It’s all here: Andrew Sullivan on marriage and his feeling of exclusion as a kid; why that isn’t directly about marriage equality; and why it indirectly is about exactly that.
Yesterday, Andrew Sullivan reported on a recent, large-scale study that determined — pretty conclusively, for science — that HIV+ people on antiretroviral drugs were much less likely to transmit the disease to their sexual partners. His “duh” response was dead-on, and not just because it’s obvious. I wrote about this some nine years ago, reporting on a smaller-scale study in Uganda that showed even more impressive results (not one case of transmission among serodiscordant couples).1 So the information has been out there for awhile.
Sullivan may well be correct in his surmise that at least part of the reason that earlier studies weren’t touted by the CDC sooner was fear of more unprotected sex (and therefore a higher incidence of transmission), but it’s also true that large-scale studies of the sort just reported do take years. When the issue is the sexual transmission of HIV, which occurs only rarely (as a percentage matter) even under the riskiest circumstances, and where neither evidence of transmission nor symptoms are immediate, it’s not surprising that it took this long.
After that, though, he makes a series of statements that make my public health sense tingle (not in a good way, but in a Spiderman, danger-sensing way).
First, he calls for sero-sorting, in which HIV-positive men “do their best” to have sex only with other HIV-positive men. Let’s start with what’s good about that statement. One belated move by public health has been to get HIV+ men to own responsibility for their status, and the risk it entails to HIV- men, and (not by the way) to HIV- women. But there’s also a need for disclosure; once that happens, then sero-discordant couples (whether of the one-night variety or of the long-term kind) can negotiate the boundaries of their mutual risk/comfort levels.
But more seriously off-target is this last suggestion:
I wonder what the full effect would be if all men diagnosed with HIV were immediately put on retrovirals and all HIV-negative men were put on a basic anti-retroviral at the same time.
I bet you’d see a sizable decline in HIV transmission.
Some problems: You can’t simply put everyone on retrovirals. Some don’t have access to them — yes, even here in the U.S., but even more so in most developing nations, where limited funding and daunting logistical problems mean that only those who are really sick have access. Even for those who do have access, though (and let’s assume that’s who he’s thinking about here), there’s the insurmountable issue of personal autonomy. Given the side effects of these drugs and the fact that HIV isn’t infectious in the way that, say, measles, is, there’s no sound justification in law or public health for putting “all men diagnosed with HIV” on these powerful drugs.
More problematic yet is the suggestion that all HIV-negative men be put on a basic anti-retroviral. Here the public health justifications and liberty-compromising justifications are even weaker. All HIV-negative men? Even sexually abstinent eighty-five year olds? Monogamous straight men? Even if he’s not suggesting that these men be compelled to go on the drugs, think of the costs and the side effects in administering these powerful pharmaceuticals to the public and the absurdity of this suggestion becomes manifest.
And why stop at men? Sullivan is writing from the perspective of a gay man (so am I!), and not thinking about other populations that are at serious risk of transmission — notably including poor women of color who are often infected by their male sex partners who, for cultural reasons, don’t know about or don’t disclose their HIV+ status. If we’re going to move in this direction at all (I don’t think we should, and in any case we couldn’t and shouldn’t force anyone to take these drugs), we need to carefully consider the populations really at risk. That’s hard to do, admittedly, but better than issuing a blunderbuss suggestion that “all men” be the targets.
- See John G. Culhane, Remarks, in AIDS in National and International Law, Proceedings of the 96th Annual Meeting of the American Society of International Law, Mar. 13-16, 2002. Available only by subcription. ↩
I don’t know whether Ann Althouse is so angry that her judgment and analytical skills are clouded, or whether she just loves the traffic on her blog so much that she’ll say anything to drive it up. Last time, it was a series of irresponsible assumptions about who was to blame about some Tea Party violence at a D.C. rally. This time, it was NPR — quite a daring target for a right-wing blogger! — that felt her fury. You should read the whole thing (which is her take on linguist Geoff Nunberg’s analysis of the political uses of the word “no), but I’ll pick up at the point where she runs into the ditch. First, she presents this part of the Nunberg piece:
“No” has a great power to bring people together, precisely because it doesn’t have to be pinned down. A child has a much harder time mastering “yes,” which is always the response to a specific prospect — “Do you need to go potty?” Whereas the child’s first “no” comes earlier, as a pure eruption of willful refusal. And the word retains that capacity, even as we learn to intone it to convey despair, anger, defiance, fear, astonishment, disappointment or resignation.
Here’s Althouse’s just plain nutty take:
And that’s how NPR sees you voters: You’re children. You’re resisting potty training. Your Tea Potty Party is mindless emotionalism. You’re — as Andrew Sullivan would put it — intellectually inert brats.
Her primal rant would make sense if the quoted material stopped before the last sentence. But perhaps by then Althouse was too angry to see (let alone read) the text. Nunberg was obviously making a complex point about the power of the word “no”, which can — as the Tea Partiers and others have learned — convey a range of emotions and responses that are (1) a far cry from what kids can express by the word; and (2) cohesive stuff, which those invoking it can then rally around, picking up folks along the way who feel the same (sometimes hard to articulate) sense that things are going wrong. (And Sullivan, for the record, was talking about Sarah Palin; is Althouse really challenging that description, or just trying to gin up her KADs’ support?)
In other words — and as Nunberg himself pointed out in an earlier part of the segment, which Althouse quoted but then left behind — “no” can be invoked by any party or interest group, not just by conservatives. Here’s the quote:
[“No”] usually gets a bad rap in public life; it’s never a compliment to call somebody a naysayer. So Democrats obviously meant to put Republicans on the defensive when they began to call them “the party of no” for opposing the stimulus bill in early 2009. As The New York Times’ Ben Zimmer pointed out, that phrase has often been used by the party in power to label the opposition as obstructionist. Ronald Reagan branded Democrats as the “party of no” in 1988, Bill Clinton did the same thing to Republicans in 1994, and Tom Delay turned the phrase back on Democrats in 2005.
So it’s used by both sides, and for obvious reasons. Oops.
There’s more, though. Here’s the last paragraph from Nunberg’s piece, which really seems to have gotten under her skin (and led to her peroration, the rant quoted below):
That’s what makes these choruses of negativity so hard to read, whether they’re coming from unhappy voters or tired preschoolers in full shutdown. Everybody is sounding the same plaintive note, but it isn’t as if there’s any single juice flavor that will make them all happy again.
His point is that the word isn’t specific when used outside of a clear and limited context. “Hell, no…” but to…what? To everything? Er, no, it’s a call to arms. If it is meant to be global, that is intellectually inert. So “no” is a response, but it only gets you so far; just as polls on what angry voters were reacting to yield an unclear picture. That’s what Nunberg was saying, in addition to providing lots of fascinating information about the whole idea of a “word of the year” and other uses of “no.” (Here‘s the transcript with a link to the five-minute audio, which Althouse proudly states she doesn’t have the patience to listen to. Do not buy this woman a book on CD for the holidays!)
Oh, I almost forgot about the juice flavor comment, which may have triggered that final, barely coherent paragraph which I must now somehow find it in myself to reproduce:
Hard to read?! Is conservatism a foreign language to Nunberg and the NPR slow-listeners stuck in traffic? Juice flavor? It would be a punch line for me to call that a punch line — juice ≈ punch — but why is that a punch line? Maybe Nunberg plied his intellectually inert brats with juice — I’ll get grape, because grape is a little more favorite — but what does that mean about what he (and NPR) think government is supposed to do? It’s supposed to give us yummy things to make us feel good (and compliant). No wonder he can’t read these choruses of negativity.
Relax. It’s a “metaphor.” And really, I have almost no idea what she’s talking about.
The controversy continues, as it must. I recently explored the issue of late-term abortions through a sort of thought experiment, asking whether anencephalics were “human” in any meaningful sense. A couple of posts later, and after a discussion about the point here at home and an internet-mediated exchange with Andrew Sullivan (see here, here, here, and here), I answered my own question — they are human and entitled to respect.
My readers mostly disagreed. Here are some of their responses to my rethinking:
“I think your initial comment was correct, and that you are silly to back down to Andrew Sullivan’s emotional bleating. What makes us human is our brain. A “baby” with no brain isn’t human in any real or significant sense of the term.
“Aborting such an entity raises none of the moral questions raised by aborting a fetus that already has the cognitive equipment of a human, or which will have such cognitive equipment in the near future.
“Yeah, the entities look vaguely human, but they have no brain, dude. They’re not entitled to any respect or empathy, because there’s nothing there to empathize with. You might as well have empathy for your desk lamp.”
This next reader agreed, eloquently:
“[I]…disagree with Sullivan. It’s important to distinguish between empathy, which requires something similar enough that we can imagine what it is like to be that other, from the emotional response to something that is physically similar to us. People cry at funerals, but that corpse is not another person. People sometimes imagine what it is like to be dead and in a coffin, but that of course is a pretense. The fact that our animal brains are cued by a corpse’s appearance to the person who once was doesn’t change that fact. Nor is a brain-dead corpse a person, even if the heart and lung are kept beating by modern medical technology. For all it might look like the person who once was, it isn’t. Nor is an anencephalic infant a person. In all three cases, the appearance of another human organism can tug at our heartstrings and cause us to imagine there is someone there. But there isn’t.”
Finally, this reader, who expressed disappointment in my change of heart:
“I found your original post refreshing and rational….”
“[I]t seems like you’re backing down now. All I can say is I wish you wouldn’t. You shouldn’t have to back down from asking a thoughtful question.”
Thanks to these readers and to others for their comments. Just a few additional thoughts seem in order.
I’d like to think I didn’t “back down,” which suggests some kind of intimidation. (Is anyone really intimidated, short of a threat of litigation or violence, on the internet?) No, I had a change of heart, upon reflection. My earlier position was lifted, more or less intact, from my days as a philosophy student. But I’m no longer than person, and — when pushed — I discovered that my views had changed, probably without my realizing it. I will confess that when I originally wrote that anencephalics weren’t human in the sense that mattered to me, it didn’t feel…right. There’s a difference in making a logically sound argument and believing it in your bones.
Nor did I — or do I — apologize for asking the question. Just because I ended up answering it differently than I or my readers expected doesn’t mean it was wrong to ask it. Judging from the intellectual firestorm this issue has generated, it seems that my raising it was a great thing.
Of course, I’ve gone back to read my “change of heart post” with Talmudic scrutiny. And I find that I never said that I had “empathy” for anencephalics; the readers’ comments suggest why that term isn’t descriptive. I did say that they are entitled to respect, and I’d say that whether or not I thought they were “human.” As I also stated in that later post (and with apology for quoting myself):
“[P]art of the problem is that we generally afford so little respect to other species that when babies without cognitive capacities appear, thinking of them as similar to other animals with lower cognition can lead to a cold place. For me, then, this conversation is a reminder that humans are part of a larger, teeming universe, and that we mostly do a terrible job of remembering and respecting that.”
Finally, I want to bring this conversation back to the women carrying these unfortunate offspring. I think we can agree that they are entitled to respect and empathy. (Here’s Sullivan’s collection of the stories, current as of about a week ago, just in case you need an empathy boost.) Their view of an anencephalic is entitled to respect, and to our deepest empathy: Can any of us really know how we’d feel (or act) in such a situation? And how might we want our own decisions treated in such a case?
As an staunch member of the pro-choice community, it’s important to keep in mind that some have made moving decisions not to abort, even in these cases. Most seem to do so for religious reasons, but…whatever. There should be enough respect go to around.
For awhile, I wish I’d never written on anencephaly. My first clue should have been that I didn’t know how to describe these unfortunate children, born without most of their brains. Since one of my points was to raise the issue of what counts as humanity, I didn’t want to answer my own question by calling them “babies”; at one point, I used the clinical term entity, which drew a criticism from Andrew Sullivan (one that I now largely accept, as I’ll soon discuss).
Several WordinEdgewise readers commented on the issue, with most taking the position that anencephalics prove the point that “human” is really just a category that we use for our own purposes; by creating anencephalics, the universe is reminding us that it doesn’t care about our efforts at taxonomy. One reader invited me and others to take a look at some of the images of anencephalics, and I did. I had planned on posting a couple of these here, but decided that it could too easily be taken as a kind of pornography. Those who are curious about exactly what these tragic babies look like can go to Google images.
I’d really just wanted to raise the issue in the context of the late-term abortion controversy so respectfully unfolding over at the Daily Dish. But the whole discussion has been valuable to me, and I hope to others, as I sort through the intractable complexity of these issues that are so central to our humanity. One immediate result was a conversation with my spouse, David, who is the one in the family with true empathy. He was astonished that I’d even raised the question of the humanity of anencephalics, uninterested in the logical case I was able to build for that possible conclusion. Eschewing metaphysical terms like “soul,” he simply stated that these babies were entitled to respect.
It’s really impossible for me to argue with that. I realized that part of the problem is that we generally afford so little respect to other species that when babies without cognitive capacities appear, thinking of them as similar to other animals with lower cognition can lead to a cold place. For me, then, this conversation is a reminder that humans are part of a larger, teeming universe, and that we mostly do a terrible job of remembering and respecting that.
But there’s more to it than our connection with other species. Logic only gets one so far. I’m not religious, but perhaps the combination of being a bit older and having kids of my own makes me realize that membership in the human race, defined broadly enough to include anencephalics, is important — even if I can’t exactly say why. Maybe it’s just the way we’re wired. (Ask Edmund O. Wilson, or some other brilliant and delightfully controversial sociobiologist.)
And every one of us is entitled to respect, which is at least to say serious consideration in any moral decision. That doesn’t necessarily lead to any particular conclusion; it may be that respecting the interest of an anencephalic, or other grossly deformed fetus, is to abort. It seems to me that reasonable people can disagree here, and it also seems to me apparent that the humility of uncertainty requires giving the woman carrying this life — who, it should go without saying, is also entitled to respect — the right to resolve these impossible questions according to her best judgment.
I still don’t believe in the “soul,” or any such dreamed-up construct. But there’s a kind of poetry of the shorthand in the term, as it captures something vital about our shared humanity. As long as it’s not used as a trump card, it can be used to express the ineffable.
Responding to my first post on the subject of late-term abortions, Andrew Sullivan takes issue with me on anencephalic fetuses (i.e., those whose brains will not develop to enable cognition, and most of whom will die shortly after birth). In the context of questioning his opposition to late-term abortions even in such cases, I had asked whether anencephalics are “human” in a morally relevant sense. After a long quote from me (see the earlier post), here’s his response:
“I am just aware that another human life is at stake here and I find describing such infants as “entities”, as Culhane does, misses an essential fact about them: their soul and their humanity. Our view of what is human “in the sense that matters to me” is where we differ. From reading the emails, it seems the mothers are actually closer to my conflicts than Culhane’s certainties.”
Yeah, I did describe them as “entities,” recognizing of course the response it would likely (and with some justification) elicit. But I did so because to have referred to them as “babies” or “humans” would have begged the very question I was seeking to raise, somewhat in the spirit of a thought experiment: What does it mean to be human? I don’t know, and I’m not even “certain” that even these most tragic figures shouldn’t have at least some rights. But why? What makes us human? Should we accord rights to anencephalics even if we decide, pace Sullivan, they’re not human in some morally relevant sense? If so, why? And, right to the point, should these rights outweigh those of the mother who makes the painful decision to terminate her pregnancy under such circumstances?
These complex issue vex moral philosophers, and I make no claim to certainty. So, to the extent that my point was presented syllogistically, I went further than I should have.
On the subject of certainty, though, what about Sullivan’s citing of the “fact” that humans have souls? And their humanity, while it would likely be debated by fewer people, isn’t a “fact” either, but a proposition in need of argument. Otherwise it’s an article of faith (yes, that kind) — take it or leave it.
Let me end this on a more conciliatory note: After yesterday’s post, I continued reading the many Dish entries on the issue; as I said earlier today, I was taken aback by the stories of the women who’d undergone late-term abortions and by Sullivan’s obviously sympathetic view of their situation. That remains true. Whatever our disagreements about abortion (in the abstract or otherwise), the Dish has contributed an important element to the often dispiriting debate: nuance.
“Come to America.”
Is he serious? Is this really the best place for them to seek asylum? Tiwonge Chimbalanga identifies as a trans-woman. They won’t be able to marry here, either. In many places, neither of them will have protection if fired from their jobs; Chimbalanga wouldn’t have anti-discrimination protection in most places. And I haven’t even gotten to the horrible violence that the most vulnerable among us — the trans-community — routinely suffer.
Despite his trenchant criticisms of the legal treatment of the LGBT community, Sullivan retains an immigrant’s zeal for his adopted nation (in this regard, it’s telling that he uses the patriotic “America” rather than “U.S.”). But surely a moment’s sober reflection would have told him that there are several obviously better choices for them in Europe. I know, I know — they have their own nativist movements, and violence against “outsiders” isn’t exactly unknown there. But at least they’d be assured that the law would treat them as full and equal citizens.
“Elena Kagan, are you a lesbian?”
I can’t imagine that question being asked directly by any of the Senators at her confirmation hearing, but how would she respond if it were? In that context, of course, the only appropriate response would be something like:
“I don’t see how that’s relevant to my qualifications to sit on the Supreme Court.”
“Bold” isn’t the first word that comes to mind in describing Kagan. Indeed, her stance on DADT – which stemmed as much from enforcing Harvard’s policy against discrimination as anything else – is notable precisely because it appears to be the only time she took a strong position on an important issue of the day….
How can someone have achieved success on this level while letting so little of herself, or her views be known? David Brooks, writing in the Times, finds Kagan’s ultra-cautious path and “her willingness to suppress so much of her mind for the sake of her career, kind of disturbing.”
So do I. In response to [a questionnaire she completed when under consideration for the Solicitor General job], Kagan stated that she didn’t recall ever discussing whether the Constitution should be read to confer a right to same-sex marriage. Do you believe that? Isn’t it likelier that she didn’t discuss it in a setting where it might come back at her?
This level of caution seems very odd. A person reaches her 50th birthday without coming out of a careful cage – one that may or may include a lesbian sexual orientation. (I have no inside information here, but there’s plenty of speculation flying around; more than usual in these kinds of cases.)
Why not be bolder, sooner? It seems that Kagan – tenured law professor at University of Chicago, Dean of Harvard Law School, and now Solicitor General of the U.S. would have by now achieved enough to come out, in every sense of that word.
I had this very conversation with a friend last week, and we joked that she might have planned her entire life for the possibility of becoming a Supreme Court Justice. But now our joke isn’t funny: This profile of the nominee shows her wearing a judicial robe, and quoting Justice Felix Frankfurter, in her high school yearbook photo! It also states that at least one classmate recalls Kagan’s stating that becoming a Supreme Court Justice was her goal.
Now what? If she gets through the Kabuki-like nomination process, will she feel liberated enough to make bold, progressive decisions?…
Will she feel comfortable and secure enough to come out, if in fact she is a lesbian?
I have doubts on both counts. Having spent one’s whole life in a carefully crafted, protective bubble, it might be hard to leave its safe casing now. I hope I’m wrong.
In a way, then, I agree with Andrew Sullivan that the public is legitimately interested in a candidate’s emotional life. The law — especially constitutional law — isn’t math, and I, for one, am interested in learning how the candidate sees the world. Someone whose entire life has been guarded, both in terms of emotional and sexual affinity and in the legal context, raises some concern.
So Sullivan has the better of the exchange here. As he notes, when someone is heterosexual, the public part of that orientation is relentlessly on display, in a way so pervasive yet mundane that it becomes wallpaper. (And when it’s no longer boring, sparks fly: See, e.g., the Clarence Thomas hearings.) Yet it “doesn’t matter” when the candidate is gay? Translation: Keep it in the closet.
The back-and-forth between Sullivan Benjamin Sarlin of the Daily Beast did raise another issue, and here I think we might have the start of an interesting, productive and ultimately irresolvable debate about the role and responsibility of the blogger. Is it just to “think out loud,” and not “to report stories,” as Sullivan maintains? I think that’s a false dichotomy. Like it or not, Sullivan is so widely read and cited (he’s prolific, smart, and conveys a clear sense of self) that his thinking out loud, when it presents statements like “we have been told by many that she is gay”, is just more likely to make people think he has some inside information than such a statement would coming from, say, me. It’s not presented as reporting, but might be taken that way. A short statement like, “I have no inside information” would be a helpful disclaimer in this kind of case, even though it’s kind of implied by the way the sentence is structured. (“We have been told” is different, in an important way, from “I have been told.”
I’m not sure what Kagan should do about this issue (if anything) at this point. Expect more thinking out loud on that issue, soon.
Last night’s surprise action by President Obama was a heartening and welcome development. In a two-page memo to HHS Secretary Kathleen Sebelius, Obama requested that the Secretary promulgate rules that will increase the chances that the wishes of lesbian and gay hospital patients respecting visitation and decision-making will be respected rather than ignored. From the memorandum:
It should be made clear that designated visitors, including individuals designated by legally valid advance directives (such as durable powers of attorney and health care proxies), should enjoy visitation privileges that are no more restrictive than those that immediate family members enjoy. You should also provide that participating hospitals may not deny visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability.
So far, I’ve not seen any criticism of this move from the right. I don’t expect much (but please let me know if you find any), because mostly everyone has conceded this point: “Oh, I’m in favor of gay people being able to visit each other in the hospital.” It’s an easy bone to throw us to make homophobia seem tolerant, and it has the benefit of feeding into the perception they’re trying to sustain that gay people are “sick.” So it’s a brilliant, unassailable — and overdue — move by the President.
What little criticism I’ve seen has come from the gays our ownselves. Here’s Andrew Sullivan:
As someone who’s written both windy law review articles and blog posts arguing for marriage equality for the past decade plus, I’m not going to disagree about the importance of “simple equality” which would make a great number of other issues disappear. (And it really is simple.) But read the Memorandum closely and you’ll see that the requested change goes far beyond marriage equality: The idea is to allow people to designate the person of their choice (either “on the spot” or through advance directives) to visit them in the hospital.
Yes, this will help those of us in same-sex relationships to avoid some of the horrors that our community has suffered, such as the inhumane and just inexplicable case that unfolded in Florida recently. But it will also help people in all kinds of relationships that the law doesn’t recognize, and never will. That respect for individual autonomy and decision-making in the most challenging circumstances is the great accomplishment of this Memorandum, and it shouldn’t go unacknowledged.
One more point: There’s a limit to what a President can accomplish all by himself, but these Executive Orders and Memoranda should be coming fast and furious. Obama could have issued this Memorandum immediately after taking office. While that would have been too late for Janice Langbehn and Lisa Pond in Florida, there have doubtless been many others since January 2009 who could have been at their partners’ side during those terrible final hours. What a needless shame.
Tomorrow’s event at the Cato Institute seems like an intriguing cage-match between Andrew Sullivan, a sort-of-lapsed [small c]onservative and the Ultra-Right wing, virulently anti-gay Maggie Gallagher. The stated topic is whether there’s a place for gays in conservatism and the conservative movement. A more perspicacious question might convert the “and” to “or”: Is there a place for gays in conservatism OR the conservative movement? Because these two things are quite different. (I expect that Sullivan will pick up on this point immediately, as he’s written about how the “movement” has lost its way, and therefore him.)
I’m pretty far from conservative. But reading thoughtful conservatives is vital for anyone with aspirations to informed commentary and discussion. The conservative “movement,” though? Not so much: Tea Parties, torture defense, hypocritical and indefensible legislative obstructionism, and…Sarah Palin. It seems that Burkean-style conservatives have plenty to do in distinguishing themselves from those who have hijacked the word “conservative” and are trying to make off with it. There’s no room for gays — or anyone else whose concern for community, nation, and world isn’t purely cynical — in that “movement.” The gay question is to some extent a distraction from this broader tension, but the issue whether conservatism can find a place for gays is important as a marker for the movement’s continued intellectual legitimacy. Any “movement” that can find no place for a large and influential demographic group is engaging in the kind of denial — closeting, to use a pointed word in this context — that is destined to consign it to history’s periphery. We’re not going away, but they will unless they can find some way of accommodating us.
Expect the third participant, a UK Conservative party “shadow” secretary (Nick Herbert) to explain how that party has abandoned its attacks on the gay community in favor of the kind of robust, inclusive conservatism that Maggie Gallagher loves to hate.