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Dr. J. Marion Sims (1813–1883) (J. Marion Sims - Wikipedia)Thanks Sean. I apologize for the length, but it is necessary to illustrate how someone so celebrated in the press and medical community became reviled.Dr. James Marion Sims, a pioneering American gynecologist, is often credited with establishing the country’s first women’s hospital in Manhattan in 1855[1][1][1][1] — but in fact the Woman’s Hospital in the State of New York was not the first institution he opened. In 1844, Sims had his slaves build a women’s hospital in Mt. Meigs, Alabama, expressly for experimenting on enslaved women who suffered from a common gynecological condition caused from childbirth injuries.[2][2][2][2]Vesicovaginal fistula was a catastrophic complication of childbirth among 19th century American women.[3][3][3][3]Sims’ surgical work in Alabama — performed with the assistance of other enslaved patients, whom he trained as nurses — helped to launch his career as one of the country’s most famous gynecologists. Celebrated as the “father of modern gynocology”[4][4][4][4] , his name appeared in the press and in medical textbooks, and his likeness was memorialized in statues throughtout the eastern seabord and south. He stands as the first person to successfully perform gallbladder surgery,[5][5][5][5] and he developed a groundbreaking technique to treat women with vesicovaginal fistula. He invented the modern speculum,[6][6][6][6] and the Sim's position for vaginal exams, both of which he tested on his female slaves.[7][7][7][7]Yet, despite the popularity and notoriety, that Sims attracted, there were a small group of contemporary detractors who questioned the doctor's methodology and ethics. Drowned out by the praise of thousands of upper and middle class Caucasian women whose lives and reproduction systems were saved by Sims’ techniques[8][8][8][8] , critics would not find a willing audience for their concerns for over a hundred years. From the late 1970s onwards, numerous modern authors have criticised and attacked Sims's medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women.Marion Sims (called Marion) was born in Lancaster County, South Carolina, ,the son of John and Mahala (Mackey) Sims.[9][9][9][9] For his first 12 years, Sims's family lived in Lancaster Village north of Hanging Rock Creek, where his father owned a store. Sims later wrote of his early school days there.[10][10][10][10] After his father was elected as sheriff of Lancaster County in 1825, Sims was enrolled the newly established Franklin Academy, in Lancaster (for white boys only).[11][11][11][11]In 1832, after two years of study at the predecessor of the University of South Carolina, South Carolina College, where he was a member of the Euphradian Society,[12][12][12][12] After interning with Dr. Churchill Jones in Lancaster and completing a three-month course at the Medical College of Charleston (predecessor of the Medical University of South Carolina)[13][13][13][13], Sims moved to Philadelphia in 1834, enrolling in Jefferson Medical College, where he graduated in 1835, "a lackluster student who showed little ambition after receiving his medical degree".[14][14][14][14]As he put it,"I felt no particular interest in my profession at the beginning of it apart from making a living.... I was really ready at any time and at any moment to take up anything that offered, or that held out any inducement of fortune, because I knew that I could never make a fortune out of the practice of medicine."[15][15][15][15]Sims returned to Lancaster to practice. After his first two patients died, Sims left and set up a practice in Mount Meigs, near Montgomery, Alabama. He described the settlement in a letter to his future wife Theresa Jones as "nothing but a pile of gin-houses, stables, blacksmith-shops, grog-shops, taverns and stores, thrown together in one promiscuous huddle".[16][16][16][16]J. Marion Sims | Encyclopedia of AlabamaIn.December 1836, he married Theresa, also from Lancaster and the daughter of the wealthy widow of a local doctor, with whom he had nine children.[17][17][17][17] In 1840 the couple moved to Montgomery, Alabama, where they lived until 1853. In 1841, after suffering bouts of malaria and intestinal disorders, he moved his practice into Montgomery, trading in his pony for a four-wheeled cart with a horse and driver.[18][18][18][18] There Sims had what he described as the "most memorable time" of his career.[19][19][19][19] Within a few years he "had the largest surgical practice in the State", the largest practice that any doctor in Montgomery had ever had, up to that time, and was considered immensely popular, and greatly beloved."[20][20][20][20] The family owned 17 slaves, a house, and a building for treating 8 patients.It was in Montgomery that Sims established his reputation among rich, white plantation owners by treating their human property.[21][21][21][21] Sims’s practice was deeply rooted in the slave trade, building an eight-person hospital in the heart of the slave-trading district in Montgomery.[22][22][22][22] While most healthcare took place on the plantations, some stubborn cases were brought to physicians like Sims who patched up slaves so they could produce—and reproduce—for their masters again.[23][23][23][23] Otherwise, they were useless to their owners.Soon after, he developed a precursor to the modern speculum using a pewter spoon and strategically placed mirrors.[24][24][24][24] From 1845 to 1849, Sims started doing experiments on enslaved women to treat vaginal problems. He developed techniques that form the basis of modern vaginal surgery. A key component was silver wire, which he had a jeweler prepare.[25][25][25][25] The Sims vaginal speculum aided in vaginal examination and surgery.Sims' position - WikipediaWhen a woman came to him with an injured pelvis and retroverted uterus from a fall from a horse, he placed the patient on the left side with the right knee flexed against the abdomen and the left knee slightly flexed,.[26][26][26][26] Inserting his finger into the vagina triggered a full distention of the vagina with air. The distention inspired him to investigate fistula treatment.In Montgomery, between 1845 and 1849, Sims conducted experimental surgery on 12 enslaved women with fistulas in his backyard hospital. They were brought to him by their owners. Sims asked for patients with this fistula, and succeeded in finding six or seven women.[27][27][27][27]“I made this proposition to the owners of the negroes: If you will give me Anarcha and Betsey for experiment, I agree to perform no experiment or operation on either of them to endanger their lives, and will not charge a cent for keeping them, but you must pay their taxes and clothe them. I will keep them at my own expense.”[28][28][28][28]Sims took responsibility for their care on the condition that the owners provide clothing and pay any taxes; Sims provided food. One woman, Lucy, he purchased "expressly for the purpose of experimentation when her master resisted Sims' solicitations."[29][29][29][29]Sims referenced three enslaved women in his records: Anarcha, Betsy, and Lucy; many others remain unidentified. Each suffered from fistula, and all were subjects of his surgical experimentation.[30][30][30][30] From 1845 to 1849 he conducted experimental surgery on each of them several times.[31][31][31][31] Sims performed these fistula repair operations without benefit of anesthesia but gave these women substantial doses of opium afterwards.[32][32][32][32] It has been alleged that Sims did this in order to addict them to the drug and thereby to enhance his control over them.Seventeen-year old Anarcha Westcott had a severe form of rickets caused by a lack of vitamin D and malnutrition , which had disfigured her pelvis, making it impossible for her to give birth.[33][33][33][33] She went into labor during June 1845 and after trying to give birth for three days, Sims showed up to assist her in her labor. The use of “forceps” was common in those days, but Sims had never used them before, and, according to one historian, Sims tried it repeatedly on other slave women.[34][34][34][34] Each of these attempts, however, resulted in an infant fatality. Sims blamed all of these deaths not on his own use of the forceps, but the slave mother’s inherent stupidity.[35][35][35][35]Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern GynecologyAnarcha had both vesicovaginal and rectovaginal fistulas, which Sims struggled to repair. operating on the young woman thirty times.[36][36][36][36] She was isolated from other slaves, separated from her infant and under the complete supervision of Sims.Notwithstanding repeated failures during four years' time, he kept his six patients and operated until he tired out his doctor assistants, and finally had to rely upon his patients to assist him to operate.[37][37][37][37] Unlike his previous essays, which included at least a brief description of his patients, the article issued in the American Journal of the Medical Sciences is devoid of any identifying characteristics of Anarcha, Betsy, and Lucy.[38][38][38][38]Years after Sims claimed to have cured Anarcha's fistula, Anarcha traveled to Sims’ New York Woman’s Hospital to be operated on again by him. Anarcha actually had a double fistula when she first was sent to Sims—a rupture in the lining between vagina and urethra and between vagina and rectum. She was probably never really fully cured. While a decade later she was living in Virginia as a midwife, “she [appeared] to be living at a separate house from the main house.” While it’s unclear whether it was due to separate quarters for people enslaved generally or stigma, her separation could be explained as “what you would expect from a woman with an ongoing fistula condition.”[39][39][39][39]Although anethesia had very recently become available, Sims did not use any anesthetic during his procedures on these three women. According to Sims, anesthesia was not yet fully accepted into surgical practice, and he was unaware of the use of diethyl ether. [40][40][40][40] Ether as an anesthetic was available as early as the beginning of 1842, but not publicly demonstrated until 1846, a year after Sims began his experimental surgery.[41][41][41][41] While ether's use as an anesthetic spread rapidly, it was not universally accepted at the time of Sims' experimental surgery.In addition, a common belief at the time was that black people did not feel as much pain as white people. One patient, named Lucy, nearly died from sepsis. He had operated on her without anesthetics in the presence of twelve doctors, following the experimental use of a sponge to wipe urine from the bladder during the procedure.[42][42][42][42] She contracted sepsis because he left this sponge in her urethra and bladder. He did administer opium to the women after their surgery, which was accepted therapeutic practice of the day.[43][43][43][43]Dr. J. Marion Sims in Montgomery, Alabama (J. Marion Sims | Encyclopedia of Alabama)Sims moved to New York in 1853 because of his health and was determined to focus on diseases of women. He had an office at 267 Madison Avenue.[44][44][44][44] In 1855 he founded Woman's Hospital, the first hospital for women in the United States. His project met with "universal opposition" from the New York medical community; it was due to prominent women that he established it.They were visited by "prominent doctors, who endeavored to convince them that they were making a mistake, that they had been deceived, that no such hospital was needed, etc. I was called a quack.and a humbug, and the hospital was pronounced a fraud. Still it went on with its work."[45][45][45][45]In the Woman's Hospital, he performed operations on indigent women, often in an operating theatre so that medical students and other doctors could view his procedures as it was considered fundamental to medical education at the time.[46][46][46][46] Patients remained in the hospital indefinitely and underwent repeated procedures.At the onset of the Civil War in 1861, Sims left the United States and settled in Paris. He became internationally famous after ministering to European royalty, including the empress of Austria.[47][47][47][47] After the end of the Civil War, he returned to the United States until his death.In 1871, Sims returned to New York. He got into a conflict with the other doctors of the Woman's Hospital, with whom he carried on a dialogue by means of published pamphlets.[48][48][48][48] One issue was whether the hospital would treat women with uterine cancer, because the hospital was founded to treat diseases of women, and cancer was not a disease peculiar to women.[49][49][49][49] In addition, cancer was feared as contagious.[50][50][50][50] The second issue was how many outsiders (doctors or medical students) could observe any given operation, as was common at the time.[51][51][51][51] This meant they could observe the sexual organs of white women patients; there were no African-American patients.After a conflict with the hospital administration, Sims resigned from the Woman's Hospital of New York State in 1874[52][52][52][52] and maintained a successful private practice. In 1876, he was named president of the American Medical Association.[53][53][53][53]Women’s Hospital New York – Ephemeral New YorkIn 1880, Sims contracted a severe case of typhoid fever. Although Sims suffered delirium, he was "constantly contriving instruments and conducting operations".[54][54][54][54] After several months and a move to Charleston South Carolina to aid his convalescence, Sims appeared healthy by.June 1881.[55][55][55][55]After travelling briefly to France, Sims began to complain of an increase in heart problems. He had previously suffered two angina attacks in 1877. Sims was positive that he had a serious disease of the heart, resulting in a deep mental depression.[56][56][56][56] Halfway through writing his autobiography and planning a return visit to Europe, Sims died of a heart attack on November 13, 1883 in Manhattan, New York City.[57][57][57][57] After Sims’ death in 1883, the Mt. Meigs hospital continued to serve the local African-American population.[58][58][58][58]That Sims achieved all this has long won him acclaim; how he achieved all this—by experimenting on enslaved women—started being included in his story much more recently. And on a Tuesday morning in April 2018, in the face of growing controversy, New York City removed a statue honoring him from Central Park.[59][59][59][59]J. Marion SimsThe move came after decades of concerted effort by historians, scholars, and activists to reexamine Sims’s legacy. Sims’ critics have discounted the enormous suffering experienced by fistula victims, have ignored the controversies that surrounded the introduction of anaesthesia into surgical practice in the middle of the 19th century[60][60][60][60], and have consistently misrepresented the historical record in their attacks on Sims. Although enslaved African American women certainly represented a “vulnerable population” in the 19th century American South, the evidence suggests that Sims's original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time.[61][61][61][61]Sims’s defenders say the Southern-born slaveholder was simply a man of his time for whom the end justified the means—and that enslaved women with fistulas were likely to have wanted the treatment badly enough that they would have agreed to take part in his experiments.[62][62][62][62] But history hasn’t recorded their voices, and consent from their owners, who had a strong financial interest in their recovery, was the only legal requirement of the time.Critics say Sims cared more about the experiments than in providing therapeutic treatment, and that he caused untold suffering by operating under the racist notion that black people did not feel pain.[63][63][63][63] They say his use of enslaved black bodies as medical test subjects falls into a long, ethically bereft history of medical apartheid that includes the Tuskegee syphilis experiment[64][64][64][64] and Henrietta Lacks.[65][65][65][65]The first serious challenge to Sims’s lionization came in a 1976 book by the historian G.J. Barker-Benfield titled The Horrors of the Half-Known.Barker-Benfield juxtaposed Sims’s “extremely active, adventurous policy of surgical interference with woman’s sexual organs” with his considerable ambition and self-interest. The man who once admitted “if there was anything I hated, it was investigating the organs of the female pelvis,” took to gynecology with a “monomania” once he realized it was his ticket to fame and fortune.[66][66][66][66]In response, during the 1978 annual meeting of the American Gynecological Society, doctors took turns vigorously defending Sims against Barker-Benfield’s book. The most fervent of them was Lawrence I. Hester Jr., who said, “I rise not to reappraise J. Marion Sims, but to praise him.”[67][67][67][67] He then announced that his institution, the Medical University of South Carolina, which Sims also attended, was raising $750,000 for an endowed chair named after J. Marion Sims.[68][68][68][68]The Secret History of the SpeculumAnother physician, Irwin Kaiser asked the audience to consider how Sims ultimately helped the enslaved women he experimented upon. The surgery that he practiced on Lucy, Anarcha, Betsey, and the other enslaved women was to repair a vesicovaginal fistula—a devastating complication of prolonged labor. When a baby’s head presses for too long in the birth canal, tissue can die from lack of blood, forming a hole between the vagina and the bladder.[69][69][69][69] The condition can be embarrassing, as women with it are unable to control urination. “Women with fistulas became social outcasts,” said Kaiser. “In the long run, they had reasons to be grateful that Sims had cured them of urinary leakage.” He concluded that Sims was “a product of his era.”[70][70][70][70]This did not quell criticisms, of course. Over the next few decades, scholars continued to criticize Sim's practice of experimenting on enslaved women.[71][71][71][71] Medical textbooks, however, were slow to mention the controversy over Sims’s legacy. A 2011 study found that they continued to celebrate Sims’s achievement, often uncritically. In contrast to the vigorous debate of Sims’s legacy in historical texts and even in the popular press, medical textbooks and journals have largely remained static in their portrayal of Sims as surgical innovator.[72][72][72][72]In recent years, one of the most prominent defenders of Sims’s legacy has been Lewis Wall, a surgeon and an anthropologist at Washington University in St. Louis.[73][73][73][73] Wall has traveled to Africa to perform the vesicovaginal fistula surgery that Sims pioneered[74][74][74][74] , and he has seen firsthand what a difference it makes in women’s lives.“Sims’s modern critics have discounted the enormous suffering experienced by fistula victims,” he wrote in a 2006 paper. “The evidence suggests that Sims’s original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time.”[75][75][75][75]Wall also defended Sims on the charge that he refused to give anesthesia only to black patients.[76][76][76][76] Anesthesia was not yet widespread in 1845, and physicians who trained without anesthesia sometimes preferred their patients to be awake.There is debate over whether Sims’s specific surgical practices were unusually gruesome for his time. But his practice of operating on enslaved women was certainly not unusual. He wrote about it openly. It is this ordinariness that is noteworthy.Should women be standing alongside the 'father' of modern gynecology?Sims did not induce illness into his subjects, nor is there any evidence that he intentionally inflicted pain or even contemplated the loss of a life in order to find a solution to the problem. On the contrary, there is every indication that his attempts were purely to find a cure for a most debilitating malady and is well documented that all of his slave patients recovered, and we can assume lived better lives because of the surgery.[77][77][77][77] There are no reports of fatalities among Sims participants and it is widely acknowledged that his work aided tens of thousands of females, both black and white.[78][78][78][78]Sims was able to advance so quickly, because he had access to bodies—first enslaved women in the south, and later also poor Irish women when he moved to New York..[79][79][79][79] These institutions that existed in this country, which allowed easy access to enslaved and impoverished women’s bodies, allowed certain branches of professional medicine to advance and grow and to also become legitimate. The history of medicine has often been written as the history of great men, rather then their forgotten female patients.In 2006, the University of Alabama at Birmingham removed a painting that depicted Sims as one of the “Medical Giants of Alabama.”[80][80][80][80] In February, the Medical University of South Carolina quietly renamed the endowed chair honoring J. Marion Sims—the one announced by Hester after the publication of The Horrors of the Half-Known.[81][81][81][81] The minutes of the board of trustees meeting where it happened did not even mention Sims’s name—just the new name of the endowed chair. The decision was made in recognition of the controversial and polarizing nature of this historical figure despite his contributions to the medical field.[82][82][82][82]A worker removes the 19th-century statue of J. Marion Sims from New York's Central Park (Controversial statue of J. Marion Sims removed from Central Park)A bust of Sims on display at his alma mater, Thomas Jefferson University, was abruptly removed without explanation and placed in storage.[83][83][83][83] The J. Marion Sims statue that stood in Central Park is being relocated to Green-Wood Cemetery in Brooklyn, where Sims is buried.[84][84][84][84] Eventually, the statue will be demoted to a lower pedestal and displayed with a sign explaining the statue’s history. There may be an opportunity, now, to use the statue to tell the full story—to tell the stories of Lucy, Anarcha, Betsey, and the other enslaved women, who were the unknown “Mothers of Modern Gynocology”, assuring their place in the history of medicine.Footnotes[1] Women’s Hospital New York – Ephemeral New York[1] Women’s Hospital New York – Ephemeral New York[1] Women’s Hospital New York – Ephemeral New York[1] Women’s Hospital New York – Ephemeral New York[2] J. Marion Sims | Encyclopedia of Alabama[2] J. Marion Sims | Encyclopedia of Alabama[2] J. Marion Sims | Encyclopedia of Alabama[2] J. Marion Sims | Encyclopedia of Alabama[3] James Marion Sims's Treatment of Vesico-Vaginal Fistula[3] James Marion Sims's Treatment of Vesico-Vaginal Fistula[3] James Marion Sims's Treatment of Vesico-Vaginal Fistula[3] James Marion Sims's Treatment of Vesico-Vaginal Fistula[4] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[4] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[4] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[4] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[5] J. Marion Sims, the father of gynecology: hero or villain?[5] J. Marion Sims, the father of gynecology: hero or villain?[5] J. Marion Sims, the father of gynecology: hero or villain?[5] J. Marion Sims, the father of gynecology: hero or villain?[6] The Secret History of the Speculum[6] The Secret History of the Speculum[6] The Secret History of the Speculum[6] The Secret History of the Speculum[7] Sims' position - Wikipedia[7] Sims' position - Wikipedia[7] Sims' position - Wikipedia[7] Sims' position - Wikipedia[8] Peering ‘Behind The Sheet’ Of Gynecology’s Darker History[8] Peering ‘Behind The Sheet’ Of Gynecology’s Darker History[8] Peering ‘Behind The Sheet’ Of Gynecology’s Darker History[8] Peering ‘Behind The Sheet’ Of Gynecology’s Darker History[9] Marion Sims and the Origin of Modern Gynecology[9] Marion Sims and the Origin of Modern Gynecology[9] Marion Sims and the Origin of Modern Gynecology[9] Marion Sims and the Origin of Modern Gynecology[10] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[10] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[10] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[10] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[11] SC-29-8 Franklin Academy[11] SC-29-8 Franklin Academy[11] SC-29-8 Franklin Academy[11] SC-29-8 Franklin Academy[12] Euphradian Society - Wikipedia[12] Euphradian Society - Wikipedia[12] Euphradian Society - Wikipedia[12] Euphradian Society - Wikipedia[13] From Midwives to Medicine[13] From Midwives to Medicine[13] From Midwives to Medicine[13] From Midwives to Medicine[14] Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified[14] Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified[14] Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified[14] Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified[15] The Story of My Life - Google Play[15] The Story of My Life - Google Play[15] The Story of My Life - Google Play[15] The Story of My Life - Google Play[16] The Story of My Life - Google Play[16] The Story of My Life - Google Play[16] The Story of My Life - Google Play[16] The Story of My Life - Google Play[17] From Midwives to Medicine[17] From Midwives to Medicine[17] From Midwives to Medicine[17] From Midwives to Medicine[18] Savior or butcher? Doctor's legacy under fire[18] Savior or butcher? Doctor's legacy under fire[18] Savior or butcher? Doctor's legacy under fire[18] Savior or butcher? Doctor's legacy under fire[19] J. Marion Sims, the controversial "father of modern gynecology," conducted experiments on slaves and did not use anesthesia[19] J. Marion Sims, the controversial "father of modern gynecology," conducted experiments on slaves and did not use anesthesia[19] J. Marion Sims, the controversial "father of modern gynecology," conducted experiments on slaves and did not use anesthesia[19] J. Marion Sims, the controversial "father of modern gynecology," conducted experiments on slaves and did not use anesthesia[20] Tribute to the late James Marion Sims ... by W.O. Baldwin ... November, 1883. [20] Tribute to the late James Marion Sims ... by W.O. Baldwin ... November, 1883. [20] Tribute to the late James Marion Sims ... by W.O. Baldwin ... November, 1883. [20] Tribute to the late James Marion Sims ... by W.O. Baldwin ... November, 1883. [21] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[21] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[21] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[21] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[22] Race, Gender, and the Origins of American Gynecology on JSTOR[22] Race, Gender, and the Origins of American Gynecology on JSTOR[22] Race, Gender, and the Origins of American Gynecology on JSTOR[22] Race, Gender, and the Origins of American Gynecology on JSTOR[23] https://www.google.com/url?sa=t&source=web&rct=j&url=https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi%3Farticle%3D1003%26context%3Dlegacy&ved=2ahUKEwjFsbCZxPnmAhWQB80KHXx3BKwQFjAOegQIBxAB&usg=AOvVaw1oX8Z_yvGKGGu7ccqb96HK[23] https://www.google.com/url?sa=t&source=web&rct=j&url=https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi%3Farticle%3D1003%26context%3Dlegacy&ved=2ahUKEwjFsbCZxPnmAhWQB80KHXx3BKwQFjAOegQIBxAB&usg=AOvVaw1oX8Z_yvGKGGu7ccqb96HK[23] https://www.google.com/url?sa=t&source=web&rct=j&url=https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi%3Farticle%3D1003%26context%3Dlegacy&ved=2ahUKEwjFsbCZxPnmAhWQB80KHXx3BKwQFjAOegQIBxAB&usg=AOvVaw1oX8Z_yvGKGGu7ccqb96HK[23] https://www.google.com/url?sa=t&source=web&rct=j&url=https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi%3Farticle%3D1003%26context%3Dlegacy&ved=2ahUKEwjFsbCZxPnmAhWQB80KHXx3BKwQFjAOegQIBxAB&usg=AOvVaw1oX8Z_yvGKGGu7ccqb96HK[24] Women as victims of medical experimentation: J. Marion Sims' surgery on slave women, 1845-1850.[24] Women as victims of medical experimentation: J. Marion Sims' surgery on slave women, 1845-1850.[24] Women as victims of medical experimentation: J. Marion Sims' surgery on slave women, 1845-1850.[24] Women as victims of medical experimentation: J. Marion Sims' surgery on slave women, 1845-1850.[25] J. Marion Sims: Paving the way | The Bulletin[25] J. Marion Sims: Paving the way | The Bulletin[25] J. Marion Sims: Paving the way | The Bulletin[25] J. Marion Sims: Paving the way | The Bulletin[26] J. Marion Sims: Paving the way | The Bulletin[26] J. Marion Sims: Paving the way | The Bulletin[26] J. Marion Sims: Paving the way | The Bulletin[26] J. Marion Sims: Paving the way | The Bulletin[27] https://as.vanderbilt.edu/archived/gfc/sitemason.vanderbilt.edu/files/dG8FJS/Kapsalis%202002.pdf[27] https://as.vanderbilt.edu/archived/gfc/sitemason.vanderbilt.edu/files/dG8FJS/Kapsalis%202002.pdf[27] https://as.vanderbilt.edu/archived/gfc/sitemason.vanderbilt.edu/files/dG8FJS/Kapsalis%202002.pdf[27] https://as.vanderbilt.edu/archived/gfc/sitemason.vanderbilt.edu/files/dG8FJS/Kapsalis%202002.pdf[28] The Women Behind the Statue - Rewire.News[28] The Women Behind the Statue - Rewire.News[28] The Women Behind the Statue - Rewire.News[28] The Women Behind the Statue - Rewire.News[29] Public Privates[29] Public Privates[29] Public Privates[29] Public Privates[30] Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified[30] Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified[30] Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified[30] Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified[31] Anarcha, Lucy, and Betsey — Michelle Hartney[31] Anarcha, Lucy, and Betsey — Michelle Hartney[31] Anarcha, Lucy, and Betsey — Michelle Hartney[31] Anarcha, Lucy, and Betsey — Michelle Hartney[32] Did J. Marion Sims deliberately addict his first fistula patients to opium?[32] Did J. Marion Sims deliberately addict his first fistula patients to opium?[32] Did J. Marion Sims deliberately addict his first fistula patients to opium?[32] Did J. Marion Sims deliberately addict his first fistula patients to opium?[33] http://Washington, Harriet A. (2006). Medical Apartheid The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (1st ed.). NY: Doubleday.[33] http://Washington, Harriet A. (2006). Medical Apartheid The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (1st ed.). NY: Doubleday.[33] http://Washington, Harriet A. (2006). Medical Apartheid The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (1st ed.). NY: Doubleday.[33] http://Washington, Harriet A. (2006). Medical Apartheid The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (1st ed.). NY: Doubleday.[34] Anarcha & Her Sisters in Slavery, Lucy & Betsey[34] Anarcha & Her Sisters in Slavery, Lucy & Betsey[34] Anarcha & Her Sisters in Slavery, Lucy & Betsey[34] Anarcha & Her Sisters in Slavery, Lucy & Betsey[35] Gifted Hands[35] Gifted Hands[35] Gifted Hands[35] Gifted Hands[36] https://dsq-sds.org/article/view/3248[36] https://dsq-sds.org/article/view/3248[36] https://dsq-sds.org/article/view/3248[36] https://dsq-sds.org/article/view/3248[37] Black on Both Sides: A Racial History of Trans Identity[37] Black on Both Sides: A Racial History of Trans Identity[37] Black on Both Sides: A Racial History of Trans Identity[37] Black on Both Sides: A Racial History of Trans Identity[38] https://www.google.com/url?sa=t&source=web&rct=j&url=https://medium.com/%40Rondaisms/do-you-know-the-story-of-anarcha-lucy-and-betsy-fa1fb1a652ea&ved=2ahUKEwiV1quQkvjmAhWVPM0KHfMqBpEQjjgwBXoECAoQAQ&usg=AOvVaw23WVoOxow_RfmvgrWlARQJ[38] https://www.google.com/url?sa=t&source=web&rct=j&url=https://medium.com/%40Rondaisms/do-you-know-the-story-of-anarcha-lucy-and-betsy-fa1fb1a652ea&ved=2ahUKEwiV1quQkvjmAhWVPM0KHfMqBpEQjjgwBXoECAoQAQ&usg=AOvVaw23WVoOxow_RfmvgrWlARQJ[38] https://www.google.com/url?sa=t&source=web&rct=j&url=https://medium.com/%40Rondaisms/do-you-know-the-story-of-anarcha-lucy-and-betsy-fa1fb1a652ea&ved=2ahUKEwiV1quQkvjmAhWVPM0KHfMqBpEQjjgwBXoECAoQAQ&usg=AOvVaw23WVoOxow_RfmvgrWlARQJ[38] https://www.google.com/url?sa=t&source=web&rct=j&url=https://medium.com/%40Rondaisms/do-you-know-the-story-of-anarcha-lucy-and-betsy-fa1fb1a652ea&ved=2ahUKEwiV1quQkvjmAhWVPM0KHfMqBpEQjjgwBXoECAoQAQ&usg=AOvVaw23WVoOxow_RfmvgrWlARQJ[39] The Women Behind the Statue - Rewire.News[39] The Women Behind the Statue - Rewire.News[39] The Women Behind the Statue - Rewire.News[39] The Women Behind the Statue - Rewire.News[40] The medical ethics of Dr J Marion Sims: a fresh look at the historical record[40] The medical ethics of Dr J Marion Sims: a fresh look at the historical record[40] The medical ethics of Dr J Marion Sims: a fresh look at the historical record[40] The medical ethics of Dr J Marion Sims: a fresh look at the historical record[41] Sept. 30, 1846: Ether He Was the First or He Wasn't[41] Sept. 30, 1846: Ether He Was the First or He Wasn't[41] Sept. 30, 1846: Ether He Was the First or He Wasn't[41] Sept. 30, 1846: Ether He Was the First or He Wasn't[42] Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology[42] Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology[42] Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology[42] Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology[43] As The Opium Trade Boomed In The 1800s, Boston Doctors Raised Addiction Concerns[43] As The Opium Trade Boomed In The 1800s, Boston Doctors Raised Addiction Concerns[43] As The Opium Trade Boomed In The 1800s, Boston Doctors Raised Addiction Concerns[43] As The Opium Trade Boomed In The 1800s, Boston Doctors Raised Addiction Concerns[44] History of the discovery of anaesthesia : Sims, J. Marion(James Marion),1813-1883 : Free Download, Borrow, and Streaming : Internet Archive[44] History of the discovery of anaesthesia : Sims, J. Marion(James Marion),1813-1883 : Free Download, Borrow, and Streaming : Internet Archive[44] History of the discovery of anaesthesia : Sims, J. Marion(James Marion),1813-1883 : Free Download, Borrow, and Streaming : Internet Archive[44] History of the discovery of anaesthesia : Sims, J. Marion(James Marion),1813-1883 : Free Download, Borrow, and Streaming : Internet Archive[45] Women’s Hospital New York – Ephemeral New York[45] Women’s Hospital New York – Ephemeral New York[45] Women’s Hospital New York – Ephemeral New York[45] Women’s Hospital New York – Ephemeral New York[46] Public Privates[46] Public Privates[46] Public Privates[46] Public Privates[47] Life for this Bavarian princess was no fairy tale[47] Life for this Bavarian princess was no fairy tale[47] Life for this Bavarian princess was no fairy tale[47] Life for this Bavarian princess was no fairy tale[48] National Library of Medicine[48] National Library of Medicine[48] National Library of Medicine[48] National Library of Medicine[49] The Woman's Hospital in 1874 : a reply to the printed circular of Drs. E.R. Peaslee, T.A. Emmet, and T. Gaillard Thomas, addressed 'to the medical profession,' 'May 5th, 1877' : Royal College of Surgeons of England : Free Download, Borrow, and Streaming : Internet Archive[49] The Woman's Hospital in 1874 : a reply to the printed circular of Drs. E.R. Peaslee, T.A. Emmet, and T. Gaillard Thomas, addressed 'to the medical profession,' 'May 5th, 1877' : Royal College of Surgeons of England : Free Download, Borrow, and Streaming : Internet Archive[49] The Woman's Hospital in 1874 : a reply to the printed circular of Drs. E.R. Peaslee, T.A. Emmet, and T. Gaillard Thomas, addressed 'to the medical profession,' 'May 5th, 1877' : Royal College of Surgeons of England : Free Download, Borrow, and Streaming : Internet Archive[49] The Woman's Hospital in 1874 : a reply to the printed circular of Drs. E.R. Peaslee, T.A. Emmet, and T. Gaillard Thomas, addressed 'to the medical profession,' 'May 5th, 1877' : Royal College of Surgeons of England : Free Download, Borrow, and Streaming : Internet Archive[50] Student guest post: Cancer isn’t contagious…or is it??[50] Student guest post: Cancer isn’t contagious…or is it??[50] Student guest post: Cancer isn’t contagious…or is it??[50] Student guest post: Cancer isn’t contagious…or is it??[51] Reply to Dr. J. Marion Sims' Pamphlet Entitled "The Woman's Hospital in 1874"[51] Reply to Dr. J. Marion Sims' Pamphlet Entitled "The Woman's Hospital in 1874"[51] Reply to Dr. J. Marion Sims' Pamphlet Entitled "The Woman's Hospital in 1874"[51] Reply to Dr. J. Marion Sims' Pamphlet Entitled "The Woman's Hospital in 1874"[52] Eponyms and Names in Obstetrics and Gynaecology[52] Eponyms and Names in Obstetrics and Gynaecology[52] Eponyms and Names in Obstetrics and Gynaecology[52] Eponyms and Names in Obstetrics and Gynaecology[53] Women as victims of medical experimentation: J. Marion Sims' surgery on slave women, 1845-1850.[53] Women as victims of medical experimentation: J. Marion Sims' surgery on slave women, 1845-1850.[53] Women as victims of medical experimentation: J. Marion Sims' surgery on slave women, 1845-1850.[53] Women as victims of medical experimentation: J. Marion Sims' surgery on slave women, 1845-1850.[54] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[54] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[54] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[54] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[55] Dr J Marion Sims[55] Dr J Marion Sims[55] Dr J Marion Sims[55] Dr J Marion Sims[56] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[56] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[56] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[56] Memorial sketch of the life of J. Marion Sims, M.D. : Wylie, W. Gill (Walker Gill), 1848-1923 : Free Download, Borrow, and Streaming : Internet Archive[57] A FAMOUS SURGEON DEAD; THE IMPORTANT LIFE WORK OF DR. J. MARION SIMS.[57] A FAMOUS SURGEON DEAD; THE IMPORTANT LIFE WORK OF DR. J. MARION SIMS.[57] A FAMOUS SURGEON DEAD; THE IMPORTANT LIFE WORK OF DR. J. MARION SIMS.[57] A FAMOUS SURGEON DEAD; THE IMPORTANT LIFE WORK OF DR. J. MARION SIMS.[58] J. Marion Sims | Encyclopedia of Alabama[58] J. Marion Sims | Encyclopedia of Alabama[58] J. Marion Sims | Encyclopedia of Alabama[58] J. Marion Sims | Encyclopedia of Alabama[59] Why a Statue of the 'Father of Gynecology' Had to Come Down[59] Why a Statue of the 'Father of Gynecology' Had to Come Down[59] Why a Statue of the 'Father of Gynecology' Had to Come Down[59] Why a Statue of the 'Father of Gynecology' Had to Come Down[60] Ether day: an intriguing history[60] Ether day: an intriguing history[60] Ether day: an intriguing history[60] Ether day: an intriguing history[61] https://www.google.com/url?sa=t&source=web&rct=j&url=https://etd.ohiolink.edu/!etd.send_file%3Faccession%3Dosu1492473135829899%26disposition%3Dinline&ved=2ahUKEwiD18uP2vfmAhUObq0KHf_uAi0QFjAJegQIARAB&usg=AOvVaw0fCdrLnzKLMWtXXrDdt5KS[61] https://www.google.com/url?sa=t&source=web&rct=j&url=https://etd.ohiolink.edu/!etd.send_file%3Faccession%3Dosu1492473135829899%26disposition%3Dinline&ved=2ahUKEwiD18uP2vfmAhUObq0KHf_uAi0QFjAJegQIARAB&usg=AOvVaw0fCdrLnzKLMWtXXrDdt5KS[61] https://www.google.com/url?sa=t&source=web&rct=j&url=https://etd.ohiolink.edu/!etd.send_file%3Faccession%3Dosu1492473135829899%26disposition%3Dinline&ved=2ahUKEwiD18uP2vfmAhUObq0KHf_uAi0QFjAJegQIARAB&usg=AOvVaw0fCdrLnzKLMWtXXrDdt5KS[61] https://www.google.com/url?sa=t&source=web&rct=j&url=https://etd.ohiolink.edu/!etd.send_file%3Faccession%3Dosu1492473135829899%26disposition%3Dinline&ved=2ahUKEwiD18uP2vfmAhUObq0KHf_uAi0QFjAJegQIARAB&usg=AOvVaw0fCdrLnzKLMWtXXrDdt5KS[62] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[62] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[62] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[62] The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Slaves[63] Pain Sensitivity: An Unnatural History from 1800 to 1965[63] Pain Sensitivity: An Unnatural History from 1800 to 1965[63] Pain Sensitivity: An Unnatural History from 1800 to 1965[63] Pain Sensitivity: An Unnatural History from 1800 to 1965[64] An Unethical Medical Study Took a Year Off the Lives of Black Men[64] An Unethical Medical Study Took a Year Off the Lives of Black Men[64] An Unethical Medical Study Took a Year Off the Lives of Black Men[64] An Unethical Medical Study Took a Year Off the Lives of Black Men[65] Henrietta Lacks’ ‘Immortal’ Cells[65] Henrietta Lacks’ ‘Immortal’ Cells[65] Henrietta Lacks’ ‘Immortal’ Cells[65] Henrietta Lacks’ ‘Immortal’ Cells[66] The Horrors of the Half-Known Life[66] The Horrors of the Half-Known Life[66] The Horrors of the Half-Known Life[66] The Horrors of the Half-Known Life[67] Skin Deep, Spirit Strong[67] Skin Deep, Spirit Strong[67] Skin Deep, Spirit Strong[67] Skin Deep, Spirit Strong[68] 'Father Of Gynecology,' Who Experimented On Slaves, No Longer On Pedestal In NYC[68] 'Father Of Gynecology,' Who Experimented On Slaves, No Longer On Pedestal In NYC[68] 'Father Of Gynecology,' Who Experimented On Slaves, No Longer On Pedestal In NYC[68] 'Father Of Gynecology,' Who Experimented On Slaves, No Longer On Pedestal In NYC[69] History of the Procedure[69] History of the Procedure[69] History of the Procedure[69] History of the Procedure[70] Reappraisals of J. Marion Sims[70] Reappraisals of J. Marion Sims[70] Reappraisals of J. Marion Sims[70] Reappraisals of J. Marion Sims[71] The medical ethics of the 'father of gynaecology', Dr J Marion Sims.[71] The medical ethics of the 'father of gynaecology', Dr J Marion Sims.[71] The medical ethics of the 'father of gynaecology', Dr J Marion Sims.[71] The medical ethics of the 'father of gynaecology', Dr J Marion Sims.[72] The Portrayal of J. Marion Sims' Controversial Surgical Legacy[72] The Portrayal of J. Marion Sims' Controversial Surgical Legacy[72] The Portrayal of J. Marion Sims' Controversial Surgical Legacy[72] The Portrayal of J. Marion Sims' Controversial Surgical Legacy[73] L. Lewis Wall, MD, DPhil, MBioeth | Washington University School of Medicine in St. Louis[73] L. Lewis Wall, MD, DPhil, MBioeth | Washington University School of Medicine in St. Louis[73] L. Lewis Wall, MD, DPhil, MBioeth | Washington University School of Medicine in St. Louis[73] L. Lewis Wall, MD, DPhil, MBioeth | Washington University School of Medicine in St. Louis[74] Obstetric Fistula Is a “Neglected Tropical Disease”[74] Obstetric Fistula Is a “Neglected Tropical Disease”[74] Obstetric Fistula Is a “Neglected Tropical Disease”[74] Obstetric Fistula Is a “Neglected Tropical Disease”[75] The medical ethics of Dr J Marion Sims: a fresh look at the historical record[75] The medical ethics of Dr J Marion Sims: a fresh look at the historical record[75] The medical ethics of Dr J Marion Sims: a fresh look at the historical record[75] The medical ethics of Dr J Marion Sims: a fresh look at the historical record[76] https://www.google.com/amp/s/www.washingtonpost.com/news/retropolis/wp/2017/08/29/a-surgeon-experimented-on-slave-women-without-anesthesia-now-his-statues-are-under-attack/%3foutputType=amp[76] https://www.google.com/amp/s/www.washingtonpost.com/news/retropolis/wp/2017/08/29/a-surgeon-experimented-on-slave-women-without-anesthesia-now-his-statues-are-under-attack/%3foutputType=amp[76] https://www.google.com/amp/s/www.washingtonpost.com/news/retropolis/wp/2017/08/29/a-surgeon-experimented-on-slave-women-without-anesthesia-now-his-statues-are-under-attack/%3foutputType=amp[76] https://www.google.com/amp/s/www.washingtonpost.com/news/retropolis/wp/2017/08/29/a-surgeon-experimented-on-slave-women-without-anesthesia-now-his-statues-are-under-attack/%3foutputType=amp[77] J. Marion Sims, MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review[77] J. Marion Sims, MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review[77] J. Marion Sims, MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review[77] J. Marion Sims, MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review[78] https://scholar.google.com/scholar?q=James%20Marion%20Sims:%20some%20speculations%20and%20a%20new%20position#d=gs_qabs&u=%23p%3DVwcwilNKUFUJ[78] https://scholar.google.com/scholar?q=James%20Marion%20Sims:%20some%20speculations%20and%20a%20new%20position#d=gs_qabs&u=%23p%3DVwcwilNKUFUJ[78] https://scholar.google.com/scholar?q=James%20Marion%20Sims:%20some%20speculations%20and%20a%20new%20position#d=gs_qabs&u=%23p%3DVwcwilNKUFUJ[78] https://scholar.google.com/scholar?q=James%20Marion%20Sims:%20some%20speculations%20and%20a%20new%20position#d=gs_qabs&u=%23p%3DVwcwilNKUFUJ[79] Medical Bondage[79] Medical Bondage[79] Medical Bondage[79] Medical Bondage[80] https://www.washingtonpost.com/archive/lifestyle/2006/01/29/a-19th-century-doctor-38/b7534292-bdce-45f0-b5e0-c01ec647bcc9/[80] https://www.washingtonpost.com/archive/lifestyle/2006/01/29/a-19th-century-doctor-38/b7534292-bdce-45f0-b5e0-c01ec647bcc9/[80] https://www.washingtonpost.com/archive/lifestyle/2006/01/29/a-19th-century-doctor-38/b7534292-bdce-45f0-b5e0-c01ec647bcc9/[80] https://www.washingtonpost.com/archive/lifestyle/2006/01/29/a-19th-century-doctor-38/b7534292-bdce-45f0-b5e0-c01ec647bcc9/[81] J. Marion Sims, the controversial "father of modern gynecology," conducted experiments on slaves and did not use anesthesia[81] J. Marion Sims, the controversial "father of modern gynecology," conducted experiments on slaves and did not use anesthesia[81] J. Marion Sims, the controversial "father of modern gynecology," conducted experiments on slaves and did not use anesthesia[81] J. Marion Sims, the controversial "father of modern gynecology," conducted experiments on slaves and did not use anesthesia[82] The Surgeon Who Experimented on Slaves[82] The Surgeon Who Experimented on Slaves[82] The Surgeon Who Experimented on Slaves[82] The Surgeon Who Experimented on Slaves[83] The controversial legacy of Jefferson University-educated 'father of gynecology'[83] The controversial legacy of Jefferson University-educated 'father of gynecology'[83] The controversial legacy of Jefferson University-educated 'father of gynecology'[83] The controversial legacy of Jefferson University-educated 'father of gynecology'[84] City Orders Sims Statue Removed From Central Park[84] City Orders Sims Statue Removed From Central Park[84] City Orders Sims Statue Removed From Central Park[84] City Orders Sims Statue Removed From Central Park

Sex education - real education, not just abstinence-only. Start it early and make it age appropriate. Growing up in the 70s and 80s, during the Satanic Panic, did one thing for me and my generation. We learned good and bad touches and the name of our body parts very young. In middle school, we learn the basics of how pregnancy happens and in high school, we learned how pregnancy happens and facts about birth control. For instance, my sex ed in high school included facts about when and how long women are fertile and how long a sperm can exist once ejaculated. We also learned the various forms of birth control and how effective they are as well as the truth of the current ‘urban myths’ about sex. For instance, the fact that a douche forces sperm farther up the vagina.Birth control - make it free, make it available and make it normal. I believe, and you can disagree about your daughter, but for the safety of the girl and the prevention of pregnancy, girls should be put on some form of birth control after their first period. Why? Because bad things happen. Rape happens to young girls and women all the time. If you want to avoid abortions from rape, including statutory rape, make sure young girls are protected as well.Make Well Woman checks normal to young women. Mothers or other female family members should take the young woman to her first Gyno appointment right after her first period completes. This way, she knows the doctor and is comfortable with Him/Her, so that if something happens, she has a medical professional to turn to if she does conceive.Stop worshipping the fetus. Young women need to know they are not just vessels or as some Republican Reps have said recently, “Host Bodies.”Adopt or foster children. A claim that is made repeatedly by Anti-choice advocates is that all children are wanted and adoption is an alternative to abortion in every case. This is not true. There are millions of children in foster care right now that need forever homes. Put your money where your mouth is! https://adoptionnetwork.com/adoption-statisticsProvide paid parental leave. In Norway, for example, Norway, parents are entitled to 49 weeks of paid parental leave with their full salary or 59 weeks with 80 percent salary. This is over a year. In a two-parent home, that would mean a parent in the home until the child is over two. Parental leave | NIKKMake childcare free or affordable. In the US, the average cost of child care outside of a family child care home is $800 per month. Outside of a home is it $1230 per month. That is per child. Understanding the True Cost of Child Care for Infants and Toddlers - Center for American ProgressMake child support easier to get. In 2011, only 61% of child support payments were made by men to the mothers of their children. But as with most pariahs, things are more complicated than they seem. The Census reports that in 2011 about the same percentage of moms who didn't live with their kids paid all the child support they owed as dads who didn't.Jun 15, 2015Deadbeat Dads: New Study Examines Non-Custodial Fathers | Timehttps://time.com/3921605/deadbeat-dads/Make health insurance free. Pregnant women see a doctor monthly, they may need to see them more often or be hospitalized if there are complications to the pregnancy. There is also the cost of labor and the three days for a caesarian section and two days for a vaginal birth, if there are no complications and the child is not premature. After that, the American Academy of Pediatrics recommends a checkup at 2 weeks, followed by visits at 2, 4, 6, and 9 months, 12, 15, and 18 months, and 2 years. And they are expensive. https://www.parents.com/baby/care/pediatricians.../well-baby-visits-for-your-baby/Make pre-K for all children free. This is not daycare. This is education that a child use to get at home. Nearly 50% of women are in the workplace. This means that nearly 50% of women are not always able to teach their children the basics of reading, math and so. https://blog.dol.gov/2017/03/01/12-stats-about-working-womenMake programs like WIC and SNAP more available and fund the heck out of them. During Fiscal Year (FY) 2017, the number of women, infants, and children receiving WIC benefits each month reached approximately 7.3 million. For the first 5 months of FY 2018, states reported average monthly participation over 7 million participants per month. In 1974, the first year WIC was permanently authorized, 88,000 people participated. By 1980, participation was at 1.9 million; by 1985, 3.1 million; by 1990, 4.5 million; and by 2000, 7.2 million. Average monthly participation for FY 2016 was approximately 7.7 million.Children have always been the largest category of WIC participants. Of the 7.3 million people who received WIC benefits each month in FY 2017, approximately 3.76 million were children, 1.79 million were infants, and 1.74 million were women. WIC Frequently Asked Questions (FAQs)End the purity culture. For millions of girls growing up in evangelical Christianity, sexuality is a sin. Girls are sexual “stumbling blocks,” they’re told—a danger to the relationship between men and God. Girls in homes and churches where purity culture is pervasive learn that sex is a sin and it is dirty. This means when they find themselves pregnant, they are bad and dirty. They will be afraid to speak up. How Evangelical Purity Culture Can Lead to a Lifetime of Sexual ShameEnd the practice of childbrides. Between 2000 and 2015, at least 200,000 minors were legally married in the US. If girls can’t drive, they shouldn’t marry. Period. They do not have the capacity to consent or understand the meaning of consent. https://en.wikipedia.org/wiki/Child_marriage_in_the_United_States

These days clinical trials are a global endeavor spanning 204 countries, according to Home - ClinicalTrials.gov (1), something that should make accusations of racial bias harder to substantiate. However, the crux of the matter is who participates in clinical trials within a given country.Briefly,Diversity mandates do little when mechanisms to enforce them are left unstated. In such a vacuum, individual biases and structural barriers drive the process.The US has a bleak history of unethical medical experimentation on minorities that has left them with a persistent and deep mistrust of the medical establishment.Meantime, being largely white, US clinical trial organizers don't reflect the ethnic diversity of the population at large. Such a decision-making silo inadvertently de-prioritizes clinical trial recruitment of minorities.Diversity mandates do little when mechanisms to enforce them are left unstatedAfter clinical trials became the norm for new drug approvals post- WWII, white males remained over-represented in them for several decades. In response, the US National Institutes of Health Revitalization Act of 1993 mandated women and minorities be represented in NIH-funded research. Enforcing a mandate is easier said than done especially when mechanisms to do so are left unstated. Not surprising then that biases and structural barriers take hold and drive the process in such a vacuum.As recently as 2015, though blacks and Latinos make up ~30% of the US populations, a study found they accounted for just ~6% of participants in federally funded clinical trials (2).Another US study found <2% of cancer clinical trials focused on the health needs of racial/ethnic minorities (3).Even though African Americans are >30% more likely to have asthma and even >3X more likely to die from it, a study found <5% of federally funded lung disease studies in the US focused on them between 1993 and 2013 (4).Even Precision medicine - Wikipedia, the notion that medical treatment could be tailored to an individual's variations in genes, environment and lifestyle, leaves minorities far behind. As of 2011, ~96% of participants in >1000 Genome-wide association study - Wikipedia (GWAS) were of European descent (5).Since some minorities tend to be poorer and to live in places far from large reputed medical centers that conduct clinical trials, practical constraints such as time and money needed to travel to a study site may hamper their participation.Diversity mandates on federally funded trials don't apply to the pharmaceutical industry which is today the biggest funder of clinical trials. For such trials, only something like a diversity mandate enforceable by the FDA during its review process of product approval could make a dent (6).The US has a bleak history of unethical medical experimentation on minorities that has left them with a persistent and deep mistrust of the medical establishmentIn the US, the Tuskegee syphilis experiment - Wikipedia looms large in collective consciousness as a constant reminder of the lengths to which racial animus could infect a clinical study design in that the study doctors knowingly and wantonly withheld treatment from syphilis-infected poor, uneducated, rural black men not for a year or two but for a whopping 40 years. Any wonder then that studies (7, 8) continue to find the African American community mistrust of the medical establishment?Given such a bleak history, where African Americans are concerned, racial bias in US clinical trial enrollment is best viewed as a two-way street with low black (and other minority) participation explainable two ways,one, implicit bias of trial researchers may play a considerable role in restricting minority enrollment. Some recent studies found a profound degree of implicit bias in medical doctors on matters of race. It stands to reason to assume such bias might well bleed into clinical trial enrollment processes as well.A 2016 study found substantial numbers of white medical students continue to hold false beliefs about biological differences between black and white people, (see below from 9),'blacks have thicker skin than do white people or that black people’s blood coagulates more quickly than white people’s blood.’Another 2016 study found (see below from 10, emphasis mine),'...significant racial-ethnic disparities, with non-Hispanic Blacks being less likely (adjusted odds ratio ranging from 0.56–0.67, p value < 0.05) to receive opioid prescription at discharge during ED visits for back pain and abdominal pain, but not for toothache, fractures and kidney stones, compared to non-Hispanic whites after adjusting for other covariate.’Indeed, such implicit bias has been used to explain the far lower rates of prescription opioid abuse among African Americans and Hispanics in the early years of the ongoing opioid crisis (11, 12).two, blacks, especially black males, have for long actively avoided participating in clinical trials due to their understandable deep-rooted mistrust of the medical establishment (7, 8). Some other minorities also avoid them due to lingering mistrust engendered by a past history of trust abuse.Apparently so hard-wired is this mistrust that as recently as 2014, a severe TB outbreak in the small rural Alabama town of Marion went unchecked because those affected chose not to go to a doctor (13).Bad acts and actors in US biomedical research didn't magically end with Tuskegee. In 1989, Arizona State University researchers collaborated with the Havasupai Tribe on a type II diabetes project. In 2003, Carletta Tiousi, a trial participant, found out that blood samples taken during this trial had been used without her and other participants' consent for testing schizophrenia, migration and inbreeding (14). A lawsuit led to an out of court settlement and the tribe members received funds for a school and clinic, and return of their samples.Being largely white, clinical trial organizers don't reflect the ethnic diversity of the population at large. Such a decision-making silo inadvertently de-prioritizes recruitment of minoritiesMinority participation in US clinical trials could be increased through concerted effort on fairly simple, practical steps (15, 16, 17, 18, 19),Situate clinical trials where minorities tend to live.Provide low income participants travel assistance back and forth to trial sites.Focus on recruitment efforts in places such as churches and barbershops where minorities tend to congregate.Employ minority recruitment staff to serve as outreach partners to engage with potential minority participants in their own languages.Advertise clinical trials within ethnic communities using culturally appropriate informational material clarifying purpose of the trial, and how data will be collected and used.Nothing new about any of these suggestions. They've floated around for years and yet little changes. Bias in clinical trial recruitment, as in any aspect of human life, need not always occur deliberately. They can and often are the result of blinkered thinking that easily takes root in silos. When a particular majority has the power, the decisions it makes reflect that.Minority researchers would be more likely to focus on issues of health disparities in minority populations and yet even after controlling for other variables such as education, training and experience, one study found that they were ~half as likely to get NIH grants (20).Racially homogenous make-up of clinical trial participants reflect the racially homogenous make-up of clinical trial decision makers. Seats at the table; changes in clinical trial participants will occur lockstep with changes in clinical trial organizers, when trials are conducted not by largely white doctors but by a healthy mix of white, black, Hispanic and other minority doctors who better represent their distribution in the US population at large.Bibliography1. Studies on Map - ClinicalTrials.gov2. Oh, Sam S., et al. 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Race, Ethnicity, and NIH Research AwardsThanks for the R2A, Christopher VanLang.