudging science--something that seems to have been surprisingly
easy to do. And such is the corporate culture that we have apparently
preferred to believe the drug companies rather than the women's health
advocates who have been lobbying for decades simply to get the
scientific evidence to back the companies' claims. The director of the
North American Menopause Society (NAMS), Dr. Wulf Utian, called the bad
news about hormones a bombshell, but it really isn't. Information has
been slowly accumulating about hormone replacement therapy's risks, even
as Wyeth and other manufacturers have been pushing their product as an
elixir for a widening group of symptoms. In recent years, this
potentially carcinogenic drug has been marketed with the nonchalance of
a vitamin pill: HRT advertising suggests that almost no woman over 50
couldn't benefit from it somehow.

Estron is the latest in a long line of scandals pitting women's health
against the interests of Big Pharma--scandals like the sale of faulty
Dalkon Shield contraceptives, which caused infertility, and medications
like DES, which caused severe illnesses in users and their children.
What all these cases have in common is that--like the manufacturers of
menopausal hormones--the drug companies, in their rush for profits,
insufficiently tested their wares before selling them to millions. What
these scandals suggest is that somewhere in the swampy landscape of
medical research funding, unhealthy relationships incubate between
medical practitioners and the drug-company reps who manage to dazzle
them with quasi science and quasi truths. The industry spends around $15
billion a year to promote its products--more than it spends to develop
them. Clearly, even those doctors who resisted the
luxury-cruise-lectures approach to sales found themselves suckered in.

The manipulation of HRT's scientific credentials began back in the
mid-1960s, when Wyeth paid gynecologist Dr. Robert Wilson to extol its
new wonder drug, estrogen replacement. In an evocatively named book,
Feminine Forever, Wilson declared that by replacing the estrogen
lost at menopause, women would remain attractive and easier to live
with. Over the decades since, Wyeth and other hormone manufacturers have
revised dosages and combinations to fit new medical revelations and
poured billions into sophisticated propaganda to get their message out.
The message is that menopause is not a natural life stage but a
disease--estrogen deficiency--and it will make you old. HRT is the cure,
and it will keep you young.

In recent years the manufacturers have claimed protective qualities for
HRT way beyond its original ambitions. First, it promised (and
delivered) relief from menopausal symptoms. Next came claims for
protection against heart disease in women already affected, and then in
healthy women. Then came its role as a treatment against osteoporosis,
which, manufacturers warned (falsely), becomes an instant risk at the
moment of menopause (it's a gradual risk over many years).

The truth is that the manufacturers didn't exactly know what HRT did or
didn't do, because they never ran a big, randomized national study
stringent enough to meet medical standards. For more than twenty years,
the companies used observational studies showing that women who took
hormones were healthier, but they didn't look at why: Was it that the
hormones themselves made women healthier, or that health-conscious women
were more likely to take hormones to begin with? There were many other
uncertainties. Yet calls to answer these questions, from women's health
groups and even from prominent politicians like Pat Schroeder and
Olympia Snowe, went unheeded.

For all the hype, there has been plenty of evidence, both scientific and
epidemiological, that estrogen, named a carcinogen by the FDA two years
ago, is not a wonder drug for everyone. Thirty percent of prescriptions
for estrogen remain unfilled, and the growing search for alternative
menopause products shows that increasing numbers of women are
uncomfortable with the prospect of a lifetime of swallowing synthesized
horse urine. And for all the spin, there has also been accumulating
evidence of serious side effects. As early as 1975 the FDA identified
links between estrogen and higher rates of uterine cancer. (Wyeth
responded by adding another product, progestin, to offset the risk.) In
1990 the Nurses Health Study reported that women on estrogen faced a 36
percent greater risk of breast cancer. That same year the FDA refused to
approve Premarin as a treatment to prevent heart disease, because the
company's evidence didn't convince them. The 2000 HERS study, actually
funded by Wyeth, found that hormone therapy increased risks in heart
disease patients in the first few years. (Wyeth countered that
long-term, it works.)

And people have been trying to warn us. As far back as the mid-1990s,
The Menopause Industry, by Australian reporter Sandra Coney,
presented heavily researched evidence of uterine bleeding, gallbladder
disease and increased cancer rates in hormone takers. In 1997 breast
cancer specialist Dr. Susan Love's Hormone Book returned to the
link between HRT and increased breast cancer risk and came under attack
for raising an alarm. Earlier this year Cindy Pearson, executive
director of the National Women's Health Network, published The Truth
About Hormone Replacement Therapy
, outlining many other
discrepancies between hormone hype and science. The medical
establishment barely paid attention.

Finally, the scientific evidence that we have now, based on two large
randomized trials, is definitive, according to one of the study's
leaders, Dr. Deborah Grady. The trials have shown that not only does HRT
do more harm than good for women with existing heart disease, but it
doesn't protect healthy women either; in fact, during the trial it
increased incidence of heart attacks, breast cancer, strokes and blood
clots--enough to have caused the study to be abandoned three years
early. And yet belief in the hormone was so strong that researchers
feared it would be unethical to put women on placebos.

How is this possible? Dr. Utian of NAMS has admitted that many different
parties--from the drug companies to their paid researchers and
spokespeople to the prescribing gynecologists--have had a vested
interest in the success of hormone replacement, and for them, he told
the New York Times, the issue is about more than data. For them,
Utian said, truth is opinion. But that seems a risky precept for
physicians to work with. It sounds like something Arthur Andersen would
say.

Hot media news: Women want hard-hitting reports on issues that affect them.

The Nation reported on Dr. Pendergraft's troubles in
"Abortion on Trial" by Hillary Frey and Miranda Kennedy, June 18, 2001.

At the fourteenth international AIDS conference, the gulf between the
United States and the rest of the world widened as US officials touted
policies that world health experts agree are ineffective strategies for
stemming the pandemic. Without stepped-up prevention efforts, 45 million
more people will become infected with HIV by 2010, according to the
Global HIV Prevention Working Group. Yet 29 million of these people
would never contract the virus if leaders ratcheted up preventive
strategies--most crucially teaching the use of condoms.

In European countries, including the Netherlands and Sweden, the
promotion of a variety of safe sex practices--abstinence, monogamy and
condom use--has reduced teen pregnancies and sexually transmitted
diseases. In Senegal and Uganda, it has cut the rate of new HIV
infections in half. In all these countries and in others, national
governments have supported such programs both rhetorically and
financially.

The White House, however, wants to expand programs enacted under the
Clinton Administration that tie federal funding of sex education to the
promotion of abstinence-only curriculums. While the vast majority of US
schools provide information about what HIV is and how it is transmitted,
less than half give students information about what condoms are or how
to use them, according to Centers for Disease Control surveys.

In a speech drowned out by angry protesters in Barcelona, US Secretary
of Health and Human Services Tommy Thompson touted the Administration's
$500 million drug initiative to prevent babies in Africa and the
Caribbean from becoming infected with HIV during birth or through
breastfeeding. He seemed confused when reporters later suggested that
preventing women, girls and their partners from becoming infected in the
first place might be a more productive strategy.

The evidence is clear: Campaigns that rely only on abstinence and drugs
to protect babies from AIDS won't slow the world pandemic. HIV
prevention does work when it is part of reproductive health programs
that recognize that sex is an integral component of human behavior.

A half-century ago T.H. Marshall, British Labour Party social theorist,
offered a progressive, developmental theory for understanding the
history of what we have come to call citizenship. Taking the experience
of Englishmen to define the superior path, he postulated a hierarchy of
citizenships: civil rights, political rights and social rights. The last of these became the
category in which twentieth-century Europeans have understood claims on
the state to health, welfare, education and protection from avoidable
risk. They conceived of these citizenships as stages in an upward climb
toward an ever better democracy.

Marshall's schema looked only at European men. Feminists have pointed
out that women did not achieve citizenship in this order. In fact, women
often won some social rights--for example, protective legislation and
"welfare"--before achieving political ones such as the right to vote.
And women's individual civil rights were often overwhelmed and even
suppressed by legally imposed family obligations and moral sanctions.
(For example, a century ago courts generally interpreted the law of
marriage to mean that women were legally obligated to provide housework,
childcare and sexual services to husbands.) Equally problematic were
Marshall's obliviousness to British imperialism and what it meant for
Third World populations, including the fact that he conceived of the
British as civilizers rather than exploiters, and his apparent ignorance
of the conditions of second-class citizenship for racial/ethnic
subordinates within nation-states. In short, his historical hierarchy
was highly ideological.

But no one has yet done what Alice Kessler-Harris has in her newest
book, In Pursuit of Equity, reaching beyond Marshall and his
critics to suggest a new concept, economic citizenship. In this history
of how women have been treated in employment, tax and welfare policy,
Kessler-Harris--arguably the leading historian of women's labor in the
United States--synthesizes several decades of feminist analysis to
produce a holistic conception of what full citizenship for women might
entail. In lucid prose with vivid (and sometimes comic) illustrations of
the snarled thinking that results from conceiving of women as
dependents--rather than equal in heading families--she offers a vision
of how we can move toward greater democracy. In the process, she also
shows us what we are up against. Her book illustrates brilliantly how
assumptions about appropriate gender roles are built into all aspects of
policy.

She aims to resolve what is perhaps the central contradiction for
policy-makers and policy scholars who care about sex equality: the
contradiction between, on the one hand, valuing the unpaid caring work
still overwhelmingly performed by women and, on the other hand, enabling
women to achieve equality in wage labor and political power. Today, for
example, although all feminists oppose the punitive new requirements of
the policy that replaced Aid to Families with Dependent Children,
repealed in 1996, they are divided about what would constitute the right
kind of welfare system. Some find it appropriate that all adults,
including parents of young children, should be employed, assuming they
can get a living wage and good childcare. Others, often called
maternalists, believe a parent should have the right to choose full-time
parenting for young or particularly needy children. Behind this difference lie two different visions of
sex equality--one that emphasizes equal treatment of the sexes and individual rights
and responsibilities, another that seeks to make unpaid caring labor,
notably for the very young, the old and the ill, as honorable and valued
as waged labor.

Kessler-Harris would resolve this contradiction through a labor-centered
view of citizenship, a notion of economic citizenship based on equity,
or fairness, in the valuation of socially worthy labor. Previously, the
policy proposal closest to this principle of equity was "comparable
worth." Second-wave feminists saw that the Equal Pay Act of 1963 and
Title VII of the Civil Rights Act of 1964 had failed to equalize male
and female wages. Because the labor force is so segregated, and female
jobs are so consistently undervalued, equal pay alone cannot produce
justice to women (or men of color). The comparable-worth strategy called
for equal wages for work of comparable expertise and value, even when
the jobs differed. For example, consider the wage gap between truck
drivers and childcare workers. Truck drivers earned much more even than
registered nurses, whose training and responsibility was so much
greater. The women's movement's challenge to inequality in jobs took off
in 1979, when Eleanor Holmes Norton, then head of the Equal Employment
Opportunity Commission, called for evaluations of job skills to remedy
women's low wages. But her successor, Clarence Thomas, refused to
consider comparable-worth claims. Although some substantial victories
were achieved in state and union battles--for example, the American
Federation of State, County and Municipal Employees (AFSCME) won wage
increases averaging 32 percent and back pay retroactive to 1979 for
Washington State employees, 35,000 of whom shared a $482 million
settlement--the comparable-worth campaigns faded in the 1980s.

But even had the comparable-worth strategy been adopted, it could not
have recognized the hours spent in caring for children, parents,
disabled relatives and friends, not to mention the work of volunteering
in underfunded schools, cooking for homeless shelters, running kids'
basketball teams. Kessler-Harris is arguing for a citizenship that
respects unpaid as well as paid labor.

She has worked out the arguments in this book systematically over many
years. Several years ago, an article of hers with the deceptively simple
title "Where Are All the Organized Women Workers?" enlarged the
understanding of gendered "interests" from an exclusive focus on women
to take in men as well. She demonstrated that so long as men dominate,
aspirations understood and characterized as class interests often
express gender interests equally strongly. She uncovered how unions
often operated as men's clubs, built around forms of male bonding that
excluded women, primarily unconsciously but often consciously, too. In
this new book she extends her analysis of men's gendered interests to
reveal how labor unionists' inability to stop defending the privileges
of masculinity have held back labor's achievements. One vivid example
was unions' opposition to state-funded welfare programs and
health-and-safety regulation, stemming from anxiety that they would
deprive workers of their manly independence. Of course, unionist
resistance to state control over workplace and work-centered programs
also derived from a defense of workers' control. But this vision of
workplace democracy was inextricably masculinist, and workingmen's
understanding of their dignity rested on distinguishing themselves from
women.

In A Woman's Wage, Kessler-Harris showed that both Marxist and
neoclassical economics were mistaken in their joint assumption that the
wage was somehow a consistent, transparent token of the capital/labor
relation. By contrast, wage rates, wage systems, indeed the whole labor
market were constructed by gender interests and ideology as well as by
supply and demand or surplus value or the actual cost of subsistence. A
wonderful example from her new book: The Hawthorne experiments of the
late 1920s have been interpreted to show that women workers were more
tractable than men. In one study, a group of women workers adapted more
cooperatively and quickly to a speedup than did a group of male workers.
In seeking to explain this behavior, investigators examined the women's
home lives and even their menstrual cycles, while paying no particular
attention to the fact that the collective rather than individual wage
structure imposed on them was such that higher productivity could only
increase their total wages, while the men's piece-rate wage structure
offered no such guarantee--in fact, the men had reason to expect that
the piece rate would be lowered if they speeded up. We see here not a
"natural" gendered difference arising informally from culture and
socialization, but female and male workers responding rationally to a
gendered system imposed by employers.

In Pursuit of Equity argues that no one can enjoy civil and
political rights without social and economic citizenship. Marshall's
alleged gradual expansion of civil and political rights not only
excluded many others but actually strengthened women's exclusion from
citizenship. One fundamental premise of democratic capitalism--free
labor--was never fully extended to all women, whose labor was often
coercively regulated, not only by husbands but by the state.
Kessler-Harris shows how free labor developed in tandem with the "family
wage" ideal, that is, that husbands/fathers should earn for the entire
family and that women's destiny was domestic unpaid labor. The correlate
was that men "naturally" sought economic and social independence while
women "naturally" sought dependence. Ironically, most feminists of the
nineteenth century went along with this dichotomy and tried to root
women's citizenship in their essential family services rather than in
the free-labor definition of independence. That is, they argued for
rights on the basis of women's spiritual and material work in unpaid
caretaking labor.

The book demonstrates particularly effectively how the dominant modern
gender system--the family-wage norm--made it difficult for women to
become full citizens. In one closely documented section, Kessler-Harris
exposes the condescending and defensive assumptions of those who drafted
the Old Age Insurance program (which later became Social Security). The
drafters agreed, for example, that the widow of a covered man with young
children should be able to receive three-quarters of his pension until
she remarried or the children reached 18. A widow without children
lacked any rights to her husband's pension. But if this pension was her
husband's by right, as the designers insisted, then why were his heirs
not entitled to all of it as with all other parts of his property? If
the widow remarried, she would not have to give up the bank account or
house or car he had left her--why should she give up a Social Security
pension? One Social Security drafter argued that retaining such an
annuity after remarriage would make widows "a prize for the fellow that
has looked for it," assuming that women are entirely passive in marriage
decisions! The drafters were all convinced that "once a woman was no
longer dependent on the earnings of a particular male (dead or
alive)...his support for her should cease." In other words, his status
as breadwinner should continue even after his death. The drafters
rejected the idea of granting all widows of covered men an equal stipend
or one based on the number of children. It was important for her
benefits to be calibrated to his earnings so as to feed "the illusion
that families deprived of a father or husband would nevertheless
conceive him...as a continuing provider." "Why should you pay the widow
less than the individual himself gets if unmarried?" Because "she can
look after herself better than he can." Imagining women as less capable
of handling money than men, the designers removed the option of a
lump-sum benefit to widows, requiring them, unlike men, to receive
monthly stipends. To avoid "deathbed marriages," they allowed a widow to
collect only if she had been married and living with her husband for at
least a year before he died.

The concern with male status was reflected particularly comically in
discussions about the age at which a wife could start to receive her
share of her husband's benefits. Some argued for an earlier "retirement"
age for women because if both men and women were eligible at 65, this
would mean that men with younger wives--a common phenomenon--might not
get their full pension for a number of years after they retired. But
others argued that since men who married much younger women were more
likely to be those who had married more than once, granting women an
earlier retirement date might reward these men over single-marriage
retirees.

Several decades ago economist Heidi Hartmann pointed out that patriarchy
was as much a system of power and hierarchy among men as a male-female
relation, and Kessler-Harris confirms that insight. For example, the
entire debate about whether married couples should be able to report
separate incomes for IRS purposes concerned the inequalities this would
create between men with employed wives and men with nonemployed wives.
Fairness to women was not a prominent concern. The fact that employed
women's old-age insurance benefits were restricted according to their
marital status while men's weren't "did not seem like sex discrimination
[to the Social Security designers] but rather like equity to men."

At the core of In Pursuit of Equity is the understanding that
what is "fair" is historically changing. The problem we face today is
not that men deliberately built policies to subordinate women but that
when our basic economic policies were established, men and women alike
tended to see male breadwinning and female domesticity as "fair." That
standard is far, far from reality today. One result is a double standard
in which supposedly ideal family life, requiring a full-time mother, is
a privilege of wives of high-earning husbands.

In the United States, the resultant damage is worse than in Europe,
because here many fundamental aspects of citizenship flow from the labor
market. "Independence" today is generally defined as earning one's
living through wages, despite the fact that the resulting dependence on
employers leaves workers as vulnerable, if not more vulnerable, than
dependence on government stipends. Social rights vital for survival,
such as medical insurance, retirement pensions and workers'
compensation, typically derive from employment in this country, in
contrast to most developed countries, which provide such help as a
matter of right to all citizens or residents. This is one way in which
American wage workers, as Kessler-Harris says, were "in a different
relationship to the constitution than those who did care-giving work."
As a result the development of democratic capitalism, even the growth of
working-class power in some ways failed to strengthen women's economic
citizenship, even weakened it. Indeed, she shows how victories against
sex discrimination in the labor force in the 1960s inadvertently
confirmed the assumption that all women could and should work for wages,
thereby contributing to the repeal of welfare without creating the
conditions that would make it possible for poor women to support
themselves through employment.

This gendered citizenship became more visible and more obnoxious to
women as wage-earning became the female norm and as "alternative
families" gained political clout. For example, if every individual was
entitled to an old-age pension and unemployment compensation, we
wouldn't have to struggle about the inheritance rights of gay partners
or stay-at-home parents' need for support. Even today, banning sex
discrimination is difficult because it is difficult to get agreement on
what constitutes discrimination. In a few cases division among feminists
has held back the struggle. Kessler-Harris ends the book with a brief
reprise of EEOC v. Sears, Roebuck & Co., a 1980s marker of
this division and a case in which she herself played a significant role.
Sears admitted that very few women held any of its well-paying
commission sales jobs but argued that women were not interested in these
jobs because the positions were competitive, pressured, demanding.
Another historian of women testified for Sears against the women
plaintiffs, using her expertise to argue that women's primary attachment
to unpaid domestic labor led them to want only jobs which did not
conflict with it. Her arguments illustrated vividly the continuing
influence of this emphasis on male/female difference, not necessarily as
"natural" or essential but nevertheless beyond the appropriate scope of
legal remedy. Sears won the case.

There is one pervasive absence in Kessler-Harris's book--race--and the
omission weakens the argument substantially. Her understanding of how
the family-wage ideal works would have to be substantially complicated
if she made African-American women more central, for they were rarely
able to adopt a male breadwinner/female housewife family model and often
rejected it, developing a culture that expects and honors women's
employment more than white culture. Mexican-American women's experience
did not fit the family-wage model either, despite their reputation as
traditional, because so many have participated in agricultural and
domestic wage labor throughout their lives in the United States. Equally
problematic to the argument, prosperous white women who accepted the
family-wage model often didn't do unpaid domestic labor because they
hired poor immigrants and women of color to do it for low wages. These
different histories must affect how we envisage a policy that recognizes
labor outside the wage system, and they need to be explored.

One aspect of Kessler-Harris's economic citizenship concept is being
expressed today by progressive feminists trying to influence the
reauthorization of Temporary Assistance for Needy Families (TANF), the
program for poor children and their parents that succeeded AFDC. We are
pushing a House bill that would recognize college education and
childcare as work under the new welfare work requirements. This book is
a sustained argument for that kind of approach and should help it become
part of the policy discussion. It probably won't win. Some will call it
unrealistic. But today's policies are already wildly unrealistic, if
realism has anything to do with actual life. If we don't begin now to
outline the programs that could actually create full citizenship for
women, we will never get there.

Victims of domestic violence defend their right to keep their children.

What would the world look like if women had full human rights? If girls
went to school and young women went to college in places where now they
are used as household drudges and married off at 11 or 12? If women
could go out for the whole range of jobs, could own the land they work,
inherit property on equal terms with men? If they could control their
own sexuality and fertility and give birth safely? If they had recourse
against traffickers, honor killers, wife beaters? If they had as much
say and as much power as men at every level of decision-making, from the
household to the legislature? If John Ashcroft has his way, we may never
find out. After twenty years of stalling by Jesse Helms, the Senate
Foreign Relations Committee in early June held hearings on the
Convention for the Elimination of All Forms of Discrimination Against
Women (CEDAW), an international treaty ratified by 169 nations.
(President Carter signed CEDAW in 1980, but the Senate blocked it.)
George W. Bush originally indicated that he would sign it--that was when
he was sending Laura onto the airwaves to blast the Taliban--but under
the influence of Ashcroft, he's since been hedging. Naturally, the
religious right has been working the phones: According to one e-mail
that came across my screen, the operator who answers the White House
comment line assumed the writer was calling to oppose CEDAW, so heavily
were the calls running against it. The reasons? CEDAW would license
abortion, promote homosexuality and teen sex and destroy The Family. In
2000, Helms called it "a terrible treaty negotiated by radical feminists
with the intent of enshrining their anti-family agenda into
international law."

How radical can CEDAW be, you may ask, given that it's been ratified by
Pakistan, Jordan and Myanmar? Genderquake is hardly around the corner.
Still, across the globe women have been able to use it to improve their
access to education and healthcare as well as their legal status. In
Japan, on the basis of a CEDAW violation, women sued their employers for
wage discrimination and failure to promote; the Tanzanian High Court
cited CEDAW in a decision to overturn a ban on clan land inheritance for
women. Given the dire situation of women worldwide, it is outrageous to
see US policy in the grip of Falwell, James Dobson and Ralph Nader's
good friend Phyllis Schlafly. Like the Vatican, which uses its UN
observer status to make common cause with Islamic fundamentalist
governments on behalf of fetus and family, on CEDAW the Bush
Administration risks allying itself with Somalia, Qatar and Syria to
promote the religious right agenda on issues of sexuality. In the same
way, at the recent UN General Assembly Special Session on the
Child--where the United States opposed providing girls with sex
education beyond "just say no," even though in much of the Third World
the typical "girl" is likely to be married with children--the Bush
Administration allied itself with Libya, Sudan and evil axis member
Iran. Some clash of civilizations.

Given this season's spate of popular books about mean girls and inhumane
women, it might seem starry-eyed to suppose that more equality for women
would have a positive general social effect. Where women are healthy and
well educated and self-determined, you can bet that men are too, but the
situation of women is not only a barometer of a society's general level
of equality and decency--improving women's status is key to solving many
of the world's most serious problems. Consider the AIDS epidemic now
ravaging much of the Third World: Where women cannot negotiate safe sex,
or protect themselves from rape, or expect fidelity from their male
partners, where young girls are sought out by older HIV-positive men
looking for tractable sex partners, where prostitution flourishes under
the most degraded conditions and where women are beaten or even murdered
when their HIV-positive status becomes known, what hope is there of
containing the virus? Under these circumstances, "just say no" is worse
than useless: In Thailand, being married is the single biggest predictor
of a woman's testing positive. As long as women are illiterate, poor and
powerless, AIDS will continue to ravage men, women and children.

Or consider hunger. Worldwide, women do most of the farming but own only
2 percent of the land. In many areas where tribal rules govern
inheritance, they cannot own or inherit land and are thrown off it
should their husband die. Yet a study by the Food and Agriculture
Organization shows that women spend more time on productive activities,
and according to the International Center for Research on Women, women
spend more of their earnings on their children than men do. Recognizing
and maximizing women's key economic role would have a host of
benefits--it would lessen hunger, improve women's and children's
well-being, improve women's status in the family, lower fertility.

And then there's war and peace. I don't think it's an accident that
Islamic fundamentalism flourishes in the parts of the world where women
are most oppressed--indeed, maintaining and deepening women's
subjugation, the violent rejection of everything female, is one of its
major themes. (Remember Mohammed Atta's weird funeral instructions?) At
the same time, the denial of education, employment and rights to women
fuels the social conditions of backwardness, provincialism and poverty
that sustain religious fanaticism.

If women's rights were acknowledged as the key to human progress that
they are, we would look at all these large issues of global politics and
economics very differently. Would the US government have been able to
spend a billion dollars backing the fundamentalist warlords who raped
and abducted women and threw acid at their unveiled faces while
"fighting communism" and destroying Afghanistan? At the recently
concluded loya jirga, which featured numerous current and former
warlords as delegates, a woman delegate stood up and denounced former
President Burhanuddin Rabbani as a violent marauder. For a moment, you
could see that, as the saying goes, another world is possible.

Let's say I'm a Jehovah's Witness, and I get a job in an understaffed
emergency room where, following the dictates of my conscience, I refuse
to assist with blood transfusions and try my best to persuade my fellow
workers to do the same. How long do you think I'd last on the job? And
after my inevitable firing, how seriously do you think a jury would take
my claim that my rights had been violated? Five minutes and not very,
right? A similar fate would surely await the surgeon who converts to
Christian Science and decides to pray over his patients instead of
operating on them, the Muslim loan officer who refuses to charge
interest, the Southern Baptist psychotherapist who tells his Jewish
patients they're bound for hell. The law rightly requires employers to
respect employees' sincerely held religious beliefs, but not if those
beliefs really do prevent an employee from performing the job for which
she's been hired.

Change the subject to reproductive rights, though, and the picture gets
decidedly strange. In 1999 Michelle Diaz, a born-again Christian nurse
who had recently been hired by the Riverside Neighborhood Health Center,
a public clinic in Southern California, decided that emergency
contraception, the so-called morning after pill that acts to prevent
pregnancy if taken within seventy-two hours of unprotected intercourse,
was actually a method of abortion. She refused to dispense it or give
referrals to other providers; the clinic offered her a position that did
not involve reproductive healthcare, but when she told temporary nurses
at the clinic that they too would be performing abortions by dispensing
EC, Diaz, who was still on probation as a new hire, lost her job. She
sued with the help of the American Center for Law and Justice (ACLJ),
the religious-right law firm headed by Jay Sekulow. At the end of May a
jury agreed that her rights had been violated and awarded her $47,000.

Excuse me? A nurse at a public health clinic has the right to refuse to
provide patients with legally mandated services, give out misleading
health information in order to proselytize her co-workers to refuse as
well, and keep her job? The low-income women who come to Riverside
desperately in need of EC and abortion referrals are flat out of luck if
they happen to turn up when the anti-choicers are on shift? Riverside is
the largest public health clinic in the county, serving 150-200 patients
a day, but it operates with a staff of four nurses--should those four
people decide what services the clinic can offer? What about the
patient's right to receive standard medical care? Or the clinic's
responsibility to deliver the services for which they receive government
funds?

Some states, California among them, have "conscience laws," permitting
anti-choice healthworkers to refuse to be involved in abortions. EC,
however, is just a high dose of regular birth control pills that
prevents ovulation and implantation. It is not abortion, because until a
fertilized egg implants in the womb, the woman is not pregnant. A long
list of medical authorities--the American Medical Association, the
American Medical Women's Association, the American College of
Obstetricians and Gynecologists and Harvard Medical School--agree that
EC is not an abortifacient, and a 1989 California court decision itself
distinguishes abortion from EC. There are lots of mysteries about the
Diaz case, ranging from why Diaz took a job she knew involved practices
she found immoral in the first place, to how the jury could possibly
have come up with a decision so contrary to law and public policy. Did
Diaz take the job with the express intention of disrupting services? Was
the jury anti-choice? Interestingly, the jury pool was partly drawn from
San Bernardino County, which last year unsuccessfully tried to bar its
public health clinics from dispensing EC.

Whatever the jury's thinking, the Diaz case represents the latest of
numerous attempts by the anti-choice movement to equate EC with abortion
and move it out of normal medical practice. Pharmacists for Life
International, a worldwide organization that claims to have some 1,500
members, calls it "chemical abortion" and urges pharmacists to refuse to
dispense it. The ACLJ is currently litigating on behalf of one who did.
Wal-Mart refuses to stock it at all. Anti-choicers in Britain made an
unsuccessful attempt to prevent EC from being dispensed over the counter
by placing it under an archaic law that prohibits "procuring a
miscarriage." Some anti-choicers have long argued that not just EC but
conventional birth-control methods--the pill, Norplant, Depo-Provera and
the IUD--are "abortifacients": In northern Kentucky anti-choice
extremists are campaigning to force one local health board to reject
Title X family-planning funds; according to the Lexington
Herald-Leader, the board's vote, scheduled for June 19, is too
close to call.

Although secular employers are expected to make reasonable
accommodations to religious employees--or even, if the Diaz verdict is
upheld, unreasonable ones--religious employers are not required to
return the favor. On the contrary, the Supreme Court, in The Church
of Jesus Christ of Latter Day Saints v. Amos
, permits them to use
religious tests to hire and fire personnel as far from the sacred
mission as janitorial workers; if a Methodist church wants to refuse to
hire a Muslim security guard, it has the blessing of the Constitution to
do so. As often noted in this column, religious organizations can and do
fire employees who violate religious precepts on and even off the job. A
pro-choice nurse could not get a job at a Catholic hospital and declare
that her conscience required her to go against policy and hand out EC to
rape victims, or even tell them where to obtain it--even though medical
ethics oblige those who refuse to provide standard services for moral
reasons to give referrals, and even though Catholic hospitals typically
get about half of their revenue from the government.

According to the ACLJ, however, secular institutions should be sitting
ducks for any fanatic who can get hired even provisionally. The
Riverside clinic has asked the judge to set aside the Diaz verdict. If
that bid is unsuccessful, it will appeal. I'll let you know what
happens.

Twenty-seven years ago, Bella Abzug introduced the first comprehensive gay civil rights bill in the history of the Congress.

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