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Led by Black Midwives, This Abortion Clinic and Birth Center Is Reimagining Health Care in the South

A reproductive health-care center in Memphis is revolutionizing what it means to offer a full spectrum of care.

With the unveiling of a new location in September, CHOICES Memphis Center for Reproductive Health is now the country’s first nonprofit organization to offer both birthing and abortion care, as well as and the first birth center in Memphis with midwives as the primary caregivers. Midwives providing birthing care is especially critical in a city like Memphis—while the infant mortality rate decreased between 2005 and 2015, the city’s rate is still higher than the overall infant mortality rate in the United States.

CHOICES traces its roots back to 1974, when the Memphis Center for Reproductive Health opened on the heels of Roe v. Wade’s watershed Supreme Court decision that made abortion legal. In the ensuing two decades, the center operated as a first-term abortion clinic, and also offered free pregnancy tests and counseling.

Two key personnel hires charted the path to setting the standard for reproductive health services: Rebecca Terrell joined as executive director in 2009 (which also led to rebranding to CHOICES), and Nikia Grayson came on board as a nurse midwife in 2016; Grayson is now the director of perinatal care.

In 2013, talks about expanding the clinic’s location began, and now, around seven years later, the vision has become a reality—and during a pandemic no less.

What sets CHOICES apart is that it views abortion care and birthing in the same framework of a reproductive health journey that includes a pre- and postnatal care, fertility treatment management, teen health services, trans-inclusive health care, and more.

CHOICES operates in a reproductive justice model, “where we center Black and brown families and personalize the care around their needs, regardless of their ability to pay,” Grayson said.

That model is especially critical because CHOICES is the only center for miles that offers some of these health services to a majority of people of color and low-income patients. At least 70 percent of its patients receive Medicaid, Katy Leopard, external affairs director for CHOICES, said.

The new location is now central to major bus routes, which makes it ideal for people who travel from out of state; Leopard noted that patients from Arkansas, Kentucky, Missouri, Mississippi, and Texas have all received care at CHOICES .

The center has more than doubled in size to house three abortion procedure rooms, three birthing suites, examination rooms, and a laboratory. A wellness courtyard brims with foliage; green is the center’s signature building color. An outdoor seating area is located in the middle of the second floor, and the building has entrances in the back with additional parking spaces for patients to enter discreetly; it’s nearly impossible to escape the shadow of anti-choice protesters at any place that provides abortion care—and CHOICES is no different.

CHOICES has a resident physician who administers abortions. And because of the rising interest in midwives, particularly during the COVID-19 pandemic, the team of midwives has been expanded.

The new CHOICES opened its doors in September with significant COVID-19 precautions in place. Despite distancing measures such as substituting an in-person grand opening with a virtual tour, the sense of duty to the community persists.

“No one was performing first-term abortions here after ‘73, and there needed to be a lot of educating to be done about both abortion and birth control then,” Leopard said. “Now, wherever there’s a gap, we try and fill it, and it carries on to today.”

“We’ve found that if we give people factual, evidence-based information, people will make the best choices for themselves,” Leopard added.

All Your Burning Sex Questions—Answered

For more sex education resources, check out our Better Sex Ed guide.

We’ve heard a lot about the so-called new normal this year: the new normal of working from home, of wearing masks in public, of mass temperature checks, of staggered school days and remote learning and shopping online and virtual dinner parties.

But there’s no such thing as a “new normal” when it comes to having sex. For that matter, there’s no “old normal,” either. Everyone’s sex life is different, and there’s no sense in trying to conform to some kind of sexual standard that doesn’t exist.

So says sex educator Cassandra Corrado, the host of Rewire News Group’s YouTube series You Deserve Good Sex. In a recent Instagram Live, Corrado answered audience questions as a theme emerged: You and your partner aren’t on the same page sexually (thanks, pandemic), and you want know how to get back to the best part of the book, so to speak.

From assessing the state of your libido to finding a sex therapist to expanding your definition of what sex even is, Corrado offers a ton of helpful advice. Watch the event below.

An Abortion Storyteller Makes History at the Amy Coney Barrett Hearings

At Amy Coney Barrett’s Supreme Court confirmation hearings this week, there was a decent amount of talk about abortion; Judge Barrett has made no secret of her animus toward reproductive freedom.

In 2006 she signed onto an ad from a far-right group that called abortion “barbaric” and called for the prosecution of abortion providers. At the hearings, Democratic senators spent a lot of time trying to squeeze Barrett’s views out of her, but she mostly sidestepped the issue except for a few moments—like calling later abortions “late-term abortions” and coincidentally using a 20-week abortion ban as one of her examples of cases where a plaintiff might not have standing before the Court.

But on the final day of hearings on Thursday, something incredible happened. Historic, in fact. Crystal Good, a writer, poet, small business owner, and mother of three in West Virginia, shared her abortion story virtually with the Senate Judiciary Committee as part of witness testimony. It was the first time anyone has shared their abortion story with the committee in connection with a Supreme Court nomination, and it was powerful.

“Who I am today is only possible because, at 16 years old, I had access to an abortion,” Good said, before going on to explain how the parental consent law in her state adversely impacted her access to abortion. Good’s stepfather sexually abused her from the time she was 5 to age 15, and when she was 16 she had an unintended pregnancy while in a relationship that she said “brought me joy and made me feel safe.”

“Immediately, I knew that I wanted an abortion,” she said.

But Good lived in a state with a parental consent law, which required her to obtain her parents’ permission to have an abortion.

“For many reasons, I couldn’t tell my mother,” she said. “She had not believed me about my stepfather’s abuse and then failed to do anything once she did finally believe me. I also knew that although she had me—a Black child—there might be consequences for my boyfriend who was Black. My white family had always tried to convince me to try and pass for white.”

So she sought a judicial bypass—an alternative to parental involvement, allowing a minor to go before a judge to argue that they’re mature enough to make the abortion decision on their own. If the judge deems them insufficiently mature, they then have to consider if it would be in the minor’s best interest to have an abortion. (And if you’re wondering in what world a minor is not mature enough to have an abortion but is mature enough to have a baby, you are not alone. It’s as backward and ridiculous as it sounds.)

“My journey to seek an abortion started first with making sure I had my homework done,” Good said. “I then had to navigate not only how to get to the judge but how to do so on a school day. I had no idea what I should wear or what information he would want. I thought I was going to court like on TV, but was ushered to his chambers instead. I remember his chambers being dark, with lots of books. He, of course, was wearing his black robe. It felt very intimidating.” She went on to talk about how the hearing went: how she had to prove she was worthy of making her own decision.

“I told him I was a good student,” Good said. “I was a leader at my school. I had opportunities that many young women from West Virginia didn’t. I wanted to go to college, to be a writer. I said, your Honor, I have a future.”

The judge granted her the bypass, and she went on to have her abortion.

Parental involvement laws like the one Good was up against exist in 37 states—they are among the most common abortion restrictions and enjoy support from both liberal and conservative legislators and voters. If abortion is the third rail of liberal politics, parental involvement laws are the third rail of that third rail, and that’s what makes Good’s testimony so striking and refreshing, especially at such a visible and high-level hearing as a Supreme Court nomination.

While the judicial bypass process was intended as an alternative to parental involvement, in reality, it’s just another unnecessary and arduous hurdle; Good’s experience feeling overwhelmed and intimidated is a common one.

These laws most adversely affect marginalized young people: those living with abuse or financial instability or any number of factors that might make disclosing an unwanted pregnancy to a parent unsafe or impossible. They fail to account for the many young people who live outside of the care of their parents; those living in foster care or with relatives are largely relegated to the bypass process, which can delay access to abortion by about two weeks (something extra shitty, when you consider most young people understandably detect their pregnancies later).

As Good pointed out in her testimony, most young people do involve a parent in their abortion decision. “But for those like me who cannot,” she said, “these kinds of restrictions make abortion hard to get because we have to travel, miss work or school, save up for weeks, and pay out of pocket.”

“I still think about what might have happened if I didn’t have that list of accomplishments, or if the judge didn’t think I was competent enough to decide when to start my family, or if he believed the harmful stereotype I was raised to believe—that Black girls were ‘fast’ and promiscuous,” Good said. “Access to abortion should not depend on our GPA, the color of our skin, where we live, or the luck of the draw. It should not depend in any shape, form, or fashion on who our governor is or who is sitting on the Supreme Court.”

“I needed compassion and trust from my government,” she said. “All I got was another barrier.”

Judge Amy Coney Barrett will soon likely be Justice Amy Coney Barrett—her confirmation is moving ahead (the committee is voting October 22 before a full Senate vote), and she’ll eventually sit on the highest court in the land, poised to undo decades of progress for reproductive freedom.

But on Thursday, Good’s testimony made history—both because she gave a voice and a face to the millions of people who have abortions and because she spoke to a facet of abortion care woefully underrepresented in even progressive circles. That’s pretty damn great, and even with everything else seemingly going wrong, it’s worth taking a moment to celebrate.

You Might Not Think So, but You Need More Lube in Your Sex Life

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If we told you there was a product that could increase your sexual pleasure and your sexual safety for less than ten bucks, what would you say? No, that’s not a rhetorical question. Luckily for you (for all of us, really), such a magic elixir really does exist, and it’s easy to find.

What’s this secret ingredient? Well, if you guessed lube, then (ding, ding!) you’re right. And though this isn’t a game show, we’ll tell you what you’ve won: better sex.

In the latest episode of You Deserve Good Sex, sex educator Cassandra Corrado busts some of the most common myths surrounding lube (for example, using it doesn’t indicate anything about you or your partner’s sexual prowess), breaks down the four basic categories of lubricant (and what you should consider when you’re shopping for it), and explains why using lube for every sex act (yep, every single one) makes sense.

IVF Won’t Be Safe With Amy Coney Barrett on the Supreme Court

For more on the Amy Coney Barrett hearings this week, check out our full coverage.

Supreme Court nominee Amy Coney Barrett’s views on abortion are among her most extreme. But during her confirmation hearings this week, it was clear that, if confirmed, Justice Barrett would pose a threat to IVF treatments as well.

It might not seem like abortion and infertility treatments have much in common: A person gets an abortion to stop being pregnant, while a person undergoes infertility treatments to become pregnant. But both communities are fighting for the same thing—their right to self-determination.

Barrett’s confirmation threatens that right for both communities.

The judge supports fetal personhood—the idea that life begins at conception—and would legally enshrine this belief into law. While personhood advocates like Barrett argue they’re protecting the sanctity of life by equating a developing pregnancy with an already-born person, giving embryos full constitutional rights would upend the services many people rely on to build their families.

“Personhood measures seek to change U.S. law to define life as beginning at the moment of conception or fertilization,” said Karla Torres, a senior staff attorney at the Center for Reproductive Rights. “Anti-reproductive rights advocates conflate fertilization with personhood and advocate that legal personhood should adhere at fertilization.”

The first personhood bill came just a week after the Roe v. Wade decision in 1973—and state lawmakers have introduced more than 300 similar bills ever since. Though most of these attempts have been unsuccessful, three states—Alabama, Kansas, and Missouri—have passed laws containing personhood language.

In addition to criminalizing abortion, personhood laws would recognize every embryo created as a legal person, thereby threatening in vitro fertilization (IVF), a critical method of infertility care.

During the IVF process, a patient takes medication to stimulate the ovaries into producing multiple eggs. Ideally the process would produce up to one to two dozen eggs to increase the odds of success. (In a typical menstrual cycle, the ovaries release one egg.) A physician then removes these eggs from the ovaries, and they are fertilized in the lab. Not all of the eggs will become embryos, and among those that do, not all of the embryos will be viable. After three or five days, a physician transfers one or two of the fertilized embryos directly into the uterus; the rest of the embryos are frozen. In other cases, all of the embryos are frozen and saved for later use and/or screened for chromosomal abnormalities. Approximately 1 percent to 2 percent of births every year are the result of IVF, but inevitably, the process might involve the destruction of some embryos.

Personhood laws would not only criminalize the destruction of embryos, but they would also make the IVF process fraught and legally precarious.

“There isn’t one kind of person who has IVF and one kind of person who has abortions—they’re often the same person at different life stages and circumstances.”
-Dr. Diane Horvath, OB-GYN and abortion provider

“If you put an embryo in a patient and she doesn’t get pregnant, can you really promise that the doctor is not going to be criminally negligent?” Dr. Kristen Cain, a fertility specialist at Carolinas Fertility Institute in North Carolina, said.

“If a patient has a miscarriage, can you really promise that patient’s not going to be charged with murder? Those are the things that come up with personhood bills.”

Cain has been fighting personhood bills in North Carolina for almost a decade. Advocates for personhood in the state have called her colleagues a baby killer and have threatened to shut down her clinic. Her experience is not uncommon and makes explicitly clear how restrictions to abortion and IVF are intrinsically tied.

Abortion can be a necessary and critical part of IVF—to terminate nonviable pregnancies or to reduce high-risk pregnancies involving multiple fetuses through selective reduction. This means accessing abortion and accessing IVF care are not mutually exclusive.

“It’s important to remember that there isn’t one kind of person who has IVF and one kind of person who has abortions—they’re often the same person at different life stages and circumstances,” Dr. Diane Horvath, an OB-GYN and abortion provider in Baltimore, said.

While people with infertility are used to advocating for their right to medical services, it can be hard for them to talk about abortion, said Casey Berna, a social worker in the infertility community.

“Feelings of grief, loss of self-determination, obstacles to accessing care, and the politicization and stigma of personal medical decisions are commonalities that patients experiencing infertility and abortion both can face,” Berna said.

Abortion rights advocates and organizations that support people living with infertility are also concerned about Barrett’s support for personhood. Personhood bills would negatively impact both abortion access and access to IVF services. Some states would remain safe havens to access while others would lose all their IVF clinics, forcing patients to travel out of state.

“Barrett wouldn’t have this effect on every state because not every state is going to pass these laws, but some states will try and those states will lose their IVF clinics because the doctors are going to say, ‘This is an unfriendly environment, we’re not going to be able to support ourselves here, we’re at very high risk of murder charges,'” Cain said.

That sentiment was echoed by Susan L. Crockin, an attorney with the American Society for Reproductive Medicine.

“If an embryo or fetus is considered a legal person, doctors who attempt to save their patient with a life-threatening ruptured ectopic pregnancy, or embryologists who drop a petri dish, could be at risk of manslaughter or murder charges,” Crockin said at a press conference last week.

These laws would also more adversely affect marginalized patients. “All birthing people would be at risk,” Erica McAfee, a Black maternal health advocate, said. “But more so those who are marginalized and may not have the resources to have access to abortion in another state/country where it is legal.”

Barrett’s stance even prompted Fertility and Sterility—the leading medical journal for fertility-related matters—to write an op-ed condemning her nomination, arguing that her appointment to the bench risks setting back reproductive freedom decades and directly “threatens those who seek to build a family through in-vitro fertilization.” It was the journal’s first-ever statement on a judicial nominee.

IVF costs could also increase with personhood laws. IVF is cost-prohibitive for a lot of people; an average cycle of treatment can cost up to $20,000. Harvesting more eggs increases the likelihood that IVF is not just a one-time cost—but up to $100,000. In addition, only 19 states mandate insurance companies cover infertility, and even those coverages can vary, as plans can set lifetime insurance caps or rigidly define what constitutes infertility, thus placing IVF treatment out of reach for many people.

But as with abortion access, people with the means and access will always be able to access IVF treatment.

“I suspect that Amy Coney Barrett would maintain that it’s about ‘saving the embryos,’” Horvath said. But “just as with abortion, rich people will always be able to access IVF somewhere else if it’s made illegal in the U.S.”

Conservatives will not rest until their racist ideal of controlling who can and cannot become parents becomes a reality—Barrett’s views and her nomination proves that. Her beliefs are a strong illustration not of some fringe view, but of a logical conclusion to laws restricting abortion and reproductive freedom. Her opposition to abortion shows how these issues—abortion, contraception, and IVF—are tied, and how restrictions to reproductive freedom are hardly about life or family values but a means of controlling who can and cannot become pregnant.

Amy Coney Barrett Didn’t Want to Talk About Abortion—Sen. Mike Lee Sure Did

Sen. Mike Lee (R-Utah) can’t figure out why the Supreme Court and all related proceedings have become politicized. During day two of Judge Amy Coney Barrett’s confirmation hearing to fill Ruth Bader Ginsburg’s vacancy on the Supreme Court, Lee lamented the polarization of such hearings and other Supreme Court-related affairs. These proceedings should be “apolitical,” Lee claimed. It’s a national disgrace that they’re now contentious, Lee groaned.

Lee then went on rant about everything from court packing to the Affordable Care Act before using remaining time to spread an insidious, politically charged anti-abortion lie: that fetuses feel pain and, as a result, gestational limits for abortion should be enacted at the state and federal levels.

This is, simply put, not true.

“To the best of our medical and scientific knowledge, fetuses do not feel pain during abortion,” Dr. Jenn Conti, OB-GYN and fellow with Physicians for Reproductive Health, said. “The brain, spinal systems, and nerves that are needed to feel pain have not developed yet. Pain requires a very high level of neurological development to create the ability to feel.”

Lee wasn’t the only Republican senator to use Barrett’s rushed confirmation hearing to perpetuate this dangerous, fabricated anti-abortion talking point.

Before lambasting his Democratic colleagues for using “political tactics” that “have nothing to do with this hearing,” Sen. Lindsey Graham (R-S.C.) claimed fetuses can feel pain after 20 weeks gestation as well. He then pointed to laws he has attempted to pass at the state and federal level to ban abortions occurring past 20 weeks.

Republican senators, for all their hypocritical, self-serving pontifications and well-documented flip-flopping, are not unintelligent. They know that research conducted by the American Congress of Obstetricians and Gynecologists and many other respected medical organizations and institutions show no evidence to back up the claim that a fetus can feel pain during an abortion or any other common, legal medical procedure that occurs during pregnancy. They also know that their efforts to eventually overturn Roe v. Wade are wildly unpopular. The majority of people in the United States support the legal right to access abortion care—including 52 percent of Republicans.

They just don’t care.

“Anti-abortion proponents are well aware of these findings and have no regard for evidence-based medicine or science,” Conti says. “The real intent here is to take the decision about abortion away from women and their doctors.”

[PHOTO: Lindsey Graham holding his hands out behind a desk]

Tom Williams/Pool/Getty Images

Senators like Graham and Lee also do not care that the choice to continue to spread these and other anti-abortion lies puts the lives of abortion providers and those they care for in immediate and direct danger. For anti-abortion senators, much like the dwindling anti-abortion movement they’ve come to rely on for reelection, any deadly means justify the ends. Death threats, bomb threats, and both in-person and online harassment against abortion providers and clinics that provide abortion have been on the rise since President Donald Trump’s inauguration, no doubt in part of his continued anti-abortion rhetoric and outright lies that falsely claim pregnant people are “executing their babies” after birth and having abortions in the “final moments of childbirth.”

These lies do not sway the public or move the political needle as it applies to abortion rights—they only demonize both the families that are faced with difficult decisions after learning that their wanted pregnancy is no longer viable and pregnant people who were unable to access abortion care when they wanted and needed it and, as a result, are forced to have an abortion later in pregnancy than they had previously and originally desired by the very people who claim to hate abortion procedures that occur later in pregnancy.

The lie that fetuses feel pain also gives credence to laws that prohibit OB-GYNs from adequately caring for their patients, putting the pregnant people who already live in a country with the worst maternal mortality rate of any developed nation at greater risk.

“The dehumanizing rhetoric and coverage of scenarios like this angers me because my patients are real people, deserving of our respect and understanding,” Conti said. “One patient that comes to mind was a young woman who at 21 weeks gestation suddenly started hemorrhaging from a condition called placental abruption. The best medical care for her was a dilation and evacuation (D&E) procedure. I cannot imagine forcing her to risk further hemorrhage and major abdominal surgery through either a vaginal delivery or c-section because of political priorities.”

Lee, Graham, and their Republican colleagues know what they’re doing when they evoke anti-abortion lies during a widely watched Supreme Court nomination process. Just like they know what they’ll be doing when they eventually vote to confirm Amy Coney Barrett, who has signed public letters calling for the reversal of Roe v. Wade and has been a featured speaker at least two anti-abortion events and, during the hearing, admitted she does not believe Roe v. Wade is “super precedent.” They know what they’re doing when they repeatedly draw attention to Barrett’s identity as a mom and celebrate the size of her family.

And Lee certainly knew what he was doing when he played infuriatingly dense and acted as if the laws that do and will reach the Supreme Court becoming “personal” for voters is an outcome far beyond his understanding.

What he meant is the possibility of Roe v. Wade falling isn’t personal for him. Because unlike the pregnant people Lee and his GOP colleagues continue to harm with their feckless lies and bad-faith arguments, he will never know what it’s like to be subjected to government-mandated forced birth and the ramifications of anti-abortion laws that put every pregnant person and those who care for them in danger.

Amy Coney Barrett Wants to Decide If You’re Virtuous Enough to Vote

Follow our coverage of the Amy Coney Barrett confirmation hearings this week.

Judge Amy Coney Barrett’s regressive views on abortion rights are well known. She has called abortion “always immoral,” and if confirmed, would be a reliable vote to overturn Roe v. Wade. Less well known, however, is her belief that a person’s virtue should determine their eligibility for basic civil rights like the right to vote.

Barrett, who is President Donald Trump’s nominee to fill Ruth Bader Ginsburg’s Supreme Court seat, doesn’t just want to go back to the pre-Roe 1970s; she also wants to drag voting and political rights back to the Jim Crow era.

In a dissent she wrote last year in Kanter v. Barr, Barrett argued for limiting participation in political rights for people not deemed “virtuous.” What Barrett conveniently left out of her argument is that all of her historical legal examples were used to disenfranchise women, people with disabilities, and people of color.

In Kanter, a two-judge majority of a three-judge panel of the U.S. Court of Appeals for the Seventh Circuit ruled it was reasonable for Rickey Kanter to lose his Second Amendment right to own a gun after his conviction for felony mail fraud. Barrett dissented. The majority found that the writers of the Constitution meant for Second Amendment protections to belong only to “virtuous” citizens, arguably excluding anyone convicted of a felony, whether violent or nonviolent.

Unfortunately, the two-judge majority’s use of “virtue” as a qualification for accessing Second Amendment rights left the door open for Barrett to argue for the application of “virtue” to other constitutional rights. Rather than limit her dissent to the case in front of her, Barrett wrote an overreaching opinion that argued for limiting citizens’ rights to vote and serve on juries.

Barrett noted that historically, states deprived people of voting rights and jury service if they had certain “infamous crime” felony convictions, but she failed to mention that this was a particular tool used to disenfranchise Black people in the Jim Crow South after the Civil War. Although many states had “criminal disenfranchisement” laws in place before the war, felon disenfranchisement was expanded after the passage of the 13th, 14th, and 15th Amendments to include more crimes and therefore disenfranchise more people.

This application of “virtue” restrictions on voting persists today: In many states, people convicted of certain felonies are still stripped of their right to vote, even as many states expand programs to re-enfranchise people convicted of felonies. Barrett further argued that historically, voting and jury service could be limited based on a “mental fitness” requirement, essentially supporting ableist restrictions on people’s voting rights based on mental disabilities.

But women, people of color, non-Christians, and people with disabilities didn’t need a felony conviction to be denied voting rights, entry to the United States, the right to serve on a jury, or even the right to testify in court on the basis of insufficient virtue or morality. Women weren’t legally allowed to vote until the passage of the 19th Amendment in 1920, and it wasn’t until 1975 that the Supreme Court ruled that women could be drafted into jury service just as men. White, Christian, able-bodied men were assumed to have sufficient moral virtue for political life, while people of color, women, non-Christians, and people with disabilities, were required to prove their morality and mental fitness to access their political rights.

Barrett’s argument in favor of “virtue” requirements for participating in the political process in antithetical to an inclusive democracy.

For many crimes, women had to be virtuous in order for a man to be held accountable. The crime of rape or seduction could only be committed against a “pure” woman whose virtue was intact. If the woman wasn’t considered virtuous, 19th- and early 20th-century laws didn’t see her as a rape victim. Black women in particular rarely got justice for crimes of sexual violence because courts didn’t view them as having Christian “virtue” to lose. The stereotype of the oversexualized Black woman meant courtrooms didn’t take their testimony or pain seriously. Sexual moral virtue was also used to keep Chinese American women from entering this country as a result of the Page Act of 1875, which barred admittance for any Chinese woman suspected of being a sex worker.

Virtue and believability in court were linked to white, Christian values. In the 19th century, Jews were asked extra questions to prove their trustworthiness before being allowed to testify under oath. New York courts required a non-Christian witness to be sworn “according to the peculiar ceremonies of his religion” after 1829, but even with this accommodation courts asked separately whether such oaths were binding on a Jewish person’s conscience. Jewish people didn’t get the same benefit of the doubt as Christian witnesses. Some courts even questioned if believing in Jesus Christ was necessary for a witness to be believed under oath. Many courts had to rule separately that Jews were “competent” witnesses after they were challenged for their lack of Christian faith.

In the first half of the 19th century, many courts didn’t even allow nonwhite people to testify against white men accused of a crime. A number of states had laws barring Black or mixed-race people from testifying against white men. The California Supreme Court ruled in 1854’s People v. Hall that Chinese immigrants couldn’t testify against white citizens and threw out the conviction of a white man found guilty of murdering a Chinese man based upon the testimony of Chinese witnesses. By prohibiting Chinese immigrants from testifying against white people, the court suggested that Chinese immigrants couldn’t be trusted based on bigoted assumptions that their moral values were different from those held by white, Christian Americans.

This is the ugly history of the sort of virtue jurisprudence that Barrett advocates. Her focus on stripping rights from people who aren’t virtuous enough for her liking ignores one of the critical questions noted by the majority in Kanter: whether the state has a reasonable interest in denying people access to their Second Amendment rights. When the state strips someone of that right, it is doing so out of concern for public safety—to keep guns away from possibly violent people. But what is the state’s interest in keeping “non-virtuous” people from voting or from serving on juries? Except for discriminatory purposes, the state has no such interest.

Rather than determine whether a state has a reasonable interest in barring entire classes of people from exercising a right, Barrett justified her argument by placing voting and jury service on a lower rung of citizenship guarantees. According to Barrett, people serve on a jury and vote not because they have the right to do so but because it is for the collective good. This argument might have worked in the 19th century, but it is now 2020, and we have decades of legislation and jurisprudence that shows such limitations result in discrimination, biased jury verdicts, and nondemocratic elections.

Barrett’s argument in favor of “virtue” requirements for participating in the political process is antithetical to an inclusive democracy. A U.S. citizen shouldn’t be required to prove “virtue” in order to access their rights. Her reasoning is also an insult to the legacy of Ruth Bader Ginsburg, whose seat Barrett has been nominated to fill. Ginsburg, who wrote a scathing dissent in Shelby v. Holderthe 2013 case that gutted the Voting Rights Act—was a champion for voting rights.

Amy Coney Barrett is not.

The Amy Coney Barrett Hearings: Follow Along With Us All Week

It’s the fourth and final day of confirmation hearings for Supreme Court nominee Amy Coney Barrett. The day will consist of character witnesses and other experts making their case. The Senate Judiciary Committee is expected to vote on October 22 and send the nominate to the full Senate.

Follow Executive Editor Jessica Mason Pieklo on social media as she live tweets the proceedings today.

For immediate reaction on the third day of the proceedings, listen to our Boom! Lawyered podcast.

Check out our full coverage of the Supreme Court nominee.

Meet the Educators Helping Indigenous Communities ‘Own Their Pleasure’

Our ability to feel good and our level of health are intrinsically linked. And access to safe, culturally relevant sexual health services is essential for living a healthy life.

But if we measure our sexual health in relation to the World Health Organization’s definition—that it’s “not merely the absence of disease” but requires “the possibility of having pleasureable and safe sexual experiences, free of coercion, discrimination, and violence”—then many of us fall short.

Across the United States, those of us who got sex education in school likely only received instruction covering abstinence, pregnancy prevention, and STI prevention. But abstinence-only (or abstinence-favored) sex ed programs don’t actually give people the skills and tools they need to live sexually healthy lives.

That’s especially true for Indigenous people, whose access to culturally relevant health services is fraught with centuries of abuse and neglect at the hands of the U.S. government.

“It always goes back to the trauma,” said sexuality educator Gabrielle Evans, who’s also a doctoral student, the co-founder of The Minority Sex Report, and a member of the Haliwa-Saponi Tribe. “From the very recent history of forced sterilization to ‘Pocahontas’ tropes that exoticize and sexualize Native women without their consent, many Native women feel like their sexuality isn’t their own.”

For Indigenous people to own their sexuality, the education needs to reach them when they’re young. (There are more than 1 million Indigenous youth between the ages of 15 and 24 in the United States.) Sex ed curricula rarely—if ever—actually meet their needs, reflecting a lack of access to culturally relevant, Indigenous-centered, positive and preventative health services and education.

Consider this:

  • One major evidence-based curriculum for Indigenous youth focuses heavily on pregnancy prevention, although family planning is just one aspect of sexual health. Pregnancy prevention is also an especially difficult and complex topic in Indigenious communities; in the 1970s, Indian Health Service (IHS) facilities sterilized thousands of Native women.
  • According to Centers for Disease Control and Prevention data, American Indian/Alaska Native people were diagnosed with chlamydia at 3.7 times the rate of white people in 2018. That same year, the rate of reported gonorrhea cases among those populations was 4.6 times that of white people.
  • The 2010 National Intimate Partner and Sexual Violence Survey found that 56.1 percent of American Indian/Alaska Native women had experienced sexual violence in their lifetime, while 55.5 percent had experienced physical violence at the hands of an intimate partner. The statistics about men are similarly alarming: 27.5 percent were survivors of sexual violence, and 43.2 percent experienced physical violence within an intimate relationship.

Both individuals and organizations are working to provide access to sex ed and help Indigenous people own their relationship to sex, which spans the full spectrum of reproductive health: pleasure, STI prevention, birth work, postnatal care, and more.

Centering birth work

Due in no small part to the stigma and lack of information and access to birth workers such as doulas and midwives, pregnant people might they have no other option but to give birth at an Indian Health Services (IHS) facility.

Aspen Mirabal, a full-spectrum doula, family support specialist, certified Indigenous breastfeeding counselor, and member of the Taos Pueblo Tribe, said her hospital birth was traumatizing for her parents. Despite the fact that home births are both rare and stigmatized in Mirabal’s community, her parents decided to have a midwife-assisted home birth for her younger sibling.

“My middle sibling was born at home, and then my youngest sibling was born at a birthing center, and that went great. Each birth just went better and better for them,” Mirabal said.

The midwife plays a key role—across North America, more and more Indigenous people are becoming midwives and birth workers. Mirabal, in fact, is training to be a midwife; there are no midwives currently practicing in Taos Pueblo.

Pregnancy and birth can be highly medicalized, traumatic experiences for anyone. Being able to control your reproductive health, pregnancy care, and birthing options helps give autonomy back to the individual instead of handing it over to a system that wasn’t designed for them.

The problem is, choice isn’t equally accessible to all people.

Although many Native women have been traumatized while in IHS care, many also feel it’s the only place where they can receive sexual health care, due to both financial strain and physical distance. Approximately 90 percent of Pueblo Native Americans are Catholic, which adds a layer of shame and silence to sexual health issues. Midwives and other birth workers help fill in that crucial gap, bringing culturally responsive and patient-guided care to the people who need it.

That work isn’t just relevant during pregnancy.

“We need consistent sexuality education all throughout our lives,” Mirabel said. “And it needs to be tailored. My dream is that my community, the Taos Pueblo community, would have a sex education curriculum that is truly designed for us.”

Centering sexual health, pleasure, and safety

For communities to thrive, it isn’t enough to focus solely on physical, psychological, and social illnesses. Pleasure (and the cultivation of pleasure) has to be at the heart of the work. Evans’ training started in HIV prevention, but today her primary work as a sexuality educator is professional development. Through The Minority Sex Report, she trains other educators on cultural competency in the classroom, and to her, that means creating curricula that go far beyond STI and pregnancy prevention.

“There are so many things that fall under the umbrella of sex education,” Evans said. “It’s so much more than learning about illnesses and infections. It includes good touch and bad touch. It includes communication. It includes birth control. It includes learning your likes and dislikes.”

That’s where Evans’ work as an educator and Mirabal’s work as a doula and midwife-in-training meet. Both aim to educate people about boundaries and touch and to restore autonomy and power to the people they work with.

“Whether it’s labor and delivery or conversations that we have throughout pregnancy, it’s essential for me to pay attention to my clients’ cues about the care they need and the boundaries they have,” Mirabal said. “It’s not just about how I interact with them, but also how I observe them interacting with their partners. That’s one way that we prioritize comfort.”

For Evans, that work starts even earlier; good touch and bad touch are two of the biggest focus areas for sexuality education for kids.

When so many people’s experiences of touch are negative (either nonconsensual, highly medicalized, or traumatic in another way), restoring positive, pleasurable associations with touch can be both radical and fundamental.

“I want Native women to know that they can own their pleasure,” Evans said. “They can explore their bodies and learn their boundaries, and they can do that well before they share themselves with a partner.”

Restoring sexual pleasure as a value happens at the individual level, but for there to be major change, it needs to happen at the generational level too. Having the buy-in of elders is essential, not only because elders and their knowledge are influential in many Native communities, but also because many Indigenous people live in multigenerational housing, where the beliefs of older generations affect how the younger ones live their lives.

“Some curricular options, like Native It’s Your Game, utilize the presence of elders even in the interactive game format,” Evans said. “It’s also the in-person education, though. Having elders in the space to learn with the youth and also to say, ‘Hey, this is important’—that makes a difference.”

The intro video to Native It’s Your Game says it all: Being healthy also means being happy, which means cultivating a pleasurable life in ways that are best for you. Those shifts won’t happen overnight, and there still is progress to be made, but between individuals advocating for change on the ground and organizations finally prioritizing Native well-being, the momentum is picking up.

“We’re not an artifact. This is our culture; it’s who we are. We’re still here,” Evans said. “And it will take a community of us to make sexual health and safety a common experience.”