Democracy Demands Women’s Health Stay Front and Center
Republicans don’t want abortion in the headlines because they know it’s an electoral loser.
It is critically important to keep reproductive health and the chaos at the Food and Drug Administration (FDA) front and center in the headlines. Why? Two words: midterm elections.
Both loomed large this month. Within 48 hours, the Supreme Court issued an emergency stay pausing the Fifth Circuit’s attempt to let Louisiana negate the FDA rule that allows telehealth provision and mail delivery of mifepristone and FDA Commissioner Marty Makary announced his immediate resignation after rumors that President Trump was planning to fire him.
Meanwhile, the FDA has churned through crises every day since. Florida attorney Kyle Diamantas was named acting FDA commissioner and was immediately excoriated by anti-abortion activists for providing legal representation in 2017 to Planned Parenthood’s Orlando affiliate. The FDA’s top drug regulator, the fifth head of the division since the start of the Trump administration 16 months ago and a well-known vaccine skeptic, was unceremoniously ousted last weekend. The dysfunction never ends.
Though Makary’s antipathy toward deregulation of flavored vapes appears to have triggered his fall from grace, and the rest of the chaos is perhaps business as usual, the Trump administration’s tip-toe approach to mifepristone is the real story.
The Justice Department’s litigation approach seemingly has been to wait until October when the FDA’s so-called “safety review” is due — ordered despite the mountain of evidence proving mifepristone’s safety and efficacy. But reports indicate that study has not even begun and is mired in data delays caused by the Department of Health and Human Services.
Foot-dragging? Finger-pointing? Old-fashioned incompetence? Who can tell anymore. But it surely hews to Republicans’ favor to keep the entire endeavor out of public sight, given that the vast majority (68 percent) of adults in this country oppose banning mifepristone according to Kaiser Family Foundation.
A New York Times story this week doubled down on what recent Contrarian columns surmised: It is quite on purpose that the Trump administration is staying mum, that the FDA is slow-walking its report, and that DOJ is avoiding with a ten-foot pole public statements about the lawsuit. Republicans know they’ll lose big — if not in the courts, certainly in the court of public opinion. Here is a point on which all sides agree: Tony Perkins, president of the right-wing Family Research Council, was quoted in the Times article as saying, “They don’t want this going into the midterm election?... It’s only going to stay in the news. It’s only going to become more of the narrative going into the midterms.”
As well it should. And we, all of us, will make sure of it. Democracy demands no less.
And now for some uncharacteristic good news in the world of women’s health:
It is not often that medical and patient advocacy communities come together — to rename a women’s hormonal health condition, no less — and in so doing, simultaneously reframe care and treatment opportunities. What was formerly referred to as polycystic ovary syndrome (PCOS) is now called polyendocrine metabolic ovarian syndrome (PMOS). It’s a hormonal condition affecting one in eight women of reproductive age around the world (and three in four in my immediate family), and many who suffer with it go undiagnosed or undertreated.
The name change, published last week in The Lancet, has been more than a decade in the making. More than 50 academic, clinical, and patient organizations made it happen, arguing that the old name is inaccurate and reduces a complex endocrine disorder to a “misunderstanding about cysts and a focus on ovaries, contributing to missed diagnoses and inadequate treatment,” according to the Endocrine Society.
What’s in a name? Pretty much everything — from physician and patient awareness to the availability and affordability of treatment to dollars for scientific research and pharmaceutical advertising. In my forthcoming book on menopause policy, I fell down the rabbit hole of the comparative history of erectile dysfunction medications and learned that the term “erectile dysfunction” itself, or ED, was chosen to avoid embarrassing or undermining men. In 1992, ED officially replaced the word previously used by the National Institutes of Health — “impotence” — in part because it was imprecise but also because it implied that the condition was mainly psychological, which added barriers for those seeking treatment. In other words, it made men feel less manly. Fast forward 30 years, ED is readily addressed with easy-to-obtain Viagra, engineered to be inexpensive with or without insurance, and receives well more than its fair share of federal research dollars and prime-time television airtime.
The name PCOS and its limited focus on ovaries meant funding, education, and treatment guidelines were destined to be minimalized in every way. But PMOS tells a fuller story — of an endocrine disorder that happens to have gynecological symptoms and that implicates Type 2 diabetes, endometrial cancer, cardiovascular disease, and high blood pressure. Changing the name to PMOS is a key step in enabling deeper research, more funding avenues, and better treatment opportunities.
We take good news where we can get it these days. And we use that fuel to keep up the fight on all other fronts. As for me, I am not letting the FDA lay low or the Trump administration off the hook by accepting silence when it suits them.
Jennifer Weiss-Wolf is executive director of the Birnbaum Women’s Leadership Center at NYU School of Law. She also leads strategy and partnerships at Ms. Magazine.
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