What did January 22nd mean to me as the anniversary of Roe v. Wade?  I am a new policy intern working for NLIRH between semesters in college.  This position represents my first official advocacy position in reproductive rights outside of my college campus.  As part of the cohort of women born after 1973, for me, abortion has always been a protected right and an assumed possibility. Without even having to think critically about whether I would choose to have one myself, I was able to assume that having an abortion would be a possibility for me.  Does this make me “casually pro-choice”?

This question was brought to mind when reading the recent NewsWeek article that identifies a lack of intensity in young pro-choice advocates.  This sentiment is consistent with the common political trope that that young people do not care about reproductive health.  According to a NARAL survey from early 2011, 51 percent of young voters (under 30) who opposed abortion rights considered it a “very important” voting issue, compared with just 26 percent of abortion-rights supporters.  The young respondents did not view abortion as a right in need of defenders.  Does this “intensity gap” mean that the pro-choice movement is losing its young supporters?

No!  Though I have grown up in a post-Roe v. Wade reality of legally protected abortion, there is nothing casual about my pro-choice views.  Perhaps I have been the spoiled child of the baby boomer generation of activists in assuming abortion as my protected right.  That does not mean that I am any less vehement in my belief that every woman has the right to decide what happens to her own body. In line with my personal perspective, I believe that perceived official silence of young women does not reflect a general lack of interest.

In fact, the majority of young people are pro-choice.  NARAL found that 61% of people under 30 are “pro-choice,” supporting legal abortion in “all cases” or “most cases.” Moreover, women in their 20s account for more than half of all abortions.  So, young people are personally engaged with their reproductive rights.  For pro-choice activism, it is a question of connecting political activism and voting habits with those experiences and view.

Though those under the age of 39 have not experienced the pre-Roe v. Wade reality of state dictated limitations on reproductive rights, the legislative proceedings of this past year introduced a glimpse of that reality.  According to Guttmacher Institute data, of the 135 reproductive health provisions passed in 2011, 92 laws restrict women’s access to abortion in 24 states.  That’s twice as many anti-choice measures passed in 2011 as the previous year. The personhood debate and introduction of Personhood Amendments in Mississippi and other states has demonstrated the vulnerability of reproductive choice. Further Targeted Regulation of Abortion Providers (TRAP) bills have been introduced to limit abortion access by singling out abortion providers for medically unnecessary, politically motivated state regulations.  Removal of state funding for Planned Parenthood also reduced access to the reproductive healthcare services.  The Texas Ultrasound Law, which has similarly been introduced in other states, invades privacy of women by requiring women to get an ultrasound before undergoing the procedure.  This requirement also increases cost to women, many of whom may be living in states that have banned insurance coverage for abortion.

According to president of NARAL Pro-Choice American Foundation Nancy Keenan, 2012 could be even worse for women’s reproductive rights. Since 44 states governments are under anti- or mixed-choice control, it will be exceedingly difficult to stop anti-choice bills like abortion-coverage bans or proposals to de-fund family planning programs.

Whether this fable of the greying pro-choice movement reflects a real dearth of young supporters or not, perhaps the state restrictions to abortion access will enable young supporters to see the vulnerability of reproductive rights and more vigorously act to defend them.

If we assume that lived experience and personal environment influence individual perspectives on reproductive choice, I wonder whether recent limitations on abortion access in the past year have awakened the intensity of young pro-choice advocates to pre-Roe pressures.  For me, it has. This year, January 22nd inspires new energy in my own journey of reproductive rights advocacy.  I see the political vulnerability of the reproductive choices I inherited and I am compelled to act to protect them.

That is why, as an intern, I support NLIRH’s new civic engagement campaign, Soy Poderosa, to mobilize, collaborate and amplify the voices of Latinas and their allies across the country to advocate for reproductive health and justice. I have also begun to think about my power as a student, to make change on my campus, in the community beyond, and in the nation as a whole. I encourage other students and young people to project our voices and stand for choice this year.  Rather than being an activist in spite of being a millennial, as an undergraduate student emerging now into official advocacy, I recognize that one of the reasons that soy poderosa es porque soy una estudiante. Even as my internship here at NLIRH ends, I will look for new ways to express and exercise that power.

The results of a new poll conducted by Lake Research Partners on behalf of the National Latina Institute for Reproductive Health and the Reproductive Health Technologies Project have been released, showing strong support for abortion rights amongst Latina/o voters.

“This is a watershed moment for the Latina/o community as it provides, for the first time, hard data which defies long held stereotypes about Latina/os and reproductive health,” said NLIRH Executive Director Jessica Gonzalez-Rojas. “This poll underscores the important role of Latino/as in the national debate about access to reproductive health care.”

Indeed, the poll is groundbreaking, and the results an important affirmation of Latina/o support for reproductive justice issues. Amongst others, important findings from the  poll include:

• A strong majority – 74% – of Latina/o registered voters agree that a woman has a right to make her own personal, private decisions about abortion without politicians interfering.
• Most Latina/o voters seem willing to disagree with church leaders on the legality of abortion, with nearly seven in ten agreeing that abortion should remain legal despite the position of the church.
• A majority of Latina/o voters agree that money should not determine access to abortion

The findings firmly reject stereotypes of Latina/os as anti-choice or unable to distinguish their political beliefs from their religious affiliation, and should be an important consideration to elected officials trying to capture the ever-growing and powerful Latino vote.

Take a look at the rest of the data from the poll and the methodology behind it at NLIRH’s website!

But don’t fret! Here is round-up of all the great posts on the blogosphere that answer the question: What will it take to end cervical cancer?

Sinsi Hernández-Cancio from Families USA with Lydia Mitts writes about the impact of stigma on cervical cancer prevention. She writes about cervical cancer and HPV:

“It is vitally important that we change the framing of this issue, especially in the Latino community, where we clearly have more to lose. This is a matter of health and safety, not of sex and stigma.”

Ernesto Dominguez at Chatmosphere too discusses the stigma around discussing sexual health from his perspective growing up in an undocumented Latino family. He writes:

“Growing up in an undocumented Latino family we never dreamed of going to the hospital unless our arm had actually fallen off, yet alone to receive preventative care. Our fear of getting deported was much worse than the fear of cervical cancer.”

Viva La Feminista also emphasizes the powerful role of stigma:

 ”We need to come to grips with the fact that women, even younger women, teenagers, are sexual beings. Shame should never kill anyone.’

Verónica Bayetti-Flores, Policy Research Specialist with NLIRH urges us not to forget LGBTQ individuals as we aim to bring the cervical cancer rate down to zero.  Verónica discusses the discrimination, bias, homophobia, transphobia the LGBTQ community faces in the health care system in addition to the systematic oppression in society.

The National Center for Transgender Equity also discuss the importance of impact of cervical cancer screening for all who have cervixes, including transgendered and gender non-conforming people, who face discrimination and bias. They urge insurance companies to stop denying coverage for transgender people, increase the cultural competence of health providers and increase the number of gender identity questions on federal health surveys to increase knowledge and support of transgender people’s health needs.

Kate Ryan at National Women’s Health Center urges us to find a balance between overscreening some women (typically women who have excellent health insurance) and underscreening other women (typically those who face barriers to health care access.)

Keely Monroe at Raising Women’s Voices discusses some of the improvements to cervical cancer prevention under the Affordable Care Act.

The National Coalition of STD Directors discusses the role of HPV vaccination in cervical cancer prevention.

Dania Palanker of National Women’s Law Center shares a personal story of discovering the link between HPV and cervical cancer and the importance of obtaining routine Pap testing and cervical cancer screenings.

Mimi Spalding of the Black Women’s Health Imperative guests posts on NLIRH’s blog Nuestra Vida, Nuestra Voz and discusses the importance of cervical cancer prevention for black women, emphasizing BWHI’s dedication to “ensuring that screening standards and guidelines are appropriate for Black women and enable them to achieve optimal health and well-being.”

Amelia MacIntyre of North American Management guests posts on NLIRH’s blog as well about the essential role Community Health Centers play in expanding access to cervical cancer screenings for folks who have been disproportionately excluded from health care systems and who are disproportionately affected by cervical cancer.

Natalie D. Camastra, Policy Fellow with NLIRH outlines what policy makers can do beyond January to reduce health disparities and ensure Latinas live cervical cancer free.

Our Bodies, Ourselves focuses on the  health disparities associated with cervical cancer. They write:

“To reduce disparities for Latinas and other under-served women, we will need to make systemic changes in our health care system to increase access to screening and vaccinations for those who need it most.”

Bianca I. Laureano of Latino Sexuality  shares  a powerful list of what it will take to end cervical cancer. She centers the experiences of cervical cancer survivors, calls for honest and open dialogue about sexual health and cervical cancer prevention, urges a commitment to valuing the bodies of people of Color, transgender and intersex and calls for non-coercive policies and practices that empower individuals to control their bodies.

While not part of the ¡Acábalo Ya! Blog Carnival, New American Media ran an interesting piece about Lilia Fuentes’ experience with a cervical cancer diagnosis and the impact of cervical cancer on Latinas in California.

We thank everyone who raised their voice this week and shared their perspective on what it will take to end cervical cancer!

For more information about cervical cancer, please visit: http://latinainstitute.org/issues/cervical-cancer

All of us here at the  National Latina Institute for Reproductive Health (NLIRH) emphasize the importance of monitoring cervical cancer incidence rates because they serve as indicators of a community’s access to preventive health care services.

Why is this? Because no woman should be diagnosed, let alone die, of cervical cancer. For the first time, we have a comprehensive set of tools to prevent and fight the disease. Cervical cancer is highly preventable with regular Pap tests, the HPV test, and a provider’s monitoring and treatment of precancerous changes to the cells of a cervix. The HPV vaccines (both Gardasil® and Cervarix®) are also effective tools in the prevention of cervical cancer. Furthermore, the disease is also highly treatable when detected early.

Yet Latinas continue to have the highest incidence of cervical cancer among women of all ethnic/racial groups and the second highest mortality rate after African American women. In certain states, particularly along the southern border, Latinas have the highest incidence and mortality rates.

NLIRH recognizes and raises awareness of the myriad barriers Latinas face to preventing cervical cancer: lack of health insurance, stigmas around STIs and sexual health, cultural and linguistic barriers with health care systems and providers, the high cost of health care, fear associated to immigration status, racism and xenophobia.

Thus, while we serve to educate Latinas about the importance of gynecological health and demystify sexual health issues, we also will work year-round to bring down the barriers Latinas face in accessing health care.

This year, we will work to increase federal funding for Title X, the only federally funded family planning program, that provides cervical cancer screening and STI counseling to low-income women. We urge the federal government to support other programs that positively impact Latina health including Medicaid,  Community Health Center grants, funding for immunizations and school-based health programs. We will continue to advocate for access to health care for immigrants, for instance by urging Congress to lift the five-year ban for qualified legal immigrants from accessing means-tested benefits under Medicaid.

In 2012, there will be many opportunities to reduce health disparities and increase Latinas’ access to health services. Beyond January, we hope that our elected officials will not only speak about cervical cancer awareness, but work work us to ensure Latinas live cervical-cancer free.

For more information, please visit NLIRH’s resources on cervical cancer.

Each January we celebrate Cervical Cancer Awareness month. This month gives us an opportunity to reflect on our mothers, daughters, sisters, aunts, and friends that we have lost to this preventable disease, and a time to consider how we will get the cervical cancer incidence and death rate among women of color to zero. There is no better time to educate and empower women to protect themselves from cervical cancer and make their health a priority.

It is no secret that women of color—specifically Black and Latina women—are at greatest risk of cervical cancer.  Latina women have the highest incidence rate of cervical cancer and Black women have the highest death rate from the disease, which is almost two times greater than for White women. These staggering and unacceptable figures are only worsened by the knowledge that this disease is largely preventable through timely screening, diagnosis, and treatment.

Then what will it take to put an end cervical cancer?

Ending cervical cancer will be no easy task. Great strides can be made by taking a multi-level approach to the problem, which includes expanding knowledge, empowering Black women to make their health a priority, and continued advocacy efforts.

Urge women to recommit to their health and get regular preventive screenings, including Pap tests.  Prevention is key!  Cervical cancer usually develops very slowly and—if abnormal cells are detected early by a Pap test—it can be treated while still in pre-cancerous stages. However, approximately 50 percent of women who are diagnosed with cervical cancer have never had a Pap test before; an additional 10 percent have not had a Pap test in the last five years. Parents of girls and young women should speak to their healthcare providers about the HPV vaccine, which protects against two types of HPV that cause 75 percent of cervical cancer. All women should undergo regular Pap tests within three years of sexual onset and no later than age 21. At age 30, women should get Pap tests in conjunction with HPV tests, which will identify women who are at greatest risk of cervical cancer and will require closer monitoring.

Continue to advocate for screening and treatment guidelines and laws that make reproductive justice and women’s health a priority.  At the Black Women’s Health Imperative we believe that screening and treatment guidelines should adequately represent the needs of Black women and the cervical cancer trends persisting within the community. We are dedicated to removing barriers and ensuring that screening standards and guidelines are appropriate for Black women and enable them to achieve optimal health and well-being. We also partner with organizations like the National Latina Institute for Reproductive Health and the National Asian Pacific American Women’s Forum to mobilize efforts aimed at improving the health of all women.

We believe that the health of Black women matters. We also believe that the number of deaths from cervical cancer should be zero and are committed to making this a reality!

The uninsured, the underinsured and those living in underserved communities in which health care services are scarce are the segments of the U.S. population that are disproportionately affected by cervical cancer.  These populations include women in rural areas, the elderly, those with less formal education, and women of color.  For example, the mortality rate for African-American and Vietnamese women continues to be twice as high as for white women – and about 50 percent higher for Latinas.  Meanwhile, in rural communities, uninsured white women have some of the poorest access to routine screening of any patient population.  Thus, cervical cancer incidence rates vividly demonstrate inequities in our health care systems and outcomes.

Community health centers supported by the Health Resources and Services Administration (HRSA) address this disparity by providing preventive health services – including Pap tests and HPV vaccinations – to any woman, regardless of insurance status and/or ability to pay. As such, health centers play a vital role in redressing health disparities and delivering care to groups excluded in the health care system, such as immigrants.

For example, in 2010, more than 11 million patients served in community health centers were women and girls, or 6 out of every 10 patients. Of that population, 69% were women over 20 – comprising the largest single patient-category in the system. In addition to HPV vaccines, health centers administered Pap tests to about 1.8 million women, resulting in 120,167 abnormal cervical findings. Of the 9,592 attending physicians in health centers, almost 1 in 10 was an OB-GYN specialist, accounting for more than 3 million patient visits-or 9% of the 34 million visits to health centers annually.

The passage of the Affordable Care Act will allow community health centers to make an even greater impact on access to preventive health services. Under the Affordable Care Act, cervical cancer screenings are already covered with no cost sharing for new health plans.  Furthermore, the Affordable Care Act created the Community Health Center fund which will provide $11 billion over a five-year period to assist in the expansion, improvement and creation of new health centers throughout the country. In September 2011, the Department of Health and Human Services (HHS) made $700 million in funds available to health centers: $600 million for current community health centers to expand operations and serve more patients and $100 million to help health centers address immediate needs. And in August 2011, HHS awarded nearly $30 million to create the New Access Points program, which will help health centers delivery primary and preventive care to an additional 286,000 patients.

Community health centers are poised to play a large role in increasing access to preventive and primary health care. Other provisions of the Affordable Care Act, including no-cost sharing for preventive services under private health insurance plans and non-discrimination protection for women with pre-existing conditions, also serve to bring down barriers to health care for women. Additionally, while greater research is needed, a recent study at the National Cancer Institute suggests that the HPV vaccine seemed to be about as effective whether women had 1, 2, or 3 doses; a development which may increase access to the HPV vaccine for women who seek it.

With the nation spending over $1.4 billion a year on cervical cancer treatment, these basic preventive services not only provide crucial access to care to the most vulnerable of populations, but also serve to reduce health care costs overall by emphasizing prevention and reducing the need for costly disease treatment and emergency room costs.

To find a HRSA health center near you or to download the free health center app, click here.

Recently, thirty members of Congress have expressed their solidarity not only with the tens of thousands of immigrants who suffer from immigration detention and deportation system’s general operation, but also with the untold hundreds or even thousands of immigrants who suffer additional abuse—sexual abuse—while detained by the state. Women and LGBTQ detainees have been particularly vulnerable to these types of abuse, and many stories have been made public. Even so, the administration has declined to apply the Prison Rape Elimination Act (PREA), which would help with developing standards, gathering data, and deploying funds to reduce prison rape, to immigration detention.

Immigration and Customs Enforcement (ICE)—the agency charged with our immigration “enforcement” system, which includes detention—does not provide data on the occurrence of sexual assault in detention, but several non-profit organizations have taken on efforts to uncover this information. The ACLU of Arizona, for instance, has identified five cases of LGBTQ detainees in Arizona who have suffered sexual assault in immigration detention.  The National Immigrant Justice Center has filed at least 17 complaints of serious human rights violations, some including sexual abuse, against LGBTQ detainees. The ACLU of Texas has similarly filed a lawsuit on behalf of three women who suffered sexual abuse in detention in Texas, but their investigation uncovered 200 allegations of sexual abuse in immigration detention facilities nationwide in approximately a four-year period.

This information isn’t new, but it’s as stunning as the first time it came to light that individuals should be maintained in such inhumane conditions. We are pleased that recognition is spreading that immigration detention has massive problems and imposes huge costs on detainees, their families, our communities, and the American people. We commend the members of Congress involved in the push for investigation of sexual assault in immigration detention and look forward to seeing what their efforts uncover.

If you’re interested in the unique struggles that women and LGBTQ immigrants face in the U.S., both in and out of immigration detention, please consult the resources of the National Coalition for Immigrant Women’s Rights (NCIWR) and consider joining us!

As you know from our work on cervical cancer, Latinas continue to suffer from the highest rates of cervical cancer among women of all ethnic and racial groups. As we work to educate Latinas about how to take action to prevent cervical cancer in their own lives, NLIRH will continue to fight to bring down the barriers Latinas face in accessing the routine gynecological care necessary to prevent, diagnose, and treat this disease.
Here is a round-up of what we have so far:

Why cervical cancer is a LGBT issue by Verónica Bayetti-Flores, Policy Research Specialist, National Latina Institute for Reproductive Health.

Cervical Cancer Awareness Month: Trans Men and Genderqueer/Gender Nonconforming People by the National Center for Transgender Equality.

Screen more women for cervical cancer – not the same women more often! by Kate Ryan, Program Coordinator, National Women’s Health Network.

Thank YOU Affordable Care Act for helping cervixes stay healthy by Keely Monroe, Program Coordinator,  National Women’s Health Network

Please stay tuned this week for more posts! 

Anyone with a cervix can contract cervical cancer, so this means that lots of trans men and genderqueer/gender nonconforming people are at risk. But because trans people face widespread discrimination from health care providers and insurance plans, they often avoid seeking or cannot access preventive care.

The post lists ways to prevent cervical cancer among trans men and gender non-conforming people, including tips to keep your own cervix healthy and advocacy items to ensure access to care. Check it out!

One of the most pressing issues for LGBTQ access to care is discrimination and bias. Homophobia at the doctor’s office is unfortunately common, and a great detractor to queer women seeking care. This then affects access to preventive care – women who have sex with women are at risk for cervical cancer, and research suggests that queer women who report positive attitudes about their providers are more likely to have had a recent pap. Transphobia is also a concern, and especially for highly gendered health services such as Pap smears, a huge barrier to access. In fact, in a recent survey about the experiences of transgender people with discrimination, nearly a quarter of trans Latin@s reported having been denied medical services due to their gender identity, and 36% reported delaying needed medicals services for fear of bias.

Discrimination at the doctor’s office is only part of the problem, however. While person-to-person discrimination is an issue, the systematic oppression and marginalization of LGBTQ communities plays a role in LGBTQ Latin@s’ ability to afford care, research and knowledge about LGBTQ health, and clinicians’ training on treating LGBTQ patients. Existing research suggests that LGBTQ communities are disproportionately poor, and the Latin@ respondents of the Transgender Discrimination Survey reported high rates of both unemployment and harassment at work due to gender identity. This means that health care is often out of reach for these communities, especially non-emergency and preventive care such as Pap smears. But even if LGBTQ people are able to afford care, most physicians are woefully unprepared to treat LGBTQ patients due to a lack of training on relevant issues.

We are seeing progress, however. Reproductive justice activism is incorporating the needs of LGBTQ communities, and the LGBTQ advocates are beginning to consider reproductive rights issues as ones that are relevant to their base. Every day we are seeing research on LGBTQ health grow. And last November, in a historic move, the American College of Obstetricians and Gynecologists released a statement urging their members to be prepared to treat transgender patients. It’s a long road ahead, but as long as we don’t forget our LGBTQ herman@s in the fight to bring down cervical cancer deaths to zero, we are moving forward.