In the US, blood donors face a variety of restrictions that leave many people excluded entirely from the donor pool. This paper explores the specific circumstances and meanings surrounding the donor ban on Men-who-have-Sex-with-Men (MSM). The ban on MSM is one of the few existing donor guidelines to receive considerable criticism on grounds that it effectively prohibits any sexually active gay man from donating blood and thus discriminates against gays. Due in part to these questions of fairness, the Blood Products Advisory Committee (BPAC) of the Food and Drug Administration (FDA) met to reconsider the decades-old policy, first in 1997 and again in 2000. The FDA asked its advisory committee to address the efficacy and utility of the MSM ban in light of technological developments in blood-banking, epidemiological data on the spread of HIV, and mounting pressures from gay rights and blood-banking organizations to update the policy. Through a detailed reading of meeting and conference transcripts that took place between 1997 and 2000, I argue that 'MSM' became a contested definitional category during the FDA's reappraisal of the policy. During and between the Committee's discussions, presenters and experts debated the differences between sexual behavior and sexual identity in relation to HIV and, eventually, HHV-8, a virus known to cause Kaposi's sarcoma in immunosuppressed individuals. I argue that the underlying flexibility in the meanings behind the term 'MSM' allowed Committee members, in the end, to retract their more nuanced discussions of human behavior and HIV and to uphold the contested policy. Finally, I suggest how the debates surrounding the MSM donor ban can help us to better understand the place of sexuality in discussions and claims of biopolitical citizenship in early 21st-century America.
References to the 'natural' are common in public health messaging about breastfeeding. For example, the WHO writes that 'Breast milk is the natural first food for babies' and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called 'It's only natural', which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of 'natural' language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as 'natural' is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, 'natural' evokes specific and controversial conceptions of gender and motherhood.
This article explores the history of breastfeeding in postwar America and places it within a larger framework of the intersections of science, culture, and gender. Through an exploration of the history of breastfeeding at its nadir, it argues that the movement back to the breast that became visible in the 1970s was rooted in the emergence of the ideology of natural motherhood in the decades surrounding World War II. Natural motherhood relied upon a scientific understanding of nature and motherhood in which interconnected physiological and emotional processes unfolded instinctually in the bodies of mothers and infants along a largely predetermined pattern. Through an analysis of scientific and prescriptive literature on family, child rearing, and sexuality, and the letters of women themselves, this article seeks to understand the persistent choices of mothers to breastfeed in this period and asks what meaning the practice held.
By the middle of the 20th century, breastfeeding rates had fallen to less than 20% in some areas of the United States. Despite these grim statistics, many mothers continued to seek information, advice, and the experience of breastfeeding their infants. This article explores the role that nurses played in these women's struggles to breastfeed in the years between the end of World War II and the 1970s. The role of the nurse in shaping the meaning and experience of breastfeeding in America has been an important, albeit often overlooked, part of the history of infant feeding. In addition to exploring the ways in which hospital policies and structures shaped nurses' relationships with breastfeeding mothers, this article looks at how different maternal ideologies influenced the nature of these (mostly) same-sex interactions. This article argues that the ideas about, and experiences with, motherhood had important implications for how nurses and mothers approached the practice of breastfeeding in the hospital.
Guidelines currently state that genetic testing is clinically indicated for all individuals diagnosed with ovarian cancer. Individuals with a prior diagnosis of ovarian cancer who have not received genetic testing represent missed opportunities to identify individuals with inherited high-risk cancer variants. For deceased individuals, post-mortem genetic testing of pathology specimens allows surviving family members to receive important genetic risk information. The Genetic Risk Assessment in Ovarian Cancer (GRACE) study aims to address this significant healthcare gap using a “traceback testing” approach to identify individuals with a prior diagnosis of ovarian cancer and offer genetic risk information to them and their family members. This study will assess the potential ethical and privacy concerns related to an ovarian cancer traceback testing approach in the context of patients who are deceased, followed by implementation and evaluation of the feasibility of an ovarian cancer traceback testing approach using tumor registries and archived pathology tissue. Descriptive and statistical analyses will assess health system and patient characteristics associated with the availability of pathology tissue and compare the ability to contact and uptake of genetic testing between patients who are living and deceased. The results of this study will inform the implementation of future traceback programs.
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