Doctors, Just Ask

Reproduction coercion, a term used to describe tactics men use to control the reproductive lives of their partners, is very common in relationships that involve violence. Coercive tactics can include forcing women to have sex or perform sex acts they find distasteful, refusing to use or interfering with the use of contraceptives, forcing women to carry unwanted pregnancies to term, or forcing women who would choose to carry a pregnancy to term to have an abortion. Reproductive coercion is present in the lives of many teenage girls who become pregnant.

A new study reveals that all doctors and other health professionals need to do to reduce the prevalence of reproduction coercion is to ask women about it.

In two of the clinics, women patients were asked whether their boyfriends had pressured them to get pregnant (for instance, by threatening to dump them if they didn’t get knocked up). Clinic workers also asked patients whether their boyfriends had sabotaged their birth control (such as by breaking condoms on purpose or hiding birth control pills).

In the two comparison clinics, patients were treated as usual.

Three to six months later, researchers followed up with all of the patients to see if they had been coerced into getting pregnant. Among women who were recent victims of intimate partner violence, the patients who were asked about pregnancy coercion and birth control sabotage were 71% less likely to become pregnant against their will, according to the study. They were also more likely to break up with their boyfriends – 52% of them did, compared with 45% of their counterparts who were treated at the clinic where pregnancy coercion and birth control sabotage weren’t discussed.

The results were published online this week in the journal Contraception.

The researchers speculated that the higher rate of break-ups contributed to the lower rate of unwanted pregnancies. The findings suggest that educating women about pregnancy coercion and birth control sabotage can empower women to get out of unsafe relationships.

If all it takes to reduce the rate of reproductive coercion is talking about it, please talk about it! Talk about it with your doctor or other healthcare providers and encourage them to contact their local domestic violence agency for tips on discussing it with their patients. Or, if you are a healthcare provider, please begin asking the question and have the phone number or pamphlet of your local domestic violence advocacy agency close at hand for those who need it. How could you justify not doing something so simple that can have such an impact on a woman's life?

Where Domestic Violence Comes From

Today in the New York Times, Maureen Dowd paints a disturbing picture of the culture that produced George Huguely V, the Virginia lacrosse player who has been charged with murdering his girlfriend Yeardley Love.

It was set up like a fantasy football league draft. The height, weight and performance statistics of the draftees were offered to decide who would make the cut and who would emerge as the No. 1 pick.

But the players in this predatory game were not famous N.F.L. stars. They were unwitting girls about to start high school.

A group of soon-to-be freshmen boys at Landon, an elite private grade school and high school for boys in the wealthy Washington suburb of Montgomery County, Md., was drafting local girls.

One team was called “The Southside Slampigs,” and one boy dubbed his team with crude street slang for drug-addicted prostitutes.

The young woman who was the “top pick” was described by one of the boys in a team profile he put up online as “sweet, outgoing, friendly, willing to get down and dirty and [expletive] party. Coming in at 90 pounds, 5’2 and a bra size 34d.” She would be a special asset to the team, he noted, because her mother “is quite the cougar herself.”

Before they got caught last summer, the boys had planned an “opening day party,” complete with T-shirts, where the mission was to invite the drafted girls and, unbeknownst to them, score points by trying to rack up as many sexual encounters with the young women as possible.

“They evidently got points for first, second and third base,” said one outraged father of a drafted girl. “They were going to have parties and tally up the points, and money was going to be exchanged at the end of the season.” He said that the boys would also have earned points for “schmoozing with the parents.”

His daughter, he said, “was very upset about it. She thought these guys were her friends. This is the way we teach boys to treat women, young ladies? You have enough to worry about as a 14- or 15-year-old girl without having to worry about guys who are doing it as sport.”

Another parent was equally appalled: “I think the girls felt like they were getting targeted, that this was some big game. Talk about using people. It doesn’t get much worse than that.”

This would have been the perfect time for an intervention. If the school had taken this predatory behavior toward women seriously enough and the boys had seen a meaningful consequence for their actions, this could have been a turning point. Men can be shown how their behavior negatively impacts the women in their life, and they can be persuaded to change. However, some of the parents don't think the boys were sufficiently punished. By not punishing young men when these mindsets and behaviors are discovered, we are telling them that punishment is not warranted and that what they did wasn't all that bad.

Maybe, to some, this wasn't all that bad. But this is just the early stage of a man seeing women only as sexual objects to be obtained, not as partners with feelings of their own. If a young man continues down this road of not seeing women as full people, something much worse could happen.

A gunman who shot and killed his wife and three other women at a South Florida restaurant before committing suicide was the half-brother of former baseball star Orlando "El Duque" Hernandez.

Police said the shooter bypassed at least two men when he fired at the women inside. Three women were hospitalized in critical condition, Hialeah police Detective Eddie Rodriguez said.

"He went straight for the women," Rodriguez said.

Four women are now dead, and three others are injured in what is only the most recent in our nation's history of gender-motivated mass murders.

This time it was Gerardo Regalado, half-brother of former baseball star Orlando “El Duque” Hernandez, and the crime took place in South Florida. Last year it was George Sodini in Collier County, PA, who opened fire in an all-female aerobics class in an act of misguided revenge for a sexually frustrated existence. Before that, it was Cho Seung-Hui, the mentally unstable stalker of women at Virginia Tech, who ended up being responsible for the worst school shooting in U.S. history. In 2006, it was the school shootings in Amish country and in Colorado’s Platte Canyon. And in 1998, it was the murder of four elementary school girls and their female teacher in Jonesboro, AR.

I am sick to death that I have to keep writing some version of this same article or blog post on loop. But I have to, because in all of these cases, gender-based violence lies at the heart of these crimes — and leaving this motivating factor uninvestigated not only deprives the public of the full, accurate picture of the events at hand, but leave us without the analysis and context needed to understand the violence, recognize warning signs, and take steps to prevent similar massacres in the future.

Those steps are exactly what parents of the girls targeted by the Landon boys were advocating. They wanted the predatory mindset punished early. They took it seriously because they saw the negative impact on their daughters. The family and friends of the women murdered and injured in Florida will be taking the punishment of predatory behavior seriously, because they have also seen the negative impact. We take it seriously, because we see its impact every day. Won't you take it seriously, too?

How It Should Be Done

Recently we posted about the baffling (to us) phenomenon of targeting all prevention of violence against women toward women instead those who are the primary perpetrators of that violence (men). Several groups in New Zealand agree with us, and have come up with a wonderfully logical response to sexual assault prevention:

Rape educators want to train New Zealand's bar staff to intervene when they see "predatory males" plying women with drinks during the Rugby World Cup.

Rape Prevention Education (formerly Rape Crisis) has teamed up with the police, Accident Compensation Corporation and the hospitality industry to train 130 bar staff in Auckland and Wellington in a pilot programme this year.

Director Kim McGregor said she hoped the other agencies would help to extend the programme nationally in the lead-up to the World Cup, which kicks off in September 2011.

"We need to do much more on prevention and social attitudes, for example around the [Cup]," she said.

"For us it's an opportunity. We have two years to prepare for it."

The programme targets bars because three-quarters of sexual offenders and half of all "date rape" victims were drinking or taking drugs before offences occurred.

A fifth of sexual violence happens in or around licensed premises.

Bars already have "host responsibilities" under the Sale of Liquor Act, which imposes fines of up to $10,000 on managers who allow anyone to become intoxicated on their premises or supply liquor to anyone who is already drunk.

Dr McGregor said staff also needed to be aware of the sexual risks for heavy drinkers.

"We are teaching bar staff how to keep patrons safe - identifying predatory males, and being aware of the consent laws," she said.

"They don't understand that it's rape if you have sex with someone who is so stupefied by alcohol or drugs that they can't give consent.

"For some bar staff there's an attitude that if a woman goes home with a guy drunk, she deserves all she gets. But they can stop giving people drinks when they're drunk, and they can be offering free water in between drinks and putting [out] nibbles and snacks."

Programme co-ordinator Kylie Tippett said the workshops trained bar staff to watch out for "red flags" such as patrons being sexually harassed, being plied with double or triple drinks or drugs without their knowledge, simply getting drunk very quickly, or leaving the bar with no way to get to their next destination safely.

She said security staff could approach offenders and say, "We have noticed your inappropriate sexual behaviour towards women or men this evening. We don't tolerate harassment on these premises - either stop or you'll be asked to leave."

Or: "We notice that you are buying large quantities of alcohol for another person. It's our policy that we check that the person is not intoxicated and is aware of what they're drinking."

She said one of the biggest problems raised in the workshops was what to do with people leaving the bar drunk and unable to get home safely.

"They may tell people where the nearest taxi stand is, or some bars know taxi companies and use those, and some felt quite comfortable calling police and said they had a great response in those situations," she said.

She plans to talk to taxi companies and other agencies about a possible voucher scheme for people at risk who did not have any money for a taxi.

"There would need to be all sorts of training required. We'd have to check that they were not being misused."

Some bars wanted posters stating policies such as: "We do not tolerate sexual harassment or aggression. If you are concerned with any patrons, do come to us and we'll deal with it."

"We've been asked to develop some posters," Ms Tippett said.

Hospitality Association operations manager Scott Necklen said the pilot programmes were successful and the industry would support further workshops. "We are supportive of initiatives that give hospitality staff practical strategies to ensure patrons' safety and ensure patrons have a happy and enjoyable night out."

This is the way prevention should look.

British Schools Teach DV Prevention

Jezebel has a great article on a plan in British schools to teach all kids about dating violence prevention:

British schools are planning classes to teach kids ages five to fifteen about preventing domestic violence — but some parents' groups aren't happy.

The classes were inspired by research that shows one in four teenage girls are hurt by a partner, and a third of girls in relationships are victims of unwanted sexual activity. Despite these statistics, only half of girls receive any sort of education about domestic violence. To remedy this, beginning in 2011 schools will teach students about healthy relationships and the unacceptability of abuse.

An unnamed contributor to the plan says that the classes would be separate from sex education:

It's nothing to do with teaching them how to put a condom on. It's about teaching boys not to be violent and girls that being a sex object isn't the only way to be validated.

Schools minister Vernon Coaker says the classes will be "age appropriate." Rather than being taught about romantic relationships, younger children might learn not to bully or call names. Christine Barter, a researcher in the area of teen violence, says what's especially scary is that teenage girls keep this violence to themselves. Classes starting at a young age might encourage them to seek help when they need it — and might teach them that violence is unacceptable and should be reported. But not all parents are behind the measure.

Margaret Morrissey, of the group Parents Outloud, says, "This political correctness is turning our children into confused mini-adults from the age of five to nine." Nick Seaton, of the Campaign for Real Education, concurs:

Youngsters should naturally know not to do these sort of things and must be called to account if they do. But teachers have enough to do in teaching English, maths and science to a reasonable level without addressing issues that parents should be dealing with.

Teaching young girls to report abuse and rape — and teaching boys not to commit these acts — is hardly mere "political correctness." But Seaton's criticism echoes an age-old debate about education that goes beyond "English, maths and science" — what should schools teach, and what is the province of parents? In this case, it's unfortunately untrue that "youngsters naturally know" not to abuse each other. And since violence is still so widespread, it doesn't appear that parents "naturally know" how to deal with it either. Parent-child relationships are complicated by a lot of emotions and expectations — parents may feel, for instance, that their son would never hurt a girl, or that their daughter would never stay in an abusive relationship. Teachers may be able to take a more dispassionate approach, especially since they will undergo special training before teaching the new classes. Ideally, all parents would teach their kids never to commit domestic violence, and to speak out immediately if they suffer it. But teenagers aren't getting this message, and school may be a good place to fix that.