The new lies about women's health
By Brian Alexander
Political
groups tell them, the government buys them—and worst of all, your
doctor may pass them on to you. Alarmed? You should be.
For
the past 15 years, Ruth Shaber, M.D., has been an ob-gyn in San
Francisco for Kaiser Permanente, one of the nation's largest health
maintenance organizations. She sees all types of women—union members,
executives, waitresses. Most of them, Dr. Shaber says, have questions
for her, including how to protect themselves from sexually transmitted
diseases, how to preserve their fertility, how to prevent breast and
cervical cancer and whether the latest Internet health scare they've
heard is really true.
Dr.
Shaber tries hard to separate fact from fiction because, she says,
"rumor and hearsay can start to seem real." In the past, she'd
sometimes refer patients to government websites and printed fact
sheets, or rely on those outlets to help create her own materials. Not
anymore. "As a physician, I can no longer trust government sources,"
says Dr. Shaber. She is not a political activist or a conspiracy
theorist; in addition to her own practice, she's Kaiser Permanente's
director of women's health services for northern California and head of
the HMO's Women's Health Research Institute. Yet this decidedly
mainstream doctor and administrator says, "I no longer trust FDA
decisions or materials generated [by the government]. Ten years ago, I
would not have had to scrutinize government information. Now I don't
feel comfortable giving it to my patients."
Such doctor mistrust
represents a major change. For the past 100 years, the Food and Drug
Administration (FDA) has been the world's premier government agency
ensuring drug safety. The National Institutes of Health (NIH) and the
Centers for Disease Control and Prevention (CDC) have similarly stellar
track records. But recently, Dr. Shaber charges, the government has
lost its most precious asset: credibility.
How did it happen?
Many prominent figures in science and public health think they know the
answer. "People believe that religiously based social conservatives
have direct lines to the powers that be within the U.S. government, the
administration, Congress, and are influencing public-health policy,
practice and research in ways that are unprecedented and very
dangerous," says Judith Auerbach, Ph.D., a former NIH official who is
now a vice president at the nonprofit American Foundation for AIDS
Research. In fact, Glamour,
has found that on issues ranging from STDs to birth control, some
radical conservative activists have used fudged and sometimes flatly
false data to persuade the government to promote their agenda of
abstinence until marriage. The fallout: Young women now read false data
on government websites, learn bogus information in federally funded
sex-education programs and struggle to get safe, legal
contraceptives—all of which, critics argue, may put them at greater
risk for unplanned pregnancies and STDs.
"Abstinence is a laudable goal," says Deborah Arrindell, vice
president of health policy for the nonpartisan American Social Health
Association, an STD-awareness group. "But it is not how young women
live their lives—the reality is that most women have premarital sex.
Our government is focusing not on women's health but on a moral
agenda." Consider this a wake-up call.
YOU MAY NOT HAVE ACCESS TO EMERGENCY CONTRACEPTION
If
it had been left up to the FDA's Reproductive Health Drugs Advisory
Committee, American women would be able to walk into any drugstore and
buy the emergency contraceptive Plan B over the counter (OTC). When the
committee was convened in 2003 to review Plan B, a "morning-after"
method of birth control that can reduce the odds of pregnancy by 95
percent if taken within 24 hours of unprotected sex, all 28 members
agreed that the drug was safe and effective. The vast majority of them
also voted to make it available OTC at any pharmacy. Susan F. Wood,
Ph.D., then the head of the FDA's Office of Women's Health, heartily
supported that decision.
Because of her focus on women's health,
Wood examined the research and closely watched the review process for
Plan B, a drug that has been available by prescription since 1999.
Among the facts: Several studies showed that it works with few side
effects and that making it more accessible does not lead to an increase
in unsafe sex or promiscuity. In 2000 alone, the drug prevented
approximately 51,000 abortions, according to a Guttmacher Institute
estimate. But women who need Plan B often have difficulty obtaining a
prescription and getting it filled—hence the need to approve it for
sale OTC.
"One member of the panel told me, 'I wish we had data
this good on everything that comes before this committee,'" Wood
recalls. Fast approval should have been a mere formality.
But
Christian fundamentalist groups like the Southern Baptist Convention
and powerful religious conservative organizations like the Family
Research Council and Concerned Women for America campaigned hard
against OTC status by lobbying members of Congress, testifying before
the FDA panels and bombarding the agency with letters. They argued that
the drug was dangerous, would lead to unsafe sex and would corrupt
children. Pia de Solenni, director of Life and Women's Issues at the
Family Research Council (a pro-life group that also believes there are
"long-lasting negative consequences of premarital sex," including
"emotional problems" and "future marital breakup"), also argued
inaccurately in a press release that Plan B "will most certainly make
[women] ill from an overdose of hormones and potentially cause further
complications."
The campaign worked. Rather than rely on the recommendations of
its medical advisory board, the FDA delayed ruling on Plan B for nearly
two years. Why? Insiders speculated that the delay was, in part, the
handiwork of conservative activist and ob-gyn W. David Hager, M.D., an
active member of Christian right political groups and the author of As
Jesus Cared for Women: Restoring Women Then and Now. Appointed by the
Bush administration to the FDA panel that reviewed Plan B, Dr. Hager
first voted with the committee that Plan B is safe and effective, but
then went on to write what he termed a "minority opinion," laying out a
case against OTC status. Contrary to numerous studies and the review
panel's findings, he argued that the drug might not be safe for teens
and that they might not understand package instructions. Shortly
thereafter, Steven Galson, M.D., a high-ranking FDA official, cited
similar concerns in a letter to Plan B's manufacturer—denying the drug
approval at that time. Some women's health advocates had hoped that the
logjam would break when Lester Crawford, DVM, Ph.D. was confirmed as
FDA commissioner in 2005. But last August, Crawford put off a decision
indefinitely.
Why did Plan B get deep-sixed? According to FDA
officials interviewed by the Government Accountability Office, the
decision to deny approval for Plan B had been made by top political
appointees at the FDA months before staff even completed reviewing the
application; many others suggested that pressure from the religious
right played a key role.
FDA spokespeople have denied those
accusations, but religious-activist organizations crowed about swaying
the FDA, and Dr. Hager claimed the decision was God's work. "I was
asked to write a minority opinion that was sent to the commissioner of
the FDA," he told an assembly at the Christian Asbury College in
Wilmore, Kentucky. "God took that information, and he used it through
this minority report to influence the decision."
Crawford's
ruling outraged the mainstream medical community. Both Wood and Frank
Davidoff, M.D., a consultant to the FDA's Nonprescription Drug Advisory
Committee, resigned in protest. Wood, a cautious woman who avoided
political issues before this, is still shocked by the decision. "If
this drug had nothing to do with sex, this wouldn't have happened," she
told Glamour.
"This decision was not based on science and clinical evidence. This
threatens the FDA's credibility, and it threatens the faith the public
has in the FDA for making sure products are safe and effective." The New England
Journal of Medicine,
the nation's leading medical journal, agreed, running an editorial
titled "A Sad Day for Science at the FDA." The decision, it said,
"appeared to reflect political meddling in the drug-approval process."
Women's
access to emergency contraception (EC) has been mysteriously derailed
by political forces in other cases, too. In April 2002, the Department
of Defense decided to allow military women the same access to EC that
civilian women have, adding Plan B to what's called the Basic Core
Formulary, and thus making it available by prescription in all military
health facilities. But one month later, Glamour discovered,
Defense Department officials, including Assistant Secretary of Defense
for Health Affairs William Winkenwerder, M.D., a political appointee,
made the extraordinary decision to remove it from the Formulary. Dr.
Winkenwerder's office declined to comment to Glamour, but
sources familiar with the events say they were stunned by what happened
and could not recall any time when a drug was added, then removed a
month later. "It was very upsetting," says one, who specifically cites
Plan B's "political sensitivity" as the reason for the change. Says
another source: "It was like a slap in the face" to be overruled by the
civilian leadership.
YOU COULD BE DENIED RAPE TREATMENT
Even
the Department of Justice (DOJ) may have been influenced by this
political climate. For years, women's advocates have asked the federal
government to establish national guidelines for the treatment of rape
victims. Hospital protocols, they argued, vary too much from state to
state and even county to county, and such guidelines could help a woman
traumatized by assault to get good care no matter where she lived.
Mainstream
medical organizations, including the American College of Obstetricians
and Gynecologists (ACOG), the American College of Emergency Physicians
and the American Medical Association, agree that emergency rooms should
offer victims EC after a sexual assault. Doing so could prevent the
estimated 32,000 pregnancies—and, subsequently, many abortions—that
occur as a result of rape. "What person who has been raped would really
welcome a pregnancy from that?" says James Trussell, Ph.D., director of
the Office of Population Research at Princeton University in New
Jersey. "Even if you oppose abortion, what could be better than
preventing the pregnancy in the first place?"
So when the DOJ was
developing its first-ever guidelines for the treatment of rape victims,
an early draft included EC. Yet strangely, in September 2004, when the
guidelines were issued, any mention of EC had been deleted.
There
was an immediate outcry. A petition signed by hundreds of nongovernment
organizations including the American Public Health Association, the
Episcopal and Presbyterian churches and the Union of Reform Judaism
urged the department "to include the routine offering of emergency
contraception to sexual-assault victims." The failure to do so, the
petition said, "is a glaring omission."
Congresswoman Carolyn
Maloney (D-N.Y.) agreed, and she spearheaded a movement by 97 members
of the House of Representatives to demand that the DOJ include the EC
information in the guidelines. "I think it is unconscionable to deprive
women who have been victimized information about their options for
treatment," Rep. Maloney says. "It is unconscionable to deprive them of
access to medicine." Her efforts were unsuccessful.
The department has never fully explained why it deleted EC from the guidelines. (A DOJ spokesman told Glamour
that EC wasn't mentioned "because it's not up to a bunch of lawyers in
the Justice Department to tell doctors what options should be
available." But the 130-page document was comprehensive in other ways;
it even suggested that examiners avoid wearing jewelry when treating
mentally impaired victims.) Rep. Maloney and many others are convinced
that they know what drives such decisions. "I'd say it is the
fundamentalist right," Rep. Maloney says. At the root of the religious
right's objection is the belief that EC constitutes a form of abortion.
Most experts agree that EC works by preventing ovulation and therefore
fertilization, but scientists cannot rule out the hypothetical
possibility that in a tiny number of cases the drug may prevent
implantation of a fertilized egg. This loophole has led some pro-life
groups to argue that Plan B causes abortions, even though the World
Health Organization (WHO), ACOG and the NIH all agree that pregnancy
begins at implantation and not before. (The most extreme groups contend
that the Pill could work in the same way, and therefore is also a form
of abortion. Some pharmacists have even used this reasoning as moral
grounds to refuse to fill EC and everyday Pill prescriptions; see "What
If You Can't Get EC?" on page 310.) The debate has had real
consequences for rape victims: As many as 80 percent of them are kept
in the dark about EC or struggle to get it in emergency rooms,
according to data from the National Center for Health Statistics.
Maya
Jacobsen* was one such victim. In fall 2001, she was raped in her room
on campus at the University of Denver. After her attacker escaped
through a back door, she sat crying on a couch, frightened and stunned.
Like many sexual-assault victims, she was too shaken at first to report
the incident and waited until the next morning before she drove to the
closest hospital, Porter Adventist. She says she spent hours undergoing
a sexual-assault exam, but nobody brought up the issue of how she might
prevent pregnancy—until she asked.
"I said, 'What are my options
here if I become pregnant?' The nurse said I would have to wait to take
a pregnancy test, and if I was pregnant, there was always adoption. I
said, 'That's it? What about the morning-after pill?' And she said,
'You would need to do that on your own.'" Fortunately, Jacobsen was
able to get the drug from a nearby Planned Parenthood clinic later that
day.
Sharon Pappas, chief nursing officer for Porter Adventist,
agrees that Jacobsen should have been administered EC if she wanted it.
In fact, she says the hospital recently established new procedures
reinforcing their policy of offering EC to all rape victims.
But
the confusion at Porter Adventist illustrates exactly why uniform
federal guidelines for EC are so critical. In the absence of any local
laws, it's up to individual hospitals to decide whether a rape victim
will be given—or even told about—the drug that could keep her from
conceiving her attacker's baby. Many have not developed clear protocols
yet, so Jacobsen's experience will be repeated in emergency rooms
around the country. Ironically, that could lead to numerous unnecessary
abortions. "I would have had an abortion," Jacobsen says. "I had dreams
of a career; my whole life was in front of me. Carrying a rapist's
child was not my dream."
YOU WON'T GET ACCURATE HEALTH INFORMATION
A
few years ago, several conservative congressional legislators asked
King K. Holmes, M.D., Ph.D., how well condoms protected against STDs.
"They asked whether condoms were effective against everything," says
Dr. Holmes, a professor at the University of Washington in Seattle and
one of the world's leading experts on STDs. He told them yes, condoms
were especially effective against HIV, and worked well against all STDs
with one exception: human papillomavirus, or HPV, a few strains of
which can cause cervical cancer. At that time, he said, researchers
suspected that condoms did offer some HPV protection, but the data were
incomplete.
"That is what they wanted to hear," says Dr. Holmes.
"It was clear the goal was to discredit condom use, and this was what
they were trying to hang their argument on."
It seems that
conservative activists saw an opportunity with HPV. Here was a disease
connected to cancer against which condoms weren't yet proven effective.
The perfect argument against premarital sex, and condoms, was born.
"Condoms, whether used correctly and consistently or not, do not
prevent the spread of HPV," the Family Research Council warns on its
website, going on to note that "HPV has been linked to over 90 percent
of all invasive cervical cancers and is the number-two cause of cancer
deaths among women." In truth, cervical cancer is only the
thirteenth-highest cancer killer of women in the U.S., behind bladder
and kidney cancer. In the majority of cases, the immune system fights
off HPV before people know they have it. Even when precancerous cells
develop, they can be detected early by a Pap smear.
Nevertheless,
the HPV fear campaign continued to escalate. Through lobbying and
testimony before Congress, the religious right attacked government
sex-education programs that included information on condom use. The
Family Research Council argued that such programs expose "our youth to
incurable disease on a daily basis. Most notable among these diseases
is human papilloma virus, HPV." The government appeared to be
listening. Until then, the CDC had accurately encouraged condom use as
smart safe-sex behavior—but in 2002, around the time of the HPV flap,
it backed off. The agency suddenly removed from its website a fact
sheet on condoms that stated "laboratory studies show that intact latex
condoms are highly effective barriers to…HIV and other STDs" and that
told readers how to use them. Later that year, the fact sheet was
replaced with one stressing sexual abstinence.
Despite condoms'
proven effectiveness against many STDs, especially HIV, conservatives
continued to suggest that they were more of a hazard than a help. Just
last year, Senator Tom Coburn, M.D., (R-Okla.) went so far as to demand
that the FDA place a warning label on every condom package saying
condoms don't help protect against HPV. (He was unsuccessful.) The
idea, contends Katharine O'Connell, M.D., an ob-gyn and assistant
professor at Columbia University in New York City who studies
contraception, is to hype the dangers of sex before marriage:
Exaggerating condom failure and the risk of HPV "is simplifying the
facts for the purposes of manipulating sexual practices," she says.
"This is not about condoms. It's all about the sex."
Glamour
has also discovered that blatantly false anticondom information has
been incorporated into several federal and state health websites. One,
an official Department of Health and Human Services (HHS) site designed
for families seeking health information for teens, 4parents.gov,
suggests that there is no evidence that condom use reduces the risk of
HPV infection and downplays its effectiveness against chlamydia,
gonorrhea and syphilis. Similarly, several states, including Louisiana,
Wisconsin, Virginia and North Carolina, have online abstinence programs
that link to a site called abstinencedu.com, which warns that HIV might
be able to penetrate a latex condom (patently false), that "condoms
offer no protection against HPV infection" (not true) and that "there
is no scientific evidence that condoms reduce the risk of becoming
infected with the other 23 major STDs" (also false). It even claims
that "the Federal Drug Administration [sic] allows up to 4 percent of a
batch of condoms to be defective before the batch is rejected!"
(Actually, the FDA rejects a batch of condoms if even one-tenth that
number are defective.)
How do lies like these become official
government health information? Both abstinencedu.com and 4parents.gov
get some of their information from yet another outfit, called the
Medical Institute for Sexual Health (MISH), which opposes premarital
sex and has become a leading provider of the kind of "scientific" data
now appearing on government sites.
For
more than a decade, public-health doctors and scientists have charged
that MISH generates dubious and sometimes outrageously false data. One
example: A 1995 letter from David R. Smith, M.D., then the Texas
Commissioner of Health, rebuked MISH for a slide presentation given by
founder Joe S. McIlhaney, M.D., to a panel of experts about a proposed
sex-education program. Dr. Smith called the show "misleading," "false,"
"inaccurate" and even "ridiculous." Yet MISH continued to present the
same data for years, and in the last two years, the federal government
gave the group at least $600,000.
Dr. McIlhaney told Glamour
that in the early days of MISH, he was still working as a physician,
not an academic, and did not have the same access to resources as the
now-larger organization does today. Nevertheless, he continues to
stress condom ineffectiveness against HPV. "I think our conclusions
were right," he says. "I was right on almost all of it, and they were
wrong." Yet science does not back him up: Last November the FDA
reaffirmed that condoms reduce the risk of every major STD including
HPV.
Soon, there will be another weapon even more effective
against HPV than condoms. The drug company Merck has found that its new
vaccine Gardasil is nearly 100 percent effective against the HPV
strains that most often cause cervical cancer. Another vaccine,
Cervarix, made by GlaxoSmithKline, appears to be just as effective.
The
world's first anticancer vaccine would represent an incredible
scientific breakthrough. But conservative groups began voicing
objections as soon as the drugs started making headlines. Sen. Coburn,
for one, testified before the House of Representatives that "going
after one or two types [of HPV] is halfway," a charge health experts
find illogical since the HPV strains prevented by the vaccine account
for most cases of cervical cancer.
"The public should be outraged
at this misrepresentation of facts for political reasons," says Dr.
Holmes. "This really reveals the true agenda for those who have argued
that the reason for not promoting condoms is to protect girls against
HPV." If you truly cared about HPV prevention, his reasoning goes,
you'd be thrilled at the advent of a vaccine to save women's lives. "It
really illustrates that the opposition to condoms has nothing to do
with protecting women and girls," he says, "but everything to do with
opposition to discussion of sexual health."
The movement against
the vaccine—Merck's version of which could be approved by the end of
the year—has left John Santelli, M.D., chairman of Columbia
University's Department of Population and Family Health, mystified. "We
have a vaccine that could prevent cancer," he says. "People should be
lining up and saying this is a great medical achievement, and yet
people are actually opposing it. That's nuts."
YOUR TAX DOLLARS FUND MISLEADING SEXUAL-HEALTH PROGRAMS
Teens
are perhaps the people most in need of trustworthy sexual-health
information. Ironically, they are also the most likely to absorb
misinformation from organizations like MISH that provide pseudo-science
not just to websites but to abstinence-only sex-ed classes in public
schools. One reason why public-health researchers now take a dim view
of such programs: They may mislead students. In a meta-analysis of
abstinence programs published in the Journal of Adolescent Health, Dr.
Santelli found that such curricula "do not seem to be well designed and
have incomplete information, misinformation and questionable
information." And last year, the office of Congressman Henry Waxman
(D-Calif.) examined the most popular federally funded abstinence-only
sex-education programs and found that nearly 70 percent of them include
"serious medical or scientific errors." Among the wholly inaccurate
claims: that up to 10 percent of women become sterile after an abortion
and that "premature birth, a major cause of mental retardation, is
increased following the abortion of a first pregnancy." Says
Princeton's Trussell, "It's an outrage. This is clearly another
ideological distortion of what the real evidence shows." Yet such
erroneous facts continue to be taught in public school districts in
Montana, California, Washington, Pennsylvania and elsewhere.
As
a result, many experts believe abstinence-only programs leave teens
unprotected against pregnancy and STDs. "These young women and men who
are taught that condoms have a high failure rate say, 'Well they do not
work anyway, so why bother?'" observes Kellie Flood-Schaffer, M.D., an
ob-gyn and associate professor at Texas Tech in Lubbock, where
high-schoolers are taught a strict abstinence-only health curriculum.
"I'm a Catholic. I believe in abstinence until marriage. But I'm also a
realist. And condoms prevent a huge percentage of STDs and are 90
percent effective against pregnancy."
She has data to back up her
strong feelings. Along with Samuel Prien, Ph.D., Dr. Flood-Schaffer
conducted a lengthy study that found that among girls under 18, the
Lubbock area has quadruple the average national rate of chlamydia—an
STD that often goes undiagnosed and that can cause infertility. Why are
the rates so high? "It's the education they are not getting," says Prien, who considers himself a conservative Christian. "At least in our area, abstinence-only is not working."
YOUR DOCTOR MAY BE FORCED TO LIE TO YOU
In
November 2002, the National Cancer Institute (NCI), which is run and
funded by the federal government, placed this statement on its website:
"Some studies have reported statistically significant evidence of an
increased risk of breast cancer in women who have had abortions, while
others have merely suggested an increased risk. Other studies have
found no increase in risk."
Confusing? Absolutely. But the facts
are straightforward: Abortion does not increase a woman's chance of
breast cancer, according to numerous independent professional groups
like the American Cancer Society, ACOG and the WHO. (Unlike the NCI,
these organizations are not part of the federal government.)
Radical
pro-life groups partly base their charge of an abortion-cancer link on
research by a biochemist named Joel Brind, Ph.D., but his
work—subsidized in part by an antiabortion group called Americans
United for Life—has been widely discredited. So scientists protested
vigorously when the NCI placed the statement on its website, and the
NCI convened a special panel to address the issue once and for all.
The
group found no increased risk of breast cancer after abortion—and by
spring 2003, the NCI had amended its website to reflect that. But
serious damage had already been done. The abortion-breast cancer link
had gained airtime: Senator Rick Santorum (R-Pa.), speaking on the
floor of the U.S. Senate, cited Brind's research to suggest that
"abortion increases a woman's risk of breast cancer by 30 percent." And
some state governments went further, actually passing laws requiring
doctors to tell patients seeking an abortion that the procedure could
increase their risk of breast cancer.
"The government allowed
people to believe—and encouraged people to believe—that abortions were
a risk factor for breast cancer, even when the government knew that
this research had been discredited and that better research showed no
connection," says Marcia Angell, M.D., a senior lecturer at Harvard
Medical School in Boston and former editor-in-chief of The New England Journal of Medicine. She goes so far as to call the pressure from the religious right "a source of corruption."
To
date, abortion-breast cancer laws, called "Women's Right to Know," have
been passed in Texas, Kansas, Montana and Mississippi. Texas State
Representative Dawnna Dukes (D-Austin) vociferously opposed such a law,
pointing to the scientific evidence that abortion does not raise the
risk of breast cancer. But, she says, legislators who "pushed this law,
supported this law, were terrified by right-wing Christian
organizations. Some of my colleagues said, in confidence, 'I agree with
you, but we are told that if we vote with you on this, we are
supporting abortion.' They knew this information was invalid. They were
frightened. These folks are afraid of this Christian coalition." Why?
She says legislators were worried that the groups would mobilize
against them in upcoming primaries. Herb Brown, M.D., an ob-gyn and
faculty member at the University of Texas Health Science Center in San
Antonio, says these laws "put doctors in a terrible position. You have
to show a pamphlet produced by the state to the patient and explain
that it is part of the regulation. The conversation I have is that,
'This is what is written in the pamphlet. I disagree with it ethically
and scientifically, but this is what the legislation has forced upon
me.' That's all I can say… If I want to be consistent with the law, I
have to lie."
HEALTH RESEARCH MAY BE STALLED
Before
experts can come up with cures or prevention strategies for complex
sexual-health problems like STDs, researchers have to discover how
diseases are spread, how they change and how they affect people. But in
recent years, religiously motivated activists have interfered with that
research process, arguing that some studies are immoral.
In 2003,
Tooru Nemoto, Ph.D., a public-health expert at the University of
California-San Francisco, was conducting a federally funded study of
sex workers in massage parlors. He wanted to find out what influenced
risky behavior—including why some women chose not to use condoms with
customers.
The study had implications far beyond high-risk sex workers.
"This is a huge public-health issue," Nemoto says, because
massage-parlor workers spread HIV and other STDs to their clients, who
then pass on the diseases to their unsuspecting spouses and girlfriends.
But
unbeknownst to Nemoto, his study caught the attention of the
Traditional Values Coalition, a lobby group that represents more than
43,000 churches. Since the late nineties, the group had been tracking
what has been widely reported in mainstream newspapers and scientific
journals as a "hit list" of government-funded health projects it found
morally objectionable, and, by early 2003, it had given the list to
congressional allies. Nemoto's study was on it.
Once again,
legislators apparently took the bait. After congressional prodding, HHS
began an in-depth audit of Nemoto's project in May 2003 and brought his
research to a standstill. After months of scrutiny, the audit uncovered
no improprieties, but he narrowly missed losing his funding.
HHS
has argued that Nemoto's audit was nothing more than routine. But other
groups and researchers say they, too, have been harassed by seemingly
punitive reviews. Advocates for Youth, a Washington, D.C.-based
research organization that educates teens about topics like drug abuse,
sexual violence and birth control, is still feeling the sting. In all,
the group underwent three government investigations into how it spent
federal money, none of which found any wrongdoing. By the time of the
third audit, James Wagoner, the president of Advocates, recalls saying
to HHS, "Let's call it what it is. This is the third audit in 11
months. This is starting to feel like more than routine attention." He
estimates that the inquiries cost the organization $160,000, money that
could have been spent on programs targeting dating violence or
preventing teen pregnancy.
Such audits, Rep. Waxman said in a
2003 letter to then-secretary of HHS Tommy Thompson, "are creating at
least the perception that [HHS] authority is being abused" for
ideological reasons. To support his assertion, he noted that no
organizations receiving federal money to promote sexual abstinence had
been investigated. (HHS spokespeople never fully responded to Rep.
Waxman's queries, and didn't reply to phone calls from Glamour.)
Many
scientists believe the audits are part of a larger pattern. In February
2004, 62 leading scientists and educators, including 20 Nobel Prize
winners, signed a statement accusing the Bush administration of
"misrepresenting and suppressing scientific knowledge for political
purposes."
No researcher contacted by Glamour said he or
she had been denied funding because of studying sexual issues. But,
says Wood, the former FDA official, NIH researchers now practice an
"internal self-censorship" because of the way politics have invaded
science. The harassment, says Auerbach, the former NIH official, "has
put the chill on people. It makes them think twice about their lines of
research and their own careers. They do not want to have to spend their
lives doing audits. Folks say, 'It is not worth it. I am not going down
this line of work.'"
SCIENTISTS FIGHT BACK
It's
extremely rare for a scientific conference to turn into something more
like a political rally. "Scientists do not normally engage in what is
going on in Washington, D.C., or politics," says Wood. But at the
annual meeting of the American Association for the Advancement of
Science last February, a special conference was added to the agenda to
discuss how politics have invaded the realm of science.
It
quickly became a standing-room-only event, and scientists applauded as
speakers like Wood and Nobel winner David Baltimore, Ph.D., president
of the California Institute of Technology in Pasadena, condemned the
government's interference in research.
Wood was struck by the
overwhelming number of people who attended. "Scientists from across the
country, from all kinds of fields, were there," she says, "because they
care a great deal about how science is done and how data are analyzed
and how the information is used." Why were they finally voicing their
fears? "I think as people become more aware [of the interference in
science], they are willing to step up and say, 'This is not what we
want,'" Wood says.
For a group of researchers, the rhetoric was fiery. Baltimore
accused the Bush administration of suppressing science. And when Wood
said that morale at the FDA had sunk to a new low because of
overwhelming pressure from social conservatives, she got a standing
ovation.
Outside of the halls of science, who are the real
victims of this political maneuvering? "The American public,
particularly American women," says Trussell. "Who's hurt when you can't
get EC over the counter? When there is a suggestion that abortion
causes breast cancer—something that is entirely made up? When it's
suggested that condoms are not effective against STDs, when in reality
they are effective against HIV and even HPV? Women."
But many
women can't imagine how these lies could possibly have an impact on
them, Trussell says. "The first time one of them walks into a pharmacy
and can't get her birth control pill prescription filled, that will
have a wake-up effect. Most won't feel the effects until these rights
are gone—they can't believe there would be a time when these things
would be outlawed. I hope their belief is true, but I'm very worried."
Brian Alexander is a contributing editor to Glamour and the author of Rapture: How Biotech Became the New Religion.
*name has been changed