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3 awkward questions about reproductive freedom — and how to answer them.

Talking about abortion and birth control with your not-so-feminist relatives can be awkward. These facts help.

3 awkward questions about reproductive freedom — and how to answer them.

If your family is like mine, political disagreements are as much a part of the Thanksgiving tradition as pumpkin pie.

Charged discussions are basically inevitable. And you can't always use Adele to deflect the conversation.

After years of practice, I've developed a pretty good plan for fielding questions about birth control, abortion, and reproductive freedom in general. Here's what I've got.


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Image from "SpongeBob SquarePants."

1. Aunt Margaret says: “I'm OK with people using birth control, but the government shouldn't be paying for it, and employers shouldn't have to cover it if they don't want to."

Here are the facts you need to know:

Obamacare requires insurance plans provided by employers to cover contraception and other preventive health services like annual well-woman visits.

This plan has been hugely successful.

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According to the Guttmacher Institute, the number of people with a $0 copay on their birth control has more than tripled for pill and ring users since 2012, and it has doubled for those who use injectable contraception. Graphic from the Guttmacher Institute, used with permission.

Since cost can be a huge barrier to contraception access, birth control coverage means fewer unplanned pregnancies, fewer teenage births, and healthier families.

The zinger:

Making birth control more accessible has enabled more Americans to make reproductive decisions for themselves. Also, contraception does count as basic health care, so there's no reason a health insurance plan should be excluding it.

2. Uncle Randall says: “Planned Parenthood should be defunded. Have you seen those sting videos?"

Uncle Randall is probably talking about those misleading videos — you know, the ones released by a group that's trying to exclude Planned Parenthood from any federal funding. The videos that claimed that health care providers are selling fetal tissue.

Here are the facts you need to know:

It's true. Some Planned Parenthood clinics DO donate fetal tissue from abortions. They do this with patients' full consent, and the tissue is used for life-saving medical research.

While Planned Parenthood once accepted reimbursements for storing and transporting that tissue (which is completely legal, by the way), they have stopped doing so in order to “reveal the true political purpose behind these attacks," according to Planned Parenthood Federation of America President Cecile Richards.

It's also worth mentioning that the controversial donated tissue has helped researchers develop the polio vaccine and better treatments for Alzheimer's disease. And so far, there has been no evidence of wrongdoing in any of the investigations into Planned Parenthood.

The zinger:

Planned Parenthood provides important reproductive health care, including abortions. And because Planned Parenthood serves many uninsured patients, they provide care to people who otherwise may not be able to access health care at all. That's really important.

YASSS. You deserve another slice of pie for that one.

3. Cousin Elliott explains: “I'm pro-choice, but I think too many women use abortion as birth control."

Here are the facts you need to know:

1 in 3 women will have an abortion in their lifetime.

Image from this awesome Mic video.

That's a lot of women, which means that there are many different reasons behind the decision to get an abortion. Maybe the woman wasn't ready to parent, she couldn't afford a child, or something went wrong with the pregnancy. Or maybe that person doesn't want to explain their decision because they don't owe anyone an explanation.

Here's the thing that many people don't know, though: Most women who have an abortion were using contraception when they became pregnant, according to these stats from the Guttmacher Institute. Therefore, it's statistically unlikely that "many people" are using abortion as their "only form of birth control."

The zinger:

Regardless of the above stats, any reason for an abortion is a sufficient reason. The decision to have or not have a child is a personal, intimate one — and no one should feel shame for making the choice that is right for them.

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Image from "Glee."

Bam. If you've gotten through these three questions, it's probably already time for dessert (#teampie).

Reproductive freedom can be a contentious topic, and chances are good that you'll disagree with someone sitting across the table this week. It happens to me a lot.

What I've found personally, though, is that feelings about abortion, or reproductive freedom in general, aren't as black and white as politicians can make them seem. In fact, lots of people consider themselves to be both pro-life and pro-choice. There aren't just two sides to the story.

Images from "Real Time With Bill Maher." <3 Sarah Silverman.

And if there aren't simply two sides to these issues, that means there's a lot of middle ground in the reproductive freedom conversation.

That's space for all of us to talk about birth control, abortion, and women's bodies in a way that's respectful, informed, and productive — a middle ground that you can hopefully find at your Thanksgiving table.

Go get 'em, friends.

This article originally appeared on August 27, 2015

Oh, society! We have such a complicated relationship with relationships.

It starts early, with the movies we are plopped in front of as toddlers.

Keep Reading Show less

This article originally appeared on August 27, 2015

Oh, society! We have such a complicated relationship with relationships.

It starts early, with the movies we are plopped in front of as toddlers.

Keep Reading Show less
True

Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."