Tying A Few Things Together

I have written a few posts recently which criticize quite strongly the recent spate of conservative "we must cut everything" hysteria over Alberta's budget:

On Alberta's Budget 2018

On Government Finances and Debt

About Hospitals and Ian Brodie

All of these posts revolve around the basic theme of how ridiculous a narrow focus on money really is when we are talking about government. Fundamentally, these arguments all boil down to money - how we're spending too much, the cost of repaying the debt, and so on. This is "banker speak".  Bankers think in these terms, because that is their framework of understanding. A banker doesn't bother to look at how the monies are being used, the policies that they are supporting, how the public benefits from it. No, they only look at the money and their ability to make further profits from it.

Then, as if to underscore my point, we get this "study" out of Goldman Sachs which basically says "curing disease is bad business".

"The potential to deliver 'one shot cures' is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies," analyst Salveen Richter wrote in the note to clients Tuesday. "While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow."

 I have long believed that the corporate business mentality which places profits ahead of "doing the right thing".  Medicine has never been about making huge piles of money - it has been about helping people. Talk to anyone going into medicine, and you will rapidly find that money isn't the top of their list of motivations (yes, doctors are well paid, but few who go into the field do so primarily for the money they can make).  Doctors like Jonas Salk created vitally important cures for diseases like Polio  - and gave them away because they understood that the benefit to the world vastly exceeded any short term pecuniary interest.

There's an old saw about conservatives:  "Conservatives know the cost of everything, and the value of nothing".  Bankers are in so many ways the "original conservatives" - the only thing they have ever paid attention to is money, and making money using money. Borrow to buy a house? Cool. But never make the mistake of thinking that the bank will be there to help you out if you fall on hard times.

The analysis of the investment bankers at Goldman Sachs echoes criticisms made about Alberta's 2018 budget.  The 2018 budget has been criticized for not laying out a clear plan to achieve a balanced budget, how it's "racking up the debt" and so on.  Like the Goldman Sachs commentary on gene therapies, this is a very narrow focus. We should also be asking where the money is going, what are the benefits to society, and so on.  Just as good medicine isn't necessarily "good business", good government isn't good investment.  We should never lose track of that reality. 

The Evidence For Transsexuals

Down in Australia, blogger Zoe has posted an excellent summary of the medical evidence to date that points to underlying biological causes for transsexualism.

I continue to temper the optimism that some of this evidence will engender with the cautious view that the evidence is persuasive, but not at this point conclusive. What we have is a series of pointers that are leading us towards an understanding of a series of factors that appear to influence the emergence of transsexualism. However, we should also be just a little wary of falling into the trap of assuming that coincidence equals causality.

That said, I am very happy with the research work that has been done, and what that work is beginning to reveal.

Oh, Woe is my Poor Conscience

Okay, abortion is a contentious subject. I get that.

Not all doctors are going to be willing to provide that service. I get that too.

Leaving patients twisting in the breeze because "your conscience won't allow you to participate"? That I don't get.

Consider the following:

The present regulations say doctors must ensure pregnant women are "offered access to information or assistance" to help them make informed decisions on their options, including possible termination.

Under the proposed changes, physicians must make sure patients who are considering terminating their pregnancies are offered access to information to make an informed decision as well as "access to available medical options."

Okay - in essence, that creates a practice obligation that if a doctor is not willing to participate, then they are obliged to provide an appropriate referral to someone who will.

This is not an unreasonable statement at all when one considers that our family physicians are most people's primary source of meaningful information and connection into our health care system.

Of course, for the "conscience crowd", this is too much pain:

"This (proposed) clause removes my ability to be a conscientious physician," said Dr. Joan Johnston, an Edmonton family physician who opposes abortion.

Speaking as someone who has had to access the medical system for reasons that some moralizing types would consider controversial, the doctor's comments are whining. Basically, what she's demanding is the right not just to be a non-participant, but to in fact be an obstacle to her patients accessing those services. This is morally and ethically reprehensible.

It is difficult enough to gain access to the correct services within the medical system without having physicians demanding that patients live under the physician's personal moral code. If you don't want to perform some procedure, that's just fine - but you need to provide your patients with access to the doctors who are willing to be involved. There is little more frustrating in life than to be facing a need for treatment, and to have various people closing the doors on you without at least having the grace to point one in the direction of someone who can be of assistance.

Yes, I'm sure that Dr. Johnston has very legitimate concerns about "not perpetrating evil" (or whatever her particular objections are). The fact is that she is not being obliged to do anything except ensure that her patients have access to the correct resources to make an informed decision, rather than just providing them with a closed door.

Dear Mr. Poilievre:

I'm going to hope that your recent comments regarding Ontario funding GRS were rooted in ignorance, not malice.

Conservative MP Pierre Poilievre says he wants the federal government to step in and prevent Ontario from funding sex reassignment surgery.

"I will write the minister of finance, Jim Flaherty, to seek assurance that federal health transfers should go only to vital health care treatments and not to the McGuinty sex-change program," said Mr. Poilievre, the MP for Nepean-Carleton.

Aren't the Federal Conservatives all about "less Ottawa intervention in provincial affairs"?; smaller government; etc.? Well - only sort of. It seems that only goes as far as their burning desire to impose their moral values upon others. As soon as they sniff something they deem "immoral", they're off to impose some kind of rule or another to make sure that they are being as obstructive as possible.

As the Editors at the Ottawa Citizen point out, it's not like Mr. Poilievre is actuall taking on a significant group in the population:

Usually politicians looking to score easy points will rail against needle exchange programs, but transgendered people are even more marginalized than drug addicts, so they make an even safer target to beat up on. This is on the same level of cheap politics as whipping up anger because an academic somewhere received a grant to write a thesis on, say, snail reproduction.

This isn't to say that people can't ask whether same-sex operations are medically necessary. This is a fair question. But Mr. Poilievre's smarmy quip about the "McGuinty sex-change program," suggesting that the government is promoting sex reassignment, shows he is simply being opportunistic.

Pardon us if we don't admire his courage for taking on the all-powerful transgendered lobby.

However, the good news is that more informed and intelligent minds than that which resides in Mr. Poilievre have chosen to make themselves heard too:

In my own practice, transgendered patients describe a lifelong, pervasive incongruity between their physical sex and their emotional status. Personally, I can't imagine a much more hellish existence.

Transgendered people exist. Gender reassignment surgery is considered an effective, appropriate therapy for some of these individuals. The withholding of such surgery can lead to severe psychological problems and suicide, as has occurred in my own practice. If we put aside our value judgments, it cannot be argued that gender reassignment surgery is anything but medically necessary. Such surgery can be as lifesaving as a coronary bypass.

Sadly, I think that Mr. Poilievre is unlikely to listen to the doctor who penned that letter - nor are most of his colleagues in the Con$ervative caucus. They have already shown Canadians time and again that they are willing to attack anyone they consider immoral or of lesser social value than themselves. Whether one is a woman, a minority or just plain old "socially unacceptable" to their idealization of 1950s "family values", they don't give a damn, and are quite happy to attack your very existence in the most vicious ways possible.

Pray that they don't decide that a heart attack is a result of a "licentious lifestyle" anytime soon.

Theology, Hospitals and Gender Identity

The whole business about a Catholic hospital refusing a transsexual access to surgical services has been rattling around in my head for some time.

So, I decided to go see if I could find some kind of reasonably intelligible, biblically-centered argument that could have led the hospital in question to the conclusion it arrived at.

As the old saying goes, seek and ye shall find. The article itself appears to be moderately old - likely from somewhere in the early to mid-1990s. However, it serves as a fairly decent jumping off point for my analysis, as it is fairly coherent, and tries to root itself in the concepts of scripture to make the case.

Looking at the paper in its entirety, it makes several very fundamental errors of reasoning that I need to point out.

First, the author makes the claim that because there are some number of stories of transfolk who have transitioned and then backed away when they "found Jesus" that one must thusly conclude that similar paths will work in the broader population of transsexuals. This is, of course, a deeply flawed attempt at a proof by induction. Even in the world of mathematics, proof by induction is fairly difficult. When people are being described, inductive proof is virtually impossible. Come to that, it's not terribly hard to find transsexuals who are in fact Christians.

The second error of reasoning that the author makes involves making the supposition that religious conversion is equivalent to psychotherapy, or if one takes certain statements of the author's at face value, possibly even higher value than psychotherapy. First, it is arrogant to outright dismiss the value of a discipline simply because it suits one's ideological goals. Second, because the author chooses not to cite either the DSM or the HBIGDA Standards of Care, it is quite clear that he is deriving his conclusions regarding psychotherapy based on supposition regarding the treatment and management of transsexual clients. This is argument by assertion, with only limited useful evidence to back it up.

The third high level error of reasoning comes in the regular mixing of terminology. Quite routinely the author switches to the term "transvestite", using it in a manner that suggests it has an equivalence to the term "transsexual". This results in the conflation of two similar, but distinct conditions in the reader's mind and implicitly links the two topics. While a transsexual may cross-dress as part of the therapeutic process to determine if transition is the appropriate path for them, they are not transvestites - their motivations for cross-gender presentation are quite different.

The last point of logical error is the author's insistence upon driving back to arguments based on biblical sexuality. Again, had the author made a more complete study of the subject area before leaping in with both feet, he would have recognized that gender is not sex, and sex is not gender. While sexual relations are part of an intimate relationship, they are not the relationship itself, and you find again and again that the rational narratives of transsexuals often has little to do with sexuality itself.

Neither biblical exegesis nor research science gives credibility to the transsexual's insistence that he or she is the opposite sex caught in an opposite sex body.

If one were seeking absolute causal explanations, I might see where this is coming from. However, when we are discussing attributes of someone's personality, seeking absolute causality seems rather pointless indeed. One might as well ask why one person is a pathological liar while their cousin has never been known to tell a lie at all.

What is important, and both the SOC and DSM emphasize this is the persistence and durability of the feelings involved. Those who are experiencing a "passing fancy" are not good candidates for transition at all.

While the author's point that we do not know the causal origins of transsexuality are valid to a degree, it fails to recognize the persistence of feelings that so many transsexuals experience and live with prior to transition.

Jesus Christ had a physical body, Col. 2:9. Clearly, then, the body is good. Biblical anthropology knows nothing of the pagan greek dualism that pits the body against the spirit with the former being evil and the latter good Bodily concerns and health are valid human concerns.

Wait a second, here. The very assertion that we have a soul, and the claim that the soul is eternal, surviving beyond our mortal lifespans is in essence to claim that even in Christian theology there is in fact a duality between body and soul. While the question of one being good, and the other not is perhaps not part of Christian belief, gender identity is neither good nor evil. By focusing upon the physical body, the author is essentially dismissing the very core narrative that is common to most transsexuals.

As I have argued in other writings on matters of identity and sexuality, it is unreasonable to simply dismiss someone else's narrative simply because it is inconvenient. That is poor reasoning at best, and condescending argument at worst.

In fact, I would argue in counterpoint to the author's supposition that in fact the distinction that Christianity makes between "body and soul" opens the door to the possibility that in fact one's "soul" may in fact be a "feminine soul" even in a masculine body. To the best of my knowledge, scripture is quite unclear on whether the soul is "gendered" or not, but it is not unreasonable to suppose that if the soul is the seat of personality that it may well be.

Confusion about gender and gender roles became the norm. God highlighted this issue in His curse on man's rebellion.

Later, God had Moses teach:

A woman shall not wear a man's clothing, nor shall a man put on a woman's clothing, for whoever does these things is an abomination to the Lord your God.

Dev. 22:5.

Ah...once again, we fall into the trap of equating transsexualism and transvestism. If one assigns even a limited truth value to the transsexual claim of "being in the wrong body", then in fact the Male to Female (MTF) transsexual is arguably not cross-dressing when she presents in the feminine role. In order for Deuteronomy to be parsable with respect to the phenomenon of transsexuality, one must first demonstrate that the transsexual narrative is utterly invalid. While the paper's author has made the claim that such is the case, he has not by any means provided the reader with any compelling evidence to back up his claim.

(I will point out that many of the writer's claims about gender role and how it is learned rest upon some of Dr. John Money's work. While I admire Money's dedication and desire to contribute positively to our knowledge of gender identity, some of his work had tragic outcomes, and may in fact have demonstrated that his early notions that gender is primarily rooted in socialization to be troublingly false.

The fact that hermaphrodites have few, if any, problems with transsexualism, when one might expect them to have problems if any group of people would, proves that there is no physiological cause. As a group they prove that once a sex gender role have been assigned, children adjust well and experience few problems." Thus, sexual gender roles are largely learned."

Well, actually, people who are Intersex probably have fewer problems with transsexuals in general because they have experienced some of the same challenges that transsexuals experience in finding treatment to help them find their "stable place" in the world. Further, more recent perspectives on the Intersex run quite at odds to what the paper claims, with an increasing demand to allow the intersexed individual to choose their gender role later in life.

"The causative factors in transsexuality appear to be the same as those in transvestism and homosexuality. The transsexualist's mother is typically an unhappy woman, who clutches her son to her bosom - literally or figuratively - entering into an intensely close relationship with him from which the father and other children of the family are excluded".22

This is blatantly false. I have not seen any literature written since I graduated from University that substantiates such a simplistic view of the causality of either homosexuality or cross-gender identity. This is arguably a hangover view in the paper which persists today in the world of people like James Dobson because it is convenient and simple. More recent work such as True Selves are more candid and freely admit that we really do not know. What we do know is that simplistic "it's the parent's fault" explanations tend to fall apart under scrutiny.

The paper then goes on to talk about the "biblical response" to transsexualism:

This supernatural washing, setting apart, and justification are sufficient to put these sinful lifestyles in the past. My friend is evidence of this truth. Perry Desmond is a man who had two sex-reassignments. God's grace truly transforms.34 Surely it is sufficient.

As with my common critique of the "ex-Gay" claim of "healing through conversion", such experiences have limited validity when mapped onto the broader population in question. There are a handful of a small population for whom religious conversion seems to be adequate to enable them to leave their sexual or gender identity issues behind. For those individuals, one must wish them well on their life journey. However, to claim that such an approach is "universally applicable" is flawed indeed. (Just as transition is not the "right path" for every cross-gender identified person, neither is religious conversion going to "work" for everyone)

It is perhaps the attitude the author takes towards Intersex children that is most telling:

While these individuals are not the direct concern of this article, a brief word is necessary. Ethically, you should help the parents take responsibility for surgical-hormonal treatment. As much as is possible, the external genitalia should be brought into conformity with the genetic gender of the child.35

Genetic gender? Huh? What is the "Genetic Gender" for someone who is a genetic mosaic (has both XX and XY chromosome pairs in different cells)? Or, for that matter what about the XXY chromosome pattern of Klinefelter's syndrome - is that person really "genetic female" or "genetic male"? Such absolutist thinking is as dangerously flawed as John Money's hypothesis about gender as primarily a 'socially learned construct'.

You need, also, to point the transsexual to Christ. Once a transsexual is converted, medical care should be given. Since the believer must live according to God's will, he or she must resume his or her created gender.

It gets worse. While I appreciate that my doctor is entitled to his religious views, and so on, the last thing that any patient wants is a sermon when sitting in the doctor's office. I would feel very sorry for any transsexual whose doctor (or therapist) chose to follow the guidance of this paper's author indeed.

While I think I understand better the kind of reasoning that Seton Medical Center used to arrive at their decisions, but I also believe that the reasoning is based not upon sound ethics and research, but instead upon assertion, a lack of research and poor logic - resulting in intolerance of anyone who does not fall within a narrowly prescribed view of the world.

Consider The Implications

It is situations like this that make me a fervent believer in keeping religion and state separated ... quite firmly.

Superficially, one may well look at things and say "so what?" - after all, a Catholic Hospital (and therefore a religious institution) refused to facilitate treatment for someone they would consider "immoral". After all, isn't it really just a matter of freedom of religion, right?

Well, not so much when we tread into the land of medical services, or for that matter government. The situation itself represents a slice of a much larger problem that affects minority populations. (* Yes, I realize that in the United States that medical services are not a government function *)

Consider, for a moment, the standard that the hospital is applying here. On one hand, the hospital provides supporting facilities for breast augmentation surgery - a procedure that one could argue plays to the "sin" of vanity in many situations. But, apparently, as long they don't know that the patient is a transsexual, that's okay.

On the other hand, if the patient is a transsexual, suddenly a second standard is brought out and used:

"God made you a man."

That's what Charlene Hastings said she was told when she called to inquire about breast enlargement surgery at Seton Medical Center, a Catholic hospital in Daly City.

So, suddenly, someone's access to services is now dependent upon the criteria that some arbitrary party (the hospital) approving of the prospective patient's past and present moral status.

The implications here are enormous. A huge percentage of surgeries in North America are classified as "elective" (which, contrary to common misconception does not mean "optional", but merely means that the patient will not die immediately without the surgery).

While I do not have a huge amount of difficulty with the concept that a hospital may well not offer services on a variety of ethical or moral grounds, I take considerable exception to offering treatment to one population and denying it to another on moral grounds.

The message is clear to transsexuals - don't come to a "Catholic Hospital" if you need treatment for something, because your past will be held against you in the decisions made about your treatment. (and it's not like it isn't hard enough for transsexuals to access treatment to begin with)

Does this mean that someone who is excommunicate from the Catholic Church is suddenly going to find themselves refused access because of that status? Or is the level of service that a patient can expect suddenly proportional to whether the local bishop decides their "status" within the church?

Churches running hospitals is a fine and noble tradition in the spirit of charity. However, there are a myriad of places where medicine can and does run afoul of church doctrine. (One might, for example, consider what could happen if certain aspects of Jehovah's Witnesses' doctrine were to be enforced by a hospital's administration) At some level a hospital that provides services to the general public (and last I checked, there's no requirement at the Seton hospital that patients must be practicing Catholics) is providing a public service that is well outside religious dogma.

It's one thing to say "we don't provide this service because we object to it" (e.g. Abortion) and simply not provide the services at all, it is quite a different thing to say "We provide this service unless you are ...".

Chilling...

[Update: Nov 30/07]
From some of the comments I've been getting over the last 24 hours, it seems that the CNN link below now points to a story about a boy who refused treatment because of his religious beliefs. That is NOT the story that this article is based on. It is in fact based on a CNN interview with doctors who were refusing treatment to patients based upon the doctor's religious beliefs.
[/Update]
When Doctors start refusing treatment on religious grounds, something is vastly out of whack in the world.

Don't misunderstand me - I have no problem with medical doctors having active religious lives. However, when otherwise perfectly legal treatments are refused on the grounds that it conflicts with the "doctor's religious beliefs", then there is a serious, serious problem.

The last thing I, or any other patient, wants is to go to a doctor and instead of treatment receive a lecture on the morality of our lives as an excuse for not treating the patient.

There's an underlying misogyny to this practice, as it is most often women who find themselves refused treatment. From abortion to birth control pills or "the morning after" pills, religious doctors are refusing to provide treatment they deem "immoral".

There's more to the picture though. What if your doctor were to decide that cancer was a punishment from "god" for an "immoral life" and refuse you treatment? Or perhaps the myriad of symptoms that some women experience as part of their monthly cycle are a punishment from "god" for being "temptresses", and therefore unworthy of treatment? Pick your scenario, just about anything can be construed as 'immoral' depending on how you interpret scripture.

What Are Alberta's Priorities?

Alberta, land of the "pseudo-Texan" and "minimalist government" in Canada...right?

Well - that depends on just whose priorities you are talking about. Albertans - and especially the conservative backers - love to spout off about how much less tax we pay, or how much less intrusive our governments are.

But, recent events really do have to make you wonder just what the Stelmach government's priorities are, and just how "minimal" the government really is.

Consider - Ted Morton's decision to allow seismic exploration on Marie Lake (a decision which Premier Stelmach subsequently had to overturn after residents continued to object). One could almost understand Morton's thinking here - after all why would he want to stand in the way of the "goose that laid the golden egg" in Alberta? Wouldn't that be undue government interference?

Then we encounter Alberta Hunting Day - another Ted Morton sponsored bit of stupidity. So, in Ted's mind, it's a bad thing for government to interfere with industry (at all, apparently), but the government should be telling us how we should spend our recreation time? WTF? I don't much care if somebody hunts - as long as they actually live on the meat they "bag", and only catch enough for their own needs for a year. I object to trophy hunting - if you want to brag about an animal, shoot them with a camera.

But, more egregious is Bill 41, quietly introduced to the Legislature just before it stood for summer recess. It's a tedious bit of reading - mostly a rather lengthy series of amendments to the Alberta Health Profession Statutes legislation. (I hope I've linked to the correct document here - the Queen's printer isn't exactly the most helpfully designed I've ever seen). This little turd of legislative "wisdom" appears to put our politicians smack in the midst of the complexities of the Alberta College of Physicians - the body which regulates the activities of our Doctors. Quite rightly, our doctors should be worried about this - The Alberta Con$ervatives have a long track record of taking control out of the hands of various groups and leaving them with untenable obligations.

For example, in the mid-90s, Ralph Klein's government took over gathering municipal and educational property taxes, and have subsequently proceeded to choke the access of those agencies to the funds involved. As a result, school boards are left with the responsibility for reaching salary agreements with teachers, and repairing schools - but are unable to levy the funds necessary to do so. Even worse, the government has taken it upon itself to impose settlements that are unfunded and then tell the school boards to "get creative" about it.

If I was the AMA, I'd be very worried about letting this bunch of ham-fisted lunks have more direct control than they already do over a regulatory body that has to date done its job quite reasonably. Allowing politicians to dictate who should be at the helm of these organizations, or control over policies and directives is extremely dangerous indeed. A reasoned regulatory framework must exist for good reasons, but at the same time, that framework must be held separate from direct interference from politicians (who are seldom qualified to speak to the ethical particulars of disciplines such as medicine).

There is a grand irony in this. Alberta has the most secretive government in the country, and the minister introducing the bill claims it will provide for greater accountability. Coming from this government, that's almost funny. In the greater picture of things, it really does make one wonder just what this government's priorities really are.

Womb Control: Twisting The Issues

I don't know whether to laugh or cry over the rank stupidity of this article.

It's a classic case of people twisting unrelated arguments together in an effort to suit their own ends - and results in a "Have you stopped beating your wife yet?" kind of logic.

The headline of the article is innocuous enough, although it hints at where the writer is going to head:

Contracepting the Environment

Environmentalists Mum on Poisoned Streams

They then proceed to whine about the environmental movements are all but ignoring this catastrophe that is happening under our noses. They start off with the following:

When EPA-funded scientists at the University of Colorado studied fish in a pristine mountain stream known as Boulder Creek two years ago, they were shocked. Randomly netting 123 trout and other fish downstream from the city’s sewer plant, they found that 101 were female, 12 were male, and 10 were strange “intersex” fish with male and female features.

Okay, this is nothing particularly new. Stories have surfaced about unusual mutations in aquatic life where human-created pollution has occurred have been around for years - including "hermaphrodite fish".

They studied the fish and decided the main culprits were estrogens and other steroid hormones from birth control pills and patches, excreted in urine into the city’s sewage system and then into the creek.

Woodling, University of Colorado physiology professor David Norris, and their EPA-study team were among the first scientists in the country to learn that a slurry of hormones, antibiotics, caffeine and steroids is coursing down the nation’s waterways, threatening fish and contaminating drinking water.

There's two leaps of inference here. First, is the insinuation that this is suddenly, magically affecting our drinking water supply. Which naturally ignores the filtration and treatment processes that already are done to most municipal drinking water long before it reaches your tap. The second, and fairly obvious point is the old cowboy principle of "never drink downstream from the herd". Few, if any municipalities have their water intakes downstream of any effluent discharge if they can help it.

The second leap is a bit of foreshadowing. Notice the use of the phrase "estrogens and other steroid hormones from birth control pills and patches". Like good little pope-bots, they zero in on "birth control pills", and try to blame it all on them:

When asked about the genetically modified fish and the contaminated drinking water, however, he said: “It just has so much competition out there for stuff to work on.”

He told the Boulder Weekly that nobody needed to consider curtailing use of artificial contraceptives out of concern for the creek.

Please note the twist here. The writer is presupposing a solution to the problem - just quit taking those nasty contraceptives, and the problem goes away. Or does it?

Well, not really. The real science points out that there are a lot of different bits of chemistry involved, not just estrogens used in birth control pills. (Among other things, estrogen has valid medical uses beyond oral contraceptives; further, we ingest (and excrete) a variety of other drugs and chemical compounds that play into the picture. {Not to mention the fact that urine is filled with all sorts of waste from the body - including hormone compounds. This is perfectly natural.

The twist is obvious at this point, the author and the publisher, the National Catholic Register, have an agenda. Their church preaches that contraception is evil, and therefore that you shouldn't use it. So, it becomes politically convenient to blame the "hermaphrodite fish" effect on hormone-based contraceptives. (Of course what they conveniently ignore is that hormones are a form of steroid, used in a wide variety of medical treatments. (Talk to someone with Crohn's about the use of steroids in the recovery from the very necessary operations they have to undergo...

Then we get to the "wife beating" accusation:

“If you’re killing mosquitoes to save people from the West Nile virus, you can count on secular environmentalists to lay down in front of the vapor truck, claiming some potential side effect that might result from the spray,” Harden said. “But if birth control deforms fish — backed by the proof of an EPA study — and threatens the drinking supply, mum will be the word.”

What really galls me about this article is the facile, and ridiculously simplistic, linkage drawn between oral contraceptives and what's happening in our rivers and lakes. To derive that the problem is the use of estrogen-based pills, and not inadequate (or perhaps incorrect) treatment of municipal sewage is horrendously dishonest.

The writer overlooks several key points:

1. The impact of various farming practices involving livestock.
2. The technology of wastewater treatment is changing (and yes, filtering out hormones is being investigated actively)
3. A variety of compounds can act "like" an estrogen, and many of these are common outputs of a range of industrial activity.


The real goal of this article is to set out a case for banning hormone-based pills - after all they cause fish to mutate! Yet another chapter in the ongoing campaign of the religious right to roll back the clock and return to an idealized era when the evils of the modern world didn't exist.