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Gingrey is a bad doctor, says science

The views expressed are those of the author and are not necessarily those of Scientific American.

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"I’ve delivered lots of babies, and I know about these things" — apparently, Phil, you don't. Photo by CQ Roll Call.

It seems like every time a male republican tries to talk about women, he somehow says something stupid and misogynistic. Last year, Missouri candidate Todd Akin was torn apart for his negligent comment that, when a woman is raped, she needn’t worry about pregnancy because “the female body has ways to try to shut that whole thing down.” Akin was vilified by his own party and lost the election. But then, just when we think republicans might have learned their lesson, former OB/GYN and current congressman from Georgia Phil Gingrey makes an even more careless blunder, calling Akin’s remark “partially right.” He cites his experience as a doctor trying to aid struggling couples, and how he told them “Just relax. Drink a glass of wine. And don’t be so tense and uptight, because all that adrenaline can cause you not to ovulate.’”

I don’t care that Gingrey has since come out with a statement saying he did not mean to say he agrees with or supports Akin’s comment. That’s exactly what he did. Citing his authority as a physician, Gingrey made the dangerous and erroneous claim that rape victims are less likely to get pregnant. When you reference science using your education to create an air of authority, you don’t have the luxury of saying ‘oops’. You get no excuses.

The errors in Akin and Gingrey’s comments are beyond the issue of whether there is such a thing as so-called “legitimate” rape. Even if we overlook the fact that they made the misogynistic assertion that women frequently lie about being raped, they are, in fact, just plain wrong when it comes to the science. Make no mistake: Gingery and Akin’s assertion that rape is less likely to result in pregnancy isn’t correct—it’s not even kind of correct. Rape victims are not less likely to ovulate or get pregnant. They aren’t even equally likely to. They are more likely to.

If you carefully listen to Gingrey’s argument, he makes the assertion that the stress a woman experiences when trying and failing to get pregnant is the same as that experienced by a rape victim. He equates high over all stress—being anxious and nervous throughout a woman’s menstrual cycle—with the acute, immediate stress induced by a violent, demeaning act. This argument is fundamentally flawed. These are not the same—not even close.

As a doctor, Gingrey should be aware of the difference. Stressed individuals like couples desperately seeking a child suffer from high overall levels of serum stress hormones like cortisol, which has consequences throughout the body. I assume that Gingrey was referring to the fact that, in women, periods of prolonged physical or emotional stress can lead to reproductive difficulties. Athletes, for example, will often fail to ovulate, or have irregular menstrual cycles—a condition known as exercise-related female reproductive disfunction—which is thought to be the result of higher overall stress hormone levels from their exhausting regimen and decreased levels of estrogen. So, his advice to struggling couples has merit; relaxing and reducing day-to-day stress may indeed help promote healthy natural cycles, making pregnancy more likely (though his suggestion of drinking alcohol to reduce this stress is way off base).

That said, the stress response elicited by rape isn’t chronic; it’s acute. Rape victims aren’t more emotionally or physically stressed than their peers before their attack occurs. No, what a rape victim suffers is an immediate, strong stress response, more akin to how an animal might react when attacked by a predator.

The difference between the effects of chronic stress and acute stress on reproduction cannot be understated. During chronic stress, serum cortisol levels are elevated repeatedly and for long periods of time, but during acute stress, serum cortisol levels only rise briefly. “There appears to be little impact of short-term increases in cortisol concentrations,” explain scientists in a review of the effects of stress on reproduction. “Many short-term stresses fail to affect reproduction and there are reports of stimulatory effects.” By ‘stimulatory effects’, they mean that acute stress actually seems to have the exact opposite effects of chronic stress: it induces ovulation instead of preventing it.

This makes sense, really, when you consider that Gingrey’s comment that ‘adrenaline prevents ovulation’ is, simply put, flat-out, 100%, dead wrong. I have no idea what he was thinking when he made that statement, because decades of scientific research show the opposite. While high levels of chronic stress may prevent proper development and release of eggs, not only does adrenaline itself not prevent ovulation, it’s required for it. Adrenaline injection even forces ovulation in fish, rabbits, chickens, and rats.

From a biological standpoint, ovulation is caused by the interplay of a number of different hormones. When a woman is ready to ovulate, specialized cells in the brain are stimulated, causing the release of GnRH (gonadotrophin releasing hormone), which further triggers the release of two other hormones—LH (luteinizing hormone) and FSH (follicle stimulating hormone)—into the bloodstream. These, together, induce ovulation. The surge of LH and FSH is so well documented that scientists and doctors can use serum levels of these hormones to track ovulation in animals as well as in humans.

Lots of animals ovulate when acutely stressed. In sheep, ewes spontaneously ovulate when they are stressed by transport or medical treatments. Similarly, female fish exposed to an acutely stressful event were 9 times more likely to ovulate within 72 hours. Acute stress can cause surges in FSH and LH that could induce ovulation in species ranging from rats to monkeys and even people, especially if a female is near ovulation to begin with. Not only does stress cause LH levels to rise, the worse the stress, the more they rise. This led scientists to conclude that women “may be induced to ovulate at any point of the menstrual cycle…if exposed to an appropriate acute stressor.”

It’s likely that stress-induced ovulation is mediated by increases in stress hormones. While long-term rises in cortisol can prevent ovulation, artificially increasing stress hormones by injecting animals with cortisol kicks the ovulation mechanism into gear early, increasing LH release. Adrenaline plays a key role, too. If you block adrenaline synthesis or deplete adrenaline, the surge in LH required for ovulation is suppressed, and ovulation is prevented.

I don’t want to scare you: none of what I just told you means rape guarantees ovulation. The duration of elevated stress hormones, timing in regards to a woman’s natural cycle, intensity of the stress response and even just innate physiological variability between women can all affect how a woman’s reproductive system responds to stressful events. Furthermore, not all rape victims react the same way (emotionally or physically) to what happened to them, and these differences will affect how their body responds. But contrary to Akin and Gingrey’s assertions, science suggests that rape victims have every reason to worry about pregnancy.

Given the connection between acute stress and ovulation, it shouldn’t come as a shock that that the odds of getting pregnant from rape are significantly higher than from consensual sex. Read that sentence again. I really want this to soak in. You are more likely to get pregnant if you are raped.

The science that stands behind that statement is strong. For a while, scientists debated whether it was true. You can’t just compare the pregnancy rates from raped and unraped women because there are many factors involved, including birth control use, number of intercourse events, and the rate of rape reporting if conception doesn’t occur. But recent studies have taken into account these confounding variables, and the result is crystal clear. Based on real data on pregnancy in the United States, they estimate that percentage of pregnancies resulting from forced intercourse is around 8%—significantly higher than the 3% that result from single episodes of consensual sex.

Gingrey is just wrong on all accounts, and so is Akin. There is no evidence to support the role of adrenaline-mediated prevention of ovulation due to rape. There is no science to support their insinuations that, somehow, rape victims are less likely to get pregnant. Their statements directly contradict reproductive science, and serve only to demean women who have already undergone a terrible atrocity. There is simply no excuse for such blatant ignorance and thinly-veiled misogyny, especially coming from the mouth of someone claiming to ‘know about these things.’

Republican war on women, by Eclectablog

Here’s a tip for the GOP and republicans in general: stop citing biology to defend your misogynistic positions. At least stop claiming things to be true without a cursory look at the literature. It’s not hard to look these things up, boys, and you have a team of assistants to do such things for you. When you flap your lips without even the slightest clue as to what the science actually is on the subject, you look stupid at best. I’d say stop talking in general, but I think it’s good that the general public sees your positions for what they really are. On second thought, ignore my advice: keep on trucking. The baseless, unscientific lies that you tell will only serve to strengthen the people who run against you.

Christie Wilcox About the Author: Christie Wilcox is a science writer and blogger who moonlights as a PhD student in Cell and Molecular Biology at the University of Hawaii. Follow on Google+. Follow on Twitter @NerdyChristie.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. ChrisSciAm 2:33 pm 01/14/2013

    Kudos for pointing out such an idiotic assertion. While there is unquestionably a contingent of GOP members that are misinformed and misogynistic, it seems unfair to blame the entire political party for such ignorant statements. A few data points, regardless of how loud, offensive, and notable they are, can’t be a sound basis for such a broad generalization.

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  2. 2. RSchmidt 3:13 pm 01/14/2013

    “The baseless, unscientific lies that you tell will only serve to strengthen the people who run against you.” wow, did I write this article? Excellent straight talk Ms Wilcox! I agree that it is hard to have a civilized conversation with those who speak with deliberate disregard for the facts in order to advance their agenda. Sometimes you just have to put knee to groin.

    I see the current christian assault on women’s reproductive rights as just another salvo in the 2 thousand year war between men and women for power over the community. The creation and spread of monotheistic religions was a coup d’état by recently “civilized” men to usurp power afforded to women by earlier pagan religions. Just as monotheists used former pagan symbols such as the pentagram and goat as their symbols for evil, they depicted the former power base, women, as the cause of man’s fall from grace. By vilifying women, man could justify enslaving them. So this is just an extension of a world view created thousands of years ago. No surprise to find it alive and well in the minds of the GOP.

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  3. 3. SteveO 3:18 pm 01/14/2013

    Great article.

    You might want to capitalize “Republican” in the first sentence. You are referring to the political party, not the philosophy.

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  4. 4. Unksoldr 4:37 pm 01/14/2013

    Gingrey is an idiot good ole boy from Georgia so course he’s stupid. That from a fellow Georgian.

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  5. 5. RSchmidt 5:33 pm 01/14/2013

    @ChrisSciAm, “it seems unfair to blame the entire political party for such ignorant statements”, It would be unfair if they were isolated comments by radical or senile fringe members, but these comments come from GOP ideology about the role of women in society. They may be extreme expressions of those beliefs but they are never-the-less what the GOP believe and what they base their policy positions on.

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  6. 6. LarryW 6:50 pm 01/14/2013

    Isn’t clear now the many medical schools are no more than diploma mills?

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  7. 7. ChrisSciAm 7:42 pm 01/14/2013

    @RSchmidt – That’s a valid point, however I think there’s a difference between the 1940′s “Men as bread winners and decision makers” sort of view that the GOP tends to cling to and statements like these that trivialize rape or imply that rape victims are lying. Regardless, I feel it’s best practice to place blame on individuals rather than groups or ideologies. In doing so, you at least leave the door open for future discussion rather than inciting hatred on both sides.

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  8. 8. RSchmidt 10:03 pm 01/14/2013

    @ChrisSciAm, “I feel it’s best practice to place blame on individuals rather than groups or ideologies.” I would agree with you if it weren’t for the fact that this group is based on mutual ideology. And we are not talking about ’40′s sexism, we are talking about Republican ideology based on a fundamentalist interpretation of the bible. If you don’t believe me please look it up. So while it would be wrong to say that because these men are white that all white men believe what they do, I think it is perfectly valid to suggest that a man representing the Republican party, making sexist statements that are in agreement with Republican ideology is a bad reflection on the Republican party. I also find it ironic that the party of systemic racism and sexism is being defended by someone saying that we shouldn’t judge someone by the group they have chosen to be a member of when the republican party judges people by the groups they had no choice to be members of. But I guess I am just one of the 47% of the population the Republicans don’t have to worry about.

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  9. 9. engineer238 10:14 pm 01/14/2013

    This article would be great if it were not targeted at GOP and simply made the point that many men do not understand their female counter parts. There is no GOP war on women. Now while I do not condone stupid comments by these men or any republican, I do think that this article has an unfair bias towards republicans. Being a republican supporter I can tell you that most of us are not misogynist and actually are supportive of their women’s careers and goals. There are just as many misogynist following the democratic party as there are in the republican. I’ve known democrats who treat women like play things or even believe their women should “make me a sandwich women”. I’ve listened to the democratic supporters rip apart republican women just because they are women, and then as in this article ignore the fact that there attack was misogynistic. Misogyny is not some horrible character flaw that only republicans can have simply because you don’t like them. Any man whether he be democrat or republican can be a misogynist. The political discussion presented in this article really has no place in Scientific American. If you want to right a piece on how evil the GOP is then write for MSNBC; if you want to keep the article about the science of rape then leave out the political agenda including the cartoon.

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  10. 10. RSchmidt 8:17 am 01/15/2013

    @engineer238, it is true that there are misogynists in all political parties. The difference is the GOP have it codified in their ideology. The term “war on women” by the GOP “refers to legislative initiatives regarding the following: access to reproductive health services, particularly birth control and abortion services; how violence against women is prosecuted; how rape is defined for purposes of public funding of abortion for rape victims; how workplace discrimination against women is treated; and litigation concerning equal pay for women. The term is often used when targeting policies that reduce or eliminate taxpayer funding for women’s health organizations, like Planned Parenthood. Other areas of concern include public funding and mandatory employer insurance coverage of such matters as contraception and sterilization.” So we are not talking about the opinion of a few fringe fanatics. We are talking about policy positions of the GOP. In that regard it is very appropriate to target the GOP in this article.

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  11. 11. engineer238 12:20 pm 01/15/2013

    The vast majority of women to do not require birth control for medical reasons, only a fraction of a percent do. As such there is no logical reason that birth control should be covered by health insurance with the exception of medical need. The cost of birth control is also extremely low often about around $100 a year if the dose strength only need regulate menstruation. Covering birth control for reasons of preventing pregnancy would imply that we should also cover condoms on birth control. Be very careful when you say “women’s right”. Everyone has the right to birth control, not the right to have someone else pay for that birth control; no more than a man has the right to make someone else pay for his condom. As for abortion that is a tricky issue. While it is true that in any type of rape case consent cannot be made in any other situation a woman was capable of consenting. Liberals often talk of “pro-choice”, well in reality, with the exception of rape, every pregnant woman chose to take a risk and engage in an activity that ultimately led to their pregnancy. Therefore, the mother’s rights are secondary to the rights of the developing human. There might be a cutoff at which we could set the definition of being human; but the point still remains, the mother made the choice. Exceptions to abortion might be made in cases of rape or when the child and/or mother will not survive; however, mortality during birth today is much lower than it has been before medicine. The reason for this move to de-fund “planned parenthood” is that there is a sigma that instead of focusing on services to teach parents how to plan their pregnancy using contraption, they focus on abortion. There is also resistance by those who do not believe that their tax payer money should be used to support an activity for which they do not believe. Now while these may not be completely fair assessments on the part of the GOP, some of the blame rests on Planned Parenthood for not doing the proper PR to inform the public on what there goals are. Planned Parenthood must make sure that people know that they cannot allocate federal funding for abortions. Doing this the only remain issue would be whether to fund Planned Parenthood due to their political lobbying or whether that should be banned from doing so. There is a conflict of interest in allowing a government affiliated organizations to lobby for federal legislation and action.

    The treatment in the workplace is not a GOP platform. What the GOP wants to see is that we work as a society to treat all people the same, not that we create legislation that intentionally benefits particular groups. You will find that the vast majority of the GOP supports the idea that women should be paid equally to men, but do not think that we should legislate it. Do not confuse the GOP’s ideological resistance to the idea of any legislation with racism or misogyny. It may be difficult to understand, but a common theme of being in the GOP is that for the most part we think that you should be a good person on your own, not for forced to be so by the government.

    There is nowhere I aware of in the GOP platform that says women are inferior or deserve to be paid less or even should be denied access to birth control. The GOP does however, believe that women are equal to men and that if you want birth control you can pay for it yourself. Most GOP women also agree with this assessment. The mistake people often make with the GOP is that they wrongly assume that the idea of personally responsibility is an act of discrimination on a particular group. Your assertion that the GOP believes, and contains within its platform misogynistic views is wrong. I doubt that you have even read the GOP platform, and such you are in no position to claim any knowledge of what the party does or does not believe. What you are doing here is simply perpetuating propaganda. Until you and the author have actually read our platform you are not justified in determining the appropriateness of an attack on the GOP in Scientific American. I will also reiterate the point that this is Scientific American, a place for science not partisan politics. As such, while the complaints against the GOP would be well placed elsewhere, they do not fall within the purpose and mission of Scientific American. This is a place for science not politics.

    From the GOP platform:
    “No healthcare professional or organization should ever be required to perform, provide for, withhold, or refer for a medical service against their conscience. This is especially true of the religious organizations which deliver a major portion of America’s healthcare, a service rooted in the charity of faith communities. We do not believe, however, that healthcare providers should be allowed to withhold services because the healthcare provider believes the patient’s life is not worth living. We support the ability of all organizations to provide, purchase, or enroll in healthcare coverage consistent with their religious, moral or ethical convictions without discrimination or penalty. We likewise support the right of parents to consent to medical treatment for their children, including mental health treatment, drug treatment, and treatment involving pregnancy, contraceptives and abortion. We urge enactment of pending legislation that would require parental consent to transport girls across state lines for abortions.” i.e. GOP accepts abortion in its platform.

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  12. 12. all4kindness2all 1:32 pm 01/15/2013

    I think we all would stop saying “republican” when republicans stopped voting fringe fanatics into state and federal government. If you really don’t see yourself agreeing with fringe fanatics, stop voting them into office.

    Paul Ryan just cosponsored another “personhood” bill that protects a couple of cells over the health and well-being of a women. Many of the GOP dominated state legislatures have been defunding planned parenthood which is the best access to quality health for low income women.

    What I can’t understand is why so-called republicans who do not see themselves as fringe want the government to interfere with women’s health choices or to stop women from having insurance that covers birth control. If you don’t want to use it, you don’t have to. Much like viagra, it should be covered. It’s cheaper for insurance companies (and society) to cover birth control than to cover the pregnancy and resulting health costs of the children that would otherwise be created.

    The morality of religion on personal life choices is something you teach, not something to be imposed by laws and regulations.

    The idea that taxpayer money should not go for things you don’t agree with is plain and simply – dumb logic. Not all the policies are relevant to us. In a free society, we don’t dictate others life choices. The aim is for each of us to make our own freely – if you believe in freedom that is.

    And BTW engineer238 is an example of why “republican” is used over fringe fanatic. I find it appalling that there are men that feel pregnancy is only a woman’s problem and responsibility since it takes sex with a guy to get pregnant. Women don’t do that on their own.

    What I love about this article is that I learned something new – that rape victims may be more likely to end up pregnant. From that point of view, I think Plan B should be much more accessible and birth control as well.

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  13. 13. ChrisSciAm 2:45 pm 01/15/2013

    “What I can’t understand is why so-called republicans who do not see themselves as fringe want the government to interfere with women’s health choices or to stop women from having insurance that covers birth control.”

    Many of them don’t. There’s a significant number (but not majority, obviously) of socially liberal republicans (Republican majority for choice, Log Cabin republicans, GOProud, etc) who are being lumped into a stereotype and directly attacked by articles like this and moderate candidates that they otherwise might agree with. Sweeping generalizations about such a large, diverse population is frankly just silly.

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  14. 14. julianpenrod 3:26 pm 01/15/2013

    This may cause this not to be printed or to be removed, but the fact that Christie Wilcox has to write “Republican” with a lowercase “r”, a demonstration of wholesale pettiness, says a great deal about the rest of what she says. Deliberately miswriting a name for the purpose of low class malingering is becoming more and more commonplace. God haters have been doing it for some time, insipidly writing the name of God, the Supreme Being, with a lowercase “g”. And, yes, it is insipid. The name of God is recognized as a proper noun, so writing it with a lowercase initial is against English. And, consider, what good does it do? It doesn’t promote an argument, it doesn’t derive a fact, it only allows a small, petty individual who, frankly, really knows there is a God, but hates Him for not answering mawkish whims, to express that hate.
    There is not reason to believe something similar doesn’t direct Christie Wilcox to violate English and write the established name of a political party deliberately incorrectly.
    It’s not a “misogynistic assertion” to say that women frequently lie about being raped. Just consult records in any police department.
    And Ms. Wilcox uses the “argument” that stress hormone levels are high only immediately following a rape. That constradicts the testimony of long standing nightmares, fears, sensitivities commonly to the point of nearly universally cited in cases of rape!
    And, note, too, the craven technique of “arguing” a point by “arguing” something else entirely. Talking about rape not causing a woman to get pregnant or even preventing it, does not address only ovulation! Nothing said it’s only ovulation that is prevented by the after effects of rape. The simle survival of semen or their ability to penetrate an egg can be affected, we all! But not Ms. Wilcox’s careful refusal to address that part of the issue, because she can’t! She will only talk about the sole facet of preventing ovulation!
    Note, too, her emphasis referencing science “using your education to create an air of authority”. Frequently, I pointed out that “scientists” sell hogwash that, five years later, would be disproved, to the public using their “credentials” and “position” as “proof” that what they said could be trusted. Often, if not always, I was told that that’s not what they do. Yet, here, when carefully aiming it to promote her own agenda, Ms. Wilcox says the same. And how many addressed that?

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  15. 15. RSchmidt 7:31 pm 01/15/2013

    @julianpenrod, you’ve gone off your meds again. You know you are not helping anyone when you let yourself get this way.

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  16. 16. RSchmidt 7:45 pm 01/15/2013

    @ChrisSciAm, “There’s a significant number (but not majority, obviously) of socially liberal republicans” then perhaps you or one of the few other socially liberal republicans need to create a new party. But if you are claiming we shouldn’t judge a group by it ideology, when that group’s soul purpose is to advance that ideology, then I think you are the one being silly.

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  17. 17. tempedan 12:20 am 01/16/2013

    Mr. Penrod, I must thank you for your entertaining publication.

    Perhaps as time passes you will learn add value as well.

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  18. 18. engineer238 12:59 am 01/16/2013

    @all4kindness2all I did not say that pregnancy is only a woman’s problem. I said that a woman who was not raped made a conscious decision to engage in a risky activity that can lead to pregnancy. This does not, however, relieve the man of the responsibility, as it takes two to get pregnant. If you actually read what I wrote I simply pointed out that many republicans believe that a woman who got pregnant out of consensual action already made their choice, and then should take responsibility for that. Personally I do not think it is the government’s right to tell you what you can and cannot do with your body, so long as there is a reasonably scientifically defined window when a woman can get an abortion. This definition should be in place such that a developed fetus is not aborted. Both men and women need to take responsibility for their actions. If you engage in intimacy there is a risk you will get pregnant. If you do then it is the responsibility of both parties to care for the child. Honestly many republicans, like myself, would prefer people have some self-control and keep it in your pants. I mean honestly life is not just about personal indulgence and pleasure. Maybe both men and women should be more selective about with whom they have children. Whether you be a man or a woman, if you meet someone that you don’t think would be a good parent and that you don’t think you can have a long term relationship with, then don’t go to bed with that person. Abortion would not be necessary outside of very specific circumstances if we would all have some self-control. It is becoming too easy to justify having abortions, such as “I don’t like the father”, “It will interfere with my career”, “I have too many kids already”, “I don’t have the money to take care of a kid right now”, “I’m too young”. Well whether any man or woman wants to here it, you cannot have your cake and eat it too. If you want to indulge yourself there are consequences for which you must take responsibility. If you are woman and get pregnant through consensual activity then you now have a responsibility to birth and raise that child the best you can. If you are man and you impregnate a woman then you darn well be there for that child; that is your child and you have just as much responsibility as the mother to care for and raise that baby. Like you I believe that women should have access to birth control and plan B. In fact many women just choose not to use it, and many who do not probably should. I do not however that insurance should pay for birth control for the purpose of preventing pregnancy anymore than it should pay for condoms. Honestly depending on how active you are condoms and birth control cost about the same a year. If you are going to be safe well it costs money. Honestly if you and your partner do not want to get pregnant then the man should wear protection whether or not the woman is on birth control (message to all you other men out there). As for you all4kindness2all, don’t put words in people’s mouths and imply I’m a misogynist. You can be appalled all you want, but you simply created ideas and messages I did not make. All republican men I know feel the same way on personal responsibility for both men and women. Men and women are responsibility for pregnancy, and should make decisions and deal with the consequences together, no one gets a free pass.

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  19. 19. engineer238 2:15 am 01/16/2013


    About your comment about viagra, you are right in the instance where the woman needs it for a medical condition that requires it. ED is a medical accepted bodily dysfunction affecting primarily part of the population of older men, and as such there is a justifiable reason to have it covered by health insurance. Some women also have medical conditions that require them to have birth control to regulate their period. These women should be able to have health insurance cover the cost.

    There is a good reason you should not cover bc for a non-medical reason and it has to do with how insurance companies work. Insurance companies do not necessarily make their money all off of premiums they must invest. Well if you have payout to a large portion of your base then you don’t have time to invest that money and make any returns. If you conservatively assume that only 20% of women between 18-50 (20% of ~70million) take advantage of insurance covered bc it cost about $33 a month on average it would cost the health insurance industry $5.5billion dollars just to cover the medicine. They must now pay for the cost to process the claim to which we could add a couple of dollars per claim bringing the total to about $5.8billion. Health insurance companies are then required to keep cash on hand, so if they are not allowed to raise rates to accommodate for the payouts then they must dip into what would have been revenues. Ultimately this money would come out of either investment or wages. If it comes out of investment, and we assume that the company is decent at investment then they could reasonably have received $600million from that money. This brings the total cost to the insurance pool of $6.4billion which means the cost for the health insurance company to give you bc increases the cost of bc by around 15%. Well if you now let them raise premiums to compensate for the bc then they either have to put access to bc on a premium plan or distribute it over the entire system. The cost to provide bc at a regular interval of one month prevents any reasonable return on investments so the increased cost of bc is still higher. If bc is then added to a premium health insurance plan then you or your employer now pay more for bc. These increased cost will then come out of wages/salaries so you take home income won’t be much different than if you simply just bought your own bc. If the cost is instead spread out over the system then you are slightly raising rates of everyone. Now $3.3 billion dollars, or even $16.5 billion dollars if all women get free bc, doesn’t seem like much the profit margin of the health insurance industry is already less than 5%. If health insurance companies saw profitability in covering bc they would. The company already covers some cost of visits to the gynecologist depending on your provider and coverage.

    I think there is a misconception about insurance in this country. Insurance is NOT a right. It is NOT a privilege. It is a PRODUCT. What you are buying with any kind of insurance is peace of mind and security. Insurance works by weighing the risks that something bad MIGHT happen in a to you given period (usually a year) and the charging you a fee based on that risk. If that undesirable thing happens to you the insurance company then pays you the money to cover the cost. Insurance is not intended to pay for something that will happen to you at a certain time. Insurance may also take advantage of the law of large numbers, using a large sample of people and taking the probability that something will happen to a certain proportion of those people. Insurance requires a degree of randomness in the population. For instance nearly all women will menstruate; however, only some women require bc for medical reasons. As such statistics would dictate that the chances of having to pay for bc given that you menstruate is high, but having to pay for bc given that you require it to function is low. Again insurance is a product not a right. If you want your insurance company to cover something than you need to pay them in a way that is profitable to them. If the risk is high then you should pay a high rate. The problem as I explained before with bc in particular is it is not only a large portion of the population but also high frequency. Forcing this by law would be analogous to requiring that car insurance companies pay for oil changes. Every car gets an oil change about every 6 months, but they don’t cost a lot. Even so, every time the insurance company would take in money they would be paying part back out for oil changes. This creates a large cost that they must pay at a fixed frequency. There are very little statistics in both the payment frequency and population. If we wanted the car company to pay for oil changes then we would have to higher premiums, these premiums could very well even result in us paying effectively more than the cost of the oil change, especially considering that the cost of oil changes can vary by shop and location. This might seem like an absurd analogy but it matches the case of bc. Now there is an argument that providing bc could save health insurance companies money in the future on birth and pregnancy; however, insurance companies are not stupid and if it were that simple to implement they would. Likely the insurance company prefers the increased premiums from adding new family members to the plan instead of prevention.

    This said, still don’t get me wrong, I do think that women should have access to bc but insurance companies should not be forced to front the cost. If a woman cannot afford birth control, which seems unlikely since the cost per year is between $160-600 a year well then some tough choices should be made. The same should be said for men. If a man cannot afford a condom then he also needs to make a tough choice. In a committed relationship it is completely reasonable for a woman to require a man to help pay for her birth control if that is the preferred method of protection. Both parties have a stake in the protection so it is fair to share the cost, but that is a discussion that each individual couple must have. If not having “free” bc is not adequate for you then you are certainly free to start an organization to provide free bc for women who need it. In fact I would encourage you to do this. You would be doing a great service. There are many people out there, both men and women, who would donate. You could start a non-profit and make it a life long cause. Doing this would be much more effective than legislation.

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  20. 20. ChrisSciAm 11:53 am 01/16/2013

    @RSchmidt: “then perhaps you or one of the few other socially liberal republicans need to create a new party”

    In an ideal system, you’re completely right. Political parties should be unified on all issues. Unfortunately it is the nature of a two party system to have a large degree of variance within a political party, and internal disagreements about almost any given issue. This simple point is the only one I have been trying to get across.

    So to summarize, I feel that not all republicans fit the stereotype portrayed in this article. You feel (I think, don’t let me put words in your mouth) that the article accurately illustrates members of the GOP, and that if members don’t fit the illustration here then they aren’t really republicans. And with that, I think we’ve hit an impasse. Cheers for sharing your point of view, it’s been interesting.

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  21. 21. julianpenrod 3:03 pm 01/16/2013

    I pointed out before that those who support the lie know they cannot depend on it to provide materuial to counter criticism. Therefore, they rely on non argument methods, such as non validated dimissiveness, arrogance, contempt, viciousness, mockery, vulgarity. In fact, to engage in these rather than address points made or admit they can’t be addressed is all but to admit that one is acting unethically and unscrupulously. That is precisely the case with RSchmidt and tempedan. No contradictions to what I said, merely dismissiveness, contempt, mokcery. This may cause this not to be printed or to be removed, but, that is apparently both because they cannot contradict what I said and they don’t possess the ethics to admit it.

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  22. 22. all4kindness2all 6:40 pm 01/16/2013

    engineer238 – hmmm – According to your logic we should not be covering diabetes and other diseases that is caused by obesity cause that’s certainly within a person’s realm of choice, nor should we cover lung cancer caused by cigarette smoking etc… BTW, freedom means others get to live according to how they want ie their morality, not yours, because while you or I may not live as others choose, I don’t believe it’s my right to dicate how others live nor is it my business either.

    Christie – this is a great article and thanks for the science on this issue.

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  23. 23. cccampbell38 4:14 pm 01/21/2013

    Bill Clinton was recently quoted as saying something like “You have to love Republicans. They don’t let evidence or facts get in the way of their thought process”.

    Actually, there seem to be a LOT of people who are unimpeded by a clear, rational, fact based reasoning process.

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