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May 12th, 2023:

FDA set to approve over the counter birth control pill


An influential advisory panel recommended that the Food and Drug Administration (FDA) approve an oral contraceptive pill for over-the-counter use without an age restriction.

While hormonal birth control is available without a prescription in many other countries, this medication, Opill, would be the first such option in the United States. The vote, conducted after a day-and-a-half discussion this week, is a significant step toward making birth control more widely available now that abortion is not federally protected.

The FDA is not obligated to accept the panel’s recommendation but is likely to do so, with a decision expected this summer. The vote means that hormonal birth control could be available without a prescription later this year.

In their review of the manufacturer’s data, FDA scientists surfaced concerns about whether people would know how to properly use the medication without the advice of a physician, highlighting in particular whether people would understand how often to take the medication, the proper way to consume it, the correct dosing, and what medical conditions might render them ineligible for the drug.

Opill, which is made of progestin, is not recommended for people who have had breast cancer. Some FDA scientists also worried that the drug may be less effective for people with higher body weights, who were not considered to the same extent when the drug was first approved in 1973.

But in their discussion this week, the group of scientists advising the FDA — including doctors and biostatisticians — argued that the value of making a safe and effective oral contraceptive more readily available outweighed those concerns. Making the pill an option without a prescription could make it easier for people who otherwise don’t have access to hormonal birth control: minors who are unable to to involve their parents, people who don’t have a regular health care provider, or those whose nearby clinics and health centers don’t provide oral contraceptives.

The over-the-counter birth control pill — which should be taken at the same time every day — is also more effective than other non-prescription methods, such as condoms or diaphragms.

“It’s really an access issue,” said Dr. Katalin Roth, a professor of medicine at George Washington University. “Making it over the counter is the right thing for women.”

There is another factor in all this, one that went unspoken in the official proceedings.

However, there’s another incredibly salient factor that was largely absent from the presentations: the current U.S. abortion landscape.

Per the Guttmacher Institute, 26 states have abortion schemes categorized as “restrictive,” “very restrictive” or “most restrictive.” In many of those states, abortions are virtually inaccessible.

Such a climate makes the accessibility of contraception a critical concern, particularly for girls and women who live in states with the most restrictive regimes. As it is, contraception has been linked to expanded educational opportunities and higher income for women and better outcomes for children; a 2012 National Bureau of Economic Research paper found that one-third of the wage gains women have made since the 1960s stem from the availability of birth control.

Though separate processes, targeting contraception has long been part of the anti-abortion movement, even if its activists sometimes muddied their stance so as not to alienate supporters.

“When emergency contraception first came about, some pharmacists refused to fill prescriptions and said that emergency contraception is an abortifacient, which it isn’t,” Carole Joffe, a sociology professor at the University of California, Davis’ center for global reproductive health, told TPM. “Then it escalates — some were at one point refusing to fill prescriptions for regular birth control.”

Immediately after the anti-abortion movement had its historic victory in the Supreme Court overturning Roe v. Wade, right-wing lawmakers started eyeing intrauterine devices and Plan B, also known as the morning-after pill, to restrict next.

“Going after contraception is such an overreach — but that’s what social movements do,” Joffe added. “When they win one battle, they think they can win more.”

There is of course opposition to this proposal.

Major medical groups, such as the American Medical Association and the American College of Obstetricians and Gynecologists, are backing the request.

But groups like the Catholic Medical Association are opposed, and not just on religious grounds.

In addition to questioning the safety of making a birth control available without a prescription, that group argues that easier access would help sex traffickers and that skipping the requirement to see a doctor would harm women’s health in other ways.

“It eliminates the need to see a physician for young ladies to see a physician for the prescription,” says Dr. Timothy Millea, who head’s the association’s health care policy committee. “That will eliminate the screenings for ovarian cancer, for cervical cancer, for sexually transmitted infections.”

An FDA assessment also raised questions about taking a health professional out the equation. FDA scientists questioned whether women would take the pill every day at the same time, as they’re supposed to, and whether women who shouldn’t take the pill because of certain health problems would know that.

But proponents dismiss those concerns, arguing there’s plenty of evidence that women can easily handle it. Pills are available without a prescription in more than 100 other countries.

“We think the evidence is quite clear,” says Dr. Jack Resneck Jr., the AMA’s president. “First of all, oral contraceptives have been used safely by millions of women in the United States and around the world since the 1960s.”

Moreover, while regular exams are important, “they’re not necessary prior to initiating or refiling an oral contraceptive,” Resneck says.

I don’t have any commentary here, just adding this to the Things To Watch in the coming weeks, as the FDA preps its final decision. We’re past the point where the Lege can do anything ridiculous, but that doesn’t mean there won’t be other opportunities. The forced birth zealots don’t like contraception either, and they’re not going to go away.

Cruise comes to Houston

I’m genuinely curious to see how this goes.

Cruise, a General Motors autonomous vehicle subsidiary, is bringing its self-driving cars to Houston with the goal of offering driverless rides.

The cars will begin testing next week, said Megan Prichard, Cruise’s vice president of ridehail.

“We designed the technology to launch first in San Francisco with the idea that we would see all sorts of challenges: everything from roller skate parties, to heavy traffic to raccoons in the roads,” Prichard said. “And we thought that if we designed our technology for a dense urban environment, that we would be able to then pick it up and put it into other cities around the country and around the world with only a little bit of fine tuning.”

Initial tests will be supervised drives, with a Cruise employee in the vehicle as a backup safety driver while the vehicle learns about Houston streets. The company did not specify where it would be tested in Houston, and the first drives will be closed to the public. Prichard said there was no timeline for when rides to the public will be offered. The company declined to say how many vehicles it planned to have in Houston.

After launching in San Francisco last year, the company started running its autonomous vehicles — a fleet of Chevrolet Bolt electric vehicles equipped with sensors — in Austin and Phoenix.

Prichard said the company is expanding to Houston because it’s a large and growing metropolitan area.

“The area that we operate (in) will be the area that we determine to be safe, and the hours that we operate will be the hours that we determine to be safe. And then we’ll expand that out over time,” Prichard said.

See here and here for some background. While the Cruise app rolled out in Austin in January, they only began testing the cars on the streets there in March, and that was not yet the public rollout. As such, I have no idea how it’s gone in Austin, so I don’t have any basis for predicting how it might go here. For that matter, and for all the hype about autonomous vehicle delivery services in Houston, I have not seen any reporting on how that’s been received by the public. I haven’t seen any stories of spectacular failures, so that’s a positive sign. I’m still unsure how big the market actually is for any of this. You can specify a driver who doesn’t talk to you when you order an Uber, so how is this any different? Like I said, I don’t know, and I’m looking forward to finding out. Does this appeal to you at all? Leave a comment and let me know. CultureMap, which answers one of my questions by noting that a Cruise ride would be cheaper than an Uber, and Bloomberg have more.

Fort Cavazos

For a number of reasons, Tuesday was a good day.

General Richard E. Cavazos

One of the U.S. military’s largest bases has been renamed after the Army’s first Hispanic four-star general.

Fort Hood, located about 70 miles north of Austin, Texas, was redesignated on Tuesday as Fort Cavazos in honor of the late Gen. Richard Edward Cavazos, a Texas native who served in the Korean and Vietnam wars.

“General Cavazos’ combat proven leadership, his moral character and his loyalty to his Soldiers and their families made him the fearless yet respected and influential leader that he was during the time he served, and beyond,” Lt. Gen. Sean Bernabe, III Armored Corps Commanding General, said in a statement.

“We are ready and excited to be part of such a momentous part of history, while we honor a leader who we all admire,” Bernabe added.

The redesignation is part of an effort by the Department of Defense to rename military bases and other sites with titles linked to members of the Confederacy.

A slew of military installations and nine Army bases are getting new names, including Fort Hood, which was named after the Confederate Gen. John Bell Hood, who commanded troops during the Civil War.

The Congressional Hispanic Caucus and other supporters had urged the military to rename the base after Cavazos, who was raised in Kingsville, Texas, and commanded troops at Fort Hood.

Born to Mexican-American parents, Cavazos was commissioned to the Army after graduating from high school and went to fight in the Korean War. There, he was a member of the Borinqueneers, a famed unit of mostly Spanish-speaking Puerto Rican soldiers. He later led troops in the Vietnam War.

Cavazos earned the Silver Star and two Distinguished Service Cross awards for his service during the two conflicts — for actions such as evacuating wounded soldiers before having his own injuries treated during the Korean War and exposing himself to enemy fire while leading attacks in the Vietnam War.

“I truly believe that a lot of us got home because of the way he conducted himself,” Melvin “Brave” Brav, who served under Cavazos, told the San Antonio Express-News.

Cavazos eventually ascended to the rank of four-star general and led the U.S. Army Forces Command, making him one of the highest-ranked Army officials at the time.

Outstanding, well deserved, and long overdue. You can learn more about Gen. Cavazos by clicking on the embedded picture. And just as a reminder, not everyone supported this.

The renaming of bases became a heated political issue in the final months of the Trump administration, when the former president blasted the idea, accusing others of wanting to “throw those names away.”

Trump had vetoed the 2021 National Defense Authorization Act, which included the Naming Commission, but in the waning days of his administration, Congress delivered its first and only veto override during his tenure, approving the legislation with overwhelming bipartisan support.

And the renaming comes at a time when Gen. Lloyd Austin, the country’s first Black secretary of defense, has identified racism and domestic extremism as some of the most pressing issues facing the country and the armed services.

“The job of the Department of Defense is to keep America safe from our enemies. But we can’t do that if some of those enemies lie within our own ranks,” Austin said at his confirmation hearing.

The fact that this happened on the same day that a jury found The Former Guy liable to the tune of $5 million for his assault on E. Jean Carroll is just *chef’s kiss*. Throw all those names right into the trash, I say. We should have done it decades ago. And if somehow your butt remains in pain because of this, just drive a few miles north of Fort Cavazos to Hood County, where that slimeball Confederate’s legacy still lives on. However much we do, it’s still not enough.

Dispatches from Dallas, May 12 edition

This is a weekly feature produced by my friend Ginger. Let us know what you think.

This week in DFW-area news, two big stories: the mass shooting in Allen and local election results. Plus, updates on the Dallas ransomware situation, Tarrant County jail troubles go to the feds, Clarence Thomas and Harlan Crow, robotaxis, a great exhibit at an area museum, and mayo beer.

First, local elections: The city of Dallas had all fourteen seats and the mayor’s office on the ballot. All the incumbents (the mayor and 12 council members) won (Archive link), with only one of the open seats proceeding to a runoff. In Fort Worth, per Fort Worth Report, Mayor Parker and most of the council also cruised to re-election and there’s going to be a runoff in D11, the new Hispanic-opportunity district. Arlington kept its mayor and the majority of its council and approved bonds for streets and parks. Denton recalled one council member (archive link), presumably over ignoring the voters on marijuana decriminalization. Local blogger Mark Steger sums up the Richardson elections; Richardson also kept most incumbents and passed a bond issue for additional funds to replace their city hall, which was due for refurbishment before it burned down.

In school board elections, the DMN summarizes results in Collin and Dallas counties (Archive link), which mostly favored incumbents, which was good news after last year’s beatdown by reactionary Patriot Mobile candidates and the like. Frankin Strong has a good summary of statewide news including where anti-reactionary forces failed in North Texas: Keller ISD and Grapevine-Colleyville ISD.

I’m not a fan of Dallas mayor Eric Johnson, but he was the only choice on the ballot. My council member (D10) was term-limited out and I live in a part of Dallas that’s a stronghold of the business Republican, so it’s unsurprising that even the candidate I voted for was a little conservative for my taste. He lost, though, and the somewhat more conservative but at least not utterly reactionary Kathy Stewart will be my council member. Meanwhile in RISD elections, the incumbent in at-large place 6 survived a reactionary challenger, which I consider enough of a victory to make up for both D10 and the mayor.

But at least I voted! A lot of people don’t, and the complaints are legion (Dallas Observer; DMN; Fort Worth Report). Looks like the numbers in the cities are about 10% of registered voters, which as that Dallas Observer story demonstrates, means hundreds of votes are deciding council seat elections. We could solve part of this problem by moving municipal elections to November, when more people vote. But since the people who could move elections keep getting re-elected in May, that’s not likely to happen.

The second big story this week is the mass shooting at the outlet mall in Allen. I assume anyone interested enough to follow Charles’ blog is aware of the outlines of the story, but here’s the DMN update on the story from the 10th (Archive link). Unsurprisingly the killer had a history of “mental illness” and his guns were legally acquired. He was wearing a patch signifying right-wing extremist views and his social media was full of Hitler love and related opinions. And half the victims were of Asian descent (Archive link). Everybody and their dog is upset with Texas Republicans who won’t do anything about guns, but of course, as Charles noted yesterday, we can’t even get the Lege to pass a bill to keep from selling assault weapons to young folks who can’t drink legally in the wake of a mass murder.

Meanwhile, since the mass shooting in Allen, we also saw an apparent attack on folks outside a migrant shelter in Brownsville that killed eight people. And in North Texas we had a shooting on a DART train that killed one and injured two (Archive link). That was just Sunday. Plus, of course, the inevitable copycat threats.

Andrea Grimes has the best take on the whole thing: “If I die by gun violence, don’t pray for me. Politicize me.”

In other news:

  • Charles has covered recent news on the ransomware attack on the City of Dallas. Today the city says it may take months to clean all city computers (Archive link). I’m glad our library is fine-free and I have a stack of books to work through before the IT folks get to it.
  • Here’s a little DMN coverage of the upcoming Senate race between hometown boy Colin Allred and Ted Cruz (Archive link). Most of this is conventional wisdom about how much it sucks to be a Democrat in Texas but I think the DMN’s political reporter may be on to something about the difference between Allred and Beto. I appreciate Beto’s positive campaigning, but he didn’t hit Cruz hard enough. Allred has come out of the gate saying what we all know is true: Cruz is awful and he’s in it for himself. Allred has a fine line to walk being positive vs bringing Cruz’s many chickens home to roost; his opening video did a great job of emphasizing both points. While Allred isn’t my congressional rep (I wish) his local profile suggests he has a good chance of threading that needle.
  • Again as Charles noted, notorious sex pest Bryan Slaton was expelled from the Lege Tuesday. I hope we’ve seen the last of him, but I doubt it. I’ll be keeping an eye out for a new election in Slaton’s district, not to mention seeing who scoops him up as a lobbyist. My condolences to his former constituents, except the ones who voted for him.
  • Speaking of hater Republicans, the Tarrant County Judge is going after a bar that hosted an all-ages drag show. He’s asked the Comptroller to rule whether Tulips, a venue I haven’t been to yet but one that’s hosted a number of concerts I’m interested in, is operating as an unlicensed sexually-oriented business. This is the same county judge who ran off a nationally-acclaimed election administrator because he’s an election denier, so take his suggestions with a mountain of salt.
  • In economic news, the Dallas Fed says Texas is losing its cheap housing advantage. Having bought two houses and sold one in the state in the last fifteen years, I’m not surprised. The price of our (free standing) new construction condo in Austin went up by half in the eight years we owned it and its current estimated value is about another half again of what we sold it for; and our house in Dallas has gone up about half in estimated value in the not-quite five years since we bought it. Near southeast Austin was hot because of the Oracle facility but I can’t tell you why northeast Dallas is this hot.
  • I’ve been watching this story for a while but it’s now coming to a head: Fort Worth activists work with Texas A&M to seek federal investigation of Tarrant County Jail. In particular this request was driven by the county’s handling of the case of Robert Miller, where the county supposedly hired a third-party expert to review the autopsy after he died in jail and the Star-Telegram questioned the results. No autopsy report was sent to the expert and nothing happened. Unsurprisingly, the Sheriff’s office did not respond to information requests for the linked story. Read the whole thing; it’s pretty grim. I’ll continue to keep an eye on this case and hope for some forward motion from the feds.
  • Robotaxis are coming: GM’s Cruise to Expand Robotaxi Service to Dallas and Houston (Archive link). “Cruise initially will offer rides to employees and have a safety driver, then open it to the public once the service is established. When the cars are truly driverless, Cruise will charge fares, a spokeswoman said.” More for somebody else.
  • You knew there was going to be a Clarence Thomas & Harlan Crow update. So here’s the ProPublica story about Harlan Crow paying for Thomas’ great-nephew, whom Thomas raised, at expensive private schools and laying out about $100,000. Crow, meanwhile, has told the Senate panel looking into the apparent corruption involved in his gifts to Thomas to to kiss off (Archive link). For commentary on all this, I recommend Dahlia Lithwick and Chris Geidner. Also, in case you can’t get enough of Clarence and Ginni Thomas, PBS has a Frontline documentary out on them.
  • In cultural news: Nearly 100 works make for a once-in-a-generation show of Mayan art at the Kimbell. The Kimbell is the best museum in the DFW metroplex and one of the best in the state despite its small size. This is going to be a fantastic show; I look forward to seeing it. If any of you reading this will be in the area this summer, check it out. The Kimbell is worth a visit even without a blockbuster exhibit and the general collection is free.
  • We Try Martin House’s Mayonnaise Beer … ‘for Some Reason’. I like mayo on my sandwiches, but … no.
  • Sad news from the zoo: Dallas Zoo elephant dies. Ajabu was seven and died of a viral infection that is often fatal. There’s no reason to suspect Ajabu’s illness was related to any of the zoo’s problems earlier this year.
  • Last, but not least, for my fellow Gen Xers: Frankie Goes to Hollywood biopic Relax in the works. I’m here for it.