What Would Happen In Wisconsin If Roe v. Wade Falls?
WHAT WOULD HAPPEN IN WISCONSIN IF ROE V. WADE FALLS?
Consequences of the Upcoming Dobbs v. Jackson Women’s Health Organization Supreme Court Decision
May 3, 2022
2022
Contraceptives’ Effects on Sexual Experiences Play a Huge Role in Satisfaction, Study Finds
Sexual acceptability – how birth control methods affect users’ sexual well-being – is likely an important component of contraceptive satisfaction, but hasn’t been systematically examined until now. Dissatisfaction with a contraceptive method leads many people to stop using contraception. If people want to use contraception, they should be able to find a method that works for them – and new CORE research indicates that how a method affects a user’s sexual experiences is a key factor in determining whether they will continue using this health product over time.
Renee D. Kramer, Jenny A. Higgins, and colleagues at the University of Utah examined contraceptive satisfaction among contraceptive users who were starting a new method. They wanted to find out if sexual acceptability measures could be used to predict contraceptive satisfaction after three months of use. Their study was recently published by the American Journal of Obstetrics & Gynecology, also known as “the Gray Journal.”
Among about 2,000 users, over half were completely satisfied with their contraceptive method after 3 months. Patients who said their contraceptive method improved their sex life were upwards of 8x as likely to be satisfied with their method.
Contraceptive care providers may wish to underscore that sexual experiences of birth control methods matter and encourage patients to find a contraceptive method that works for them sexually.
Gender-Affirming Hormone Therapy in Wisconsin: Opportunity to Expand Access by Enabling Family Planning Providers to Bill Medicaid
There is an opportunity in Wisconsin to expand access to gender-affirming care for low-income, transgender people in our state. Rachel Dyer, a CORE researcher and a PhD student in the UW-Madison Department of Counseling Psychology, prepared a brief on this subject with support from CORE staff. In it, Dyer dives into the process and potential outcomes of updating Wisconsin’s Medicaid policy to expand specific family planning coverage.
Dyer compiles extensive research showing that gender-affirming hormone therapy, or GAHT, can improve the health and wellbeing of transgender people. GAHT is a safe and effective form of medical care that may be sought by transgender, nonbinary, two-spirit, gender nonconforming, and other gender diverse people. Like other forms of gender-affirming care, the purpose of GAHT is to support transgender people in feeling more aligned with their gender identity, namely by reducing sex characteristics that they were born with and inducing sex characteristics that align with their gender identity.
Wisconsin could efficiently expand access to GAHT by permitting family planning clinics to bill state Medicaid for GAHT services provided in their clinics. Because each state determines for itself what constitutes family planning and what services can be covered, Wisconsin has the ability to expand the interpretation of family planning to include important healthcare services that fall under the umbrella of GAHT. As a major form of regular and preventative healthcare, family planning providers have a unique capacity to provide gender-affirming services.
The reach of family planning clinics in Wisconsin also make them a useful choice for a site to provide GAHT; there are approximately 150 clinical sites in rural and urban communities across the state that already provide publicly-funded family planning services. Further, expanding Medicaid coverage to include GAHT services provided at these clinics would be of minimal cost to the state of Wisconsin.
To learn more about the importance of clinical provision of gender-affirming hormone therapy, and the opportunity to expand access via Medicaid coverage, check out our CORE Brief.
CORE Review Finds Close Association Between Economic and Sexual Wellbeing
A new analysis led by CORE Director Jenny A. Higgins, Madison Lands, Mfonobong Ufot, and Sara McClelland reviewed 47 studies from over 22 countries, and found nearly universal associations between socioeconomic constraints and poorer sexual wellbeing.
Public health organizations such as the American Public Health Association and the World Health Organization emphasize that sexual health involves positive and pleasurable sexual experiences, not only the prevention of negative sexual outcomes. However, surprisingly little research has paid specific attention to sexual pleasure and its relationship with poverty. To address this gap, CORE researchers systematically drew from nearly studies to document relationships between socioeconomic conditions (such as financial stressors, income, and education level) with indicators of sexual wellbeing (such as sexual satisfaction, functioning, and orgasm).
The authors proposed a variety of pathways through which socioeconomic conditions may shape sexual wellbeing and flourishing. Such pathways include, but aren’t limited to:
- financial-associated stress, which can undermine positive aspects of sexuality;
- the psychosocial effects of having comparatively less social and political clout, which can undermine all aspects of health, including sexual health;
- expectations for enjoyable sexual experiences, which can be undermined by poverty;
- inadequate housing and access to private space, which can also erode pleasurable sexual experiences.
The authors argue that true “erotic equity” can only come about after sweeping changes to educational and employment opportunities as well as access to health and social services.
While these changes will take time, sexual health as a human right depends on them. Sexual pleasure and positive sexual experiences are a critical part of reproductive autonomy and reproductive justice.
In 94% of studies the authors reviewed, poorer socioeconomic conditions were significantly associated with poorer sexual wellbeing and flourishing. People with comparatively low levels of income reported much lower levels of sexual satisfaction compared to those living on higher incomes. The relationship between socioeconomic conditions and sexual flourishing were consistent across geographic location and gender.
The authors identified many limitations with the existing research on this topic, including narrow and one-dimensional approaches to poverty – a very complex concept and experience. The articles included in the review were primarily focused on cisgender women, and studies from the United States and Europe contained overwhelmingly white samples. Future research in this area must attend to both gender and racial diversity.
Without broader structural improvements to socioeconomic opportunities for all, poverty will continue to undermine sexual wellbeing, which is a fundamental human right.
Read the open-access article in The Journal of Sex Research here.
Sexual Health and Flourishing Negatively Impacted by Economic Constraints
New research by CORE investigators documents that poverty and other financial constraints undermine people’s ability to have positive sexual experiences.
All major public health organizations in the United States underscore that sexual health involves both the absence of negative outcomes (such as unwanted pregnancies and STIs), and the presence of sexual flourishing, including a pleasurable and satisfying sex life.
CORE researchers examined how these positive aspects of sexual health may be affected by by socioconomic conditions. Their research brief, just published online in Perspectives on Sexual and Reproductive Health, shares findings from a study of over 2,500 people of reproductive age seeking family planning services. The project was a collaboration between researchers at the University of Wisconsin-Madison’s Collaborative for Reproductive Equity (UW CORE) and the University of Utah, using data from the HER Salt Lake Initiative.
Researchers collected information on people’s financial resources (for example, whether they had trouble paying for basic needs in the past month) as well as indicators of sexual flourishing (for example, sexual satisfaction and orgasm).
Nearly universally, those who reported experiencing more financial constraints also reported fewer signs of sexual flourishing. Results from this analysis suggest that economics are strongly associated with sexual wellbeing, with indications that financial scarcity may reduce sexual satisfaction, orgasm, and overall functioning. These results remind us that structural constraints affect sexual bodies.
A reproductive justice framework indicates that all people must have access to the social conditions needed for healthy and autonomous reproductive and sexual lives.
To address inequities in sexual health, public health leaders and policymakers must continue to support economic reform and poverty reduction.
Read the open-access article here: https://onlinelibrary.wiley.com/doi/10.1363/psrh.12189
Study Finds Over Half of Physicians Who Are Willing to Refer for Abortion Care Don’t Know How to Do So
A new study by CORE researchers shows that physicians want to refer patients for abortion services, but many lack the knowledge on how to do so. Published in in Social Science and Medicine – Population Health, the paper shares findings from a survey of over 800 physicians across specialties at the University of Wisconsin School of Medicine and Public Health, the state’s largest and only public medical school.
Elizabeth Anderson, Sarah K. Cowan, Jenny A. Higgins of CORE, Nicholas B. Schmuhl, and Cynthie K. Wautlet teamed up to learn more about how referral knowledge may serve as a barrier to abortion access.
Their survey results indicate that the overwhelming majority (over 80%) of physicians were willing to consult on abortion-related patient cases. However, only half (53%) of physicians who were willing to refer a patient for abortion care knew how to do so. Physicians who had not received abortion-related information in medical school, as well as more junior physicians, were especially lacking in abortion referral knowledge.
These findings illustrate another obstacle for those seeking abortion: healthcare providers who are “willing but unable” to direct patients to abortion services if needed.
Clear and robust referral systems could aid physicians in helping their patients get the reproductive healthcare they need.
Read the open-access article here, titled “Willing but unable: Physicians’ referral knowledge as barriers to abortion care.”