Immigrant Women, Seeking Status Adjustment, Face Forced Vaccination

From RH Reality Check by Jessica Gonzalez-Rojas and Emily Alexander.

This July, the U.S. Citizenship and Immigration Services (USCIS) announced new requirements, including five new vaccinations for individuals seeking adjustment of immigration status. One of these vaccinations is Gardasil, the human papillomavirus (HPV) vaccine. Gardasil, manufactured by Merck, is the only HPV vaccine in the U.S.--also the most expensive vaccine on the market and the only vaccine to be approved for use in only one sex. The CDC's Advisory Committee on Immunization Practices (ACIP) is the only federal body that makes recommendations about immunizations; the committee's recommendations serve as the template that USCIS uses to determine immunization requirements for immigration procedures. These new requirements put increased barriers and additional burdens on women's access to adjustment of immigration status and applications for visas to enter the U.S. and stoke the already reverberating anxieties among communities of color about the HPV vaccine.

Most immigration applicants are currently required to undergo a medical exam by a certified "civil surgeon." These civil surgeons complete an I-693 medical examination and vaccination record. The new regulations that require the HPV vaccine apply to female applicants between the ages of 11 to 26. This is the only sex-specific vaccination requirement, putting particular burden on immigrant women applying for a visa or adjustment of status, further marginalizing a group that already has reduced access to health information and services that are affordable, accessible and culturally and linguistically competent.

According to the Census, there are approximately 17.5 million immigrant women in the United States today, 3 million of whom are undocumented, and 16 percent that live in poverty. These women encounter obstacles to employment and health access; they also face violence and discrimination. Immigrant rights and reproductive justice are intrinsically linked because the reproductive health of immigrant women is profoundly affected by immigration policy. For women seeking adjustment of status, the USCIS' additional vaccine requirements create tremendous barriers to one of the many steps towards a pathway to citizenship.

While women of color, many who are immigrants, face disproportionate rates of cervical cancer in the U.S. (Latina women get cervical cancer at twice the rate of white women; and Vietnamese women get cervical cancer at five-times the rate of white women), efforts should be made to increase access and education about HPV and the vaccine, rather than creating further impediments to the already onerous immigration process. The HPV vaccine is out of reach for many women with its high price tag: at a minimum, it costs $360 for the three shot regimen. Publicly-funded access to the HPV vaccine varies state-to-state, although all low-income adolescents between the ages of 9 through 19 who are either uninsured, Medicaid-eligible, American Indian, or Alaska Native, have access to the vaccine through the federal Vaccines for Children (VFC) program. Immigrant women over the age of 19 may have greater challenges in obtaining the vaccine. According to the Kaiser Commission on Medicaid and Uninsured and the National Council of La Raza (NCLR), between 45% and 51% of immigrants lack health coverage in the US. The lack of health insurance, coupled with the high cost of the vaccine, limits access to the vaccine for low-income immigrant women. In addition, for immigration visa applicants abroad, the global availability and accessibility of the vaccine is questionable.

States also use the CDC's Advisory Committee on Immunization Practices recommendations when developing their own vaccine requirements for school entry. Calls for state school mandate bills for this vaccine seem to have calmed down, allowing advocates the opportunity to provide much-needed education and advocacy around HPV and cervical cancer prevention. Now this new requirement threatens that critical work.

Instead of mandating vaccines for immigrant women's bodies, the U.S. government should increase access to health information and services that are unbiased, age-appropriate, culturally-competent and non-coercive. Mandating a vaccine that specifically targets young non-citizen women is both sexist and xenophobic. It will only add to the current anxieties among many communities of color about the vaccine and the government's interest in vaccinating a particular community, in this case, immigrant women.

On Bullshit (by Dan Savage)

In case you don't know, Dan Savage is an amazing sex and relationship advice columnist. I particularly appreciated this response, so I'm reposting it here. Question is in italics, his response is the rest.

I feel ridiculous e-mailing you, but I figure that if anyone has heard of all manner of ass-hole behavior during sex, it would be you.

I'm a 17-year-old girl, and I've only had one boyfriend—who was, at the time, 21 and, I thought, perfect. The only thing that's still bothering me is the reason we broke up. After promising that he would never hurt me, and reassuring me that he was SO passionate about contraception, I agreed to have sex with him and lose my virginity. And in the middle of fucking me, he removed the condom without a word! He was hoping I wouldn't notice! I did notice—and I kicked his ass to the curb. He cried, he sent stupid gifts, and still calls. At least he didn't get me pregnant.

How upset should I be about this? Or is this something that horny males do? I'm not traumatized. I could nominate him for "Crappy Boyfriend of the Year," but surely someone else's boyfriend has done worse. I really just don't know how to feel about this.

[signed,] Just Confused

How upset should you be? Very. Did you do the right thing? Absofuckinlutely.

Hell, JC, you did precisely what I would have urged you to do had I been in the room. Of course, the second-to-last thing a straight girl needs in the room with her when she's losing her virginity to some asshole straight boy is a gay man twice her age desperately trying to get out. But if I had been there, JC, and I realized what was going on, I would've stopped trying to break down your locked bedroom door long enough to give your boyfriend—aka the last thing you needed in the room that night—something to cry about for real.

You consented to intercourse with protection, and that asshole deceitfully initiated unprotected intercourse. When a fucker removes a condom during intercourse—gay or straight, vaginal or anal—it invalidates the fuckee's consent to the fucking. (And what is sex without consent, class?) So your "more experienced" boyfriend sexually assaulted you, JC, and placed you at risk of an unplanned pregnancy—and for what? An ever-so-slightly enhanced orgasm for him?

What.

An.

Asshole.

This isn't something that decent guys do at all, JC, much less "all the time." He's an abusive douchebag, and you're well rid of him. Here's hoping his next girlfriend takes proactive steps to make sure the condom stays securely on—I'd suggest staple-gunning the thing in place.

D.I.Y (Do It Yourself) Cleaners... and why?

"They hate our freedom!"

“You can only protect your liberties in this world by protecting the other man’s freedom. You can only be free if I am free.” — Clarence Darrow

Who owns your organic food?

On being an energy-efficient renter

From Grist:

Renting is a blessing and a curse: little control, and little responsibility. You don't get to make long-term, expensive investments, but you can certainly undergo behavior modifications to reduce your energy bills. I've offered the generally recommended steps over the years, and I'm happy to collect them all here. We might as well go room by room.

In the KITCHEN, our main hope for energy savings is in reducing hot water use in the sink and dishwasher. Install low-flow attachments on the sink -- and, in fact, on all the faucets in your apartment. If you have a dishwasher that's not a dinosaur, use it; the newer models are more efficient than cleaning dishes by hand. Run it only when full, and don't use the "heated dry" setting. Use a dish tub if you do have to lave the old-fashioned way. Keep the fridge and freezer relatively full and at 36 to 38 degrees Fahrenheit for the main compartment and between 0 and 5 degrees for the freezer. Turns out, cleaning the coils doesn't make a big difference in fridge energy use. Phew. (As an aside, replacing an old refrigerator with an Energy Star model is good, so if you can persuade your landlord ...) Microwaves and plug-in kettles are more efficient than using the stovetop and oven.

Over in the bathroom, we can continue our crusade to get in less hot water. We've already installed a flow restrictor on the faucet, and now we can put a low-flow head on the shower. Take short showers and fewer baths if you can bear it (I personally find bath restriction an onerous duty).

In the bedroom, a major help is to have an ample comforter, so the thermostat can be turned down as far as possible at night. The overall goal, of course, is to keep the thermostat as low as you can when it's cold outside, and as high and un-air conditioned as you can when it's warm. If you or the landlord can pony up the dollars for a programmable thermostat, it may be worth it. They're fairly cheap, and they always remember to lower the heat while we're at work -- something we ourselves might forget. It takes less energy to reheat or re-cool the apartment when you get home than it takes to keep it toasty or cool while you're away.

Throughout your dwelling, replace incandescent bulbs with compact fluorescents, and turn off lights when you leave a room. Turn off your computer if you're not going to use it for an hour. Unplug electronic devices that come with LED lights or standby functions: These draw small amounts of power that add up over time. The same goes for "wall warts" such as cell phones and iPod chargers -- even when they're not charging anything, they're drawing phantom energy. Power strips are a handy way to turn off a whole bunch of the suckers at once.

There is also a lot you can do with your windows, which can be huge panes in the glass (sorry). Windows, seriously, are a major source of excess heat loss and heat gain, but here I'll refer you to a previous column that examines the problem in detail. Suffice it to say that key items for window efficiency include curtains, caulk, and glazing. As to doors, if your apartment has one leading to the outside, you might consider putting weather-stripping around the jamb.

What else? Laundry should be washed in cold water and hung dry when possible. If you're doing all these things already and have rooms and quandaries I haven't imagined, then I have failed you today. Write back and let me know, and I'll see if I can dig a little deeper.

Guaranteedly,
Umbra

More on children and veganism.

The full article can be read here.

Let me start by saying this: if you decide not to have kids, that’s completely cool. I fully understand the reasons and respect all of them, whether it’s concerns about overpopulation, not having the maternal/paternal instinct, not being comfortable around kids, or just plain old not wanting kids messing up your well-organized collection of vintage LPs. I promise you I’ll never tell you, “Oh, you’ll change your mind” or say anything like “You never know real love until you have your own child” because that’s just obnoxious. Parenthood isn’t for everyone and I think we are each fully capable of making the decision to parent or not to parent for ourselves.

That said, I think one important thing to remember is that the kids are on our side. They shouldn’t be viewed as enemies and even if you’re staunchly anti-breeding, don’t hate the kid. it’s not their fault they were born. You don’t have to be their best friend or even talk to them, but reserve your hate for something else. Honestly, as a parent, I’d rather you hate me and snub me for having a kid rather than taking it out on my daughter. Thankfully, I’ve never had to deal with that, but then again, I’m not really around vegans very often.

Another thing to keep in mind is that these kids are at a point in their veganism that most of us didn’t reach until high school or much later. I look at 5-year-old kids that are happy vegans and have a grasp of animal rights concepts that I didn’t have when I was in college and it’s amazing to me. Kids deal with much more peer pressure than we do as adults, and if they can keep their vegan edge at a point in their lives where all they want to do is fit in, more power to ‘em.

I’m also constantly amazed (and inspired) when I hear about kids that aren’t even teenagers that decide to give up meat even when no one else in their family does. Often, these kids get their friends or families to go veg with them. That’s some realness right there.

Kids are a huge influence on other kids. Strong, confident vegan kids are going to influence their peers over time. So, maybe it would be better to think of those kids you “hate” as advocates for the future generation. We’re going to have a tougher time as adults reaching eight-year-olds than one of their classmates is, so let’s give those vegan kids all the support we can. And if “support” for you just means showing a little more tolerance to a kid and not hating him based solely on the fact he’s a kid, that’s fine by me.