After a decade, South Dakota's Amish are moving on
Jason Harward, The Daily Republic, Mitchell, S.D.
Fri, March 24, 2023
Mar. 24—TRIPP, S.D. — About two miles west of Tripp, past a yellow warning sign with a horse and buggy and down a dirt road muddied from snow melt, sit a set of red barns and white homes, all with green roofs.
The structures dotting the rolling landscape house South Dakota's lone Amish community, a nine-family, 60-person settlement that started in 2010, widely believed to be the religious group's first venture into South Dakota.
But come this summer, they'll be gone — some of their homes are listed on
Zillow, and an auction is scheduled for April 28.
"We wanted there to be an Amish community here, but seems like everybody Amish is more from Ohio or Pennsylvania, where there are more trees," Rudy Borntreger, the community's bishop, or elder, explained. "I think it's so open, nobody wants to join us. Now more people decided to move back to Iowa and Minnesota, so kind of for unity's sake."
Though their time in the state will be cut short — and an aversion to technology, deep focus on family and generally reclusive nature limited their socializing potential — they left a lasting impression on the Tripp area and beyond, community members say.
"We love 'em here," Marion Ymker, the owner and manager of Ymker Greenhouse and Landscaping in Armour, where some of the Amish have worked for about a decade, said. "We're disappointed they're moving."
That feeling is mutual.
"Good country. Good area. Good friends," Borntreger said, speaking in a tone of finality on his time in South Dakota, where he's spent around half of his adult life. "Lot of things change in 13 years. Most businesses in Tripp all changed hands. Old friends passed on."
The Amish are part of the Anabaptist Christian movement, closely related to the Mennonites and more distantly connected to the Hutterites. They first arrived in the United States in the 1720s, initially landing in Lancaster, Pennsylvania, which remains the largest single community of Amish in the nation, numbering around 30,000.
Most of the Tripp Amish come from Tomah, Wisconsin, a settlement formed in 1969 that numbers more than 8,000. Borntreger said his family and some others plan to go back to a different region in Wisconsin.
Faith sits at the center of their lives: Bortntreger reads the Bible daily and attends church every other week. The children attend an Amish parochial school on the farm.
Likely the most well-known characteristic of the Amish is an eschewing of modern conveniences. However, there is a somewhat wide range of technology usage among Amish communities, and most of those decisions come down to the discretion of the leadership of individual church districts.
Borntreger described himself as a more conservative bishop. His family's large, white home has no electricity, though they do sometimes use propane lamps. The community also shares a pay phone.
For shorter-distance communication, a large bell sits in front of the Borntreger home; as the reporter arrived on the property for an interview for this story, his wife, donning a white bonnet and blue dress, shook the instrument to hail him from a distant barn.
In the chilly March air, Borntreger wore a black hat low over his forehead. Opposite the round brim, jointly framing his square jaw and forehead, is a dense, curly black beard.
His black coat and dark blue pants are handmade by his wife from spools of thick denim. Completing his stringy, 5-foot-10 frame is the only purchased portion of his outfit: grime-stained, brown boots nearly up to the knee.
Next to him is his youngest child, who carries a bright yellow, orange and green turtle toy, a pop of color in the otherwise drab landscape.
The humble lifestyle — from clothes to horse-and-buggy transportation — is about keeping a focus on God and family, explained Erik Wesner, who publishes Amish America, an Amish news website.
"They adopt certain technologies, but the way they approach technology is really trying to be thoughtful about how it's used," said Wesner, who became acquainted with the Amish by selling the population educational materials. "What are the effects of that technology, whether they're intended or unintended? What are the potential negative effects of that technology? Does the benefit that this tech brings us outweigh the negative side?"
Wesner used the example of a car to illustrate the point. While ownership of a personal vehicle does offer ease of transportation — and the Tripp Amish community has a slate of drivers who often bring them back to Wisconsin for familial engagements or around the state — it also has the potential to "fragment and disperse the family."
Borntreger shared some of these views, tying the root cause of many social ills to a breakdown in family structure.
"It's important to have parents that are willing to work together to raise their children," Borntreger, a father of 14, said. "If we look at overall situations, I think some are neglected; they have questions and their parents don't have answers so the children may look elsewhere."
While discussing family values, he mentioned a fondness for Gov. Kristi Noem, whose speeches he sometimes reads in local weeklies.
However, the Amish do not vote.
"We leave that to the rest," he said.
The Tripp Amish uprooted from their home in Wisconsin partially for "elbow room," which also served as the headline for a 2010 article in the Yankton Daily Press and Dakotan announcing their arrival.
South Dakota as a landing spot was a budgetary decision.
"There's a corn belt between here and there that's more higher-priced ground," Borntreger explained. "But it's good ground, we like it."
It wasn't always easy: he recalled extreme drought in 2012 and the 2022 derecho, which took down some of their buildings. But that didn't factor into the choice to relocate; instead, the problem was an inability to attract and retain population.
A set of six families, referred to as the "Founding Six" by Jim Mize, who sometimes serves as a driver on trips to Wisconsin, rolled in during the first two years. Of that group, only one, Rudy Borntreger's family, remains.
A total of around two dozen families lived in the community throughout the years, though the settlement never numbered more than 90 people.
While Borntreger chalked up the churn to familial ties being elsewhere, Mize surmised that the inner workings of the group were not always the best.
"They won't tell you specifically why, but you can read between the lines; they made a couple of comments that Rudy was hard to get along with," he said. "In Amish practice, the bishop controls where they can work, how much they can work, the type of technology."
Leaving that aside, the impression the Tripp Amish left on local businesses was overwhelmingly positive.
At Ymker Greenhouse in Armour, where mainly younger Amish work a few days per week, they showed exceptional skills in repairing buildings or working in the greenhouse.
"When it comes to craftsmanship, you won't find better people to have," Marion Ymker, who owns the shop, said. "You don't have to worry about foul language. You don't need to worry about back talk or anything like that."
Matt Mehlhaf, the owner of the sale barn in Menno frequented by the Tripp Amish, had similar comments.
"They're good people as far as I'm concerned. And they're good customers, too," he said. "They're willing to work and work hard. And that's what it takes to raise livestock."
In the end, those takeaways are essentially all Borntreger would like to leave behind.
"When we first moved here, people probably figured we were a little different. And I guess we are different, but we're just trying to be friendly people, make an honest living, raise our families," Borntreger said. "That's what our mission is, I guess. Serve God, and don't forget to pray."
Jason Harward is a Report for America corps reporter who writes about state politics in South Dakota.
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Sunday, March 26, 2023
Thursday, March 23, 2023
Cyberterrorism, China top list of international concerns for Americans, Gallup says
Most Americans deem cyberterrorism as the most critical threat to the United States, a new poll from Gallup says.
March 22 (UPI) -- Most Americans view cyberterrorism as the most critical threat to the United States, a new poll from Gallup says.
Gallup's poll on world affairs measured how important respondents perceive 11 potential threats to the country. Cyberterrorism overwhelmingly outpaced the other topics, with 85% of respondents calling it a "critical threat."
Responses to cyberterrorism were consistent across political party lines, with 86% of both Democrats and Republicans calling it a critical threat. About 79% of Independents answered this way.
"Americans continue to cite cyberterrorism as the leading critical threat to U.S. vital security interests, as they have since 2021," Mohamad Younis of Gallup wrote. "Before that, international terrorism and the development of nuclear weapons by Iran and North Korea ranked highest. But concern about each of these has ebbed over the past decade."
RELATED Gallup: LGBT identification steady at 7.2% in 2022 after doubling from a decade ago
The Department of Defense shares in the concerns about cyberterrorism. In a 2022 report, the department said that while state actors like China and Russia are commonly considered the most likely adversaries in cyber warfare, independent criminal organizations also pose a significant threat.
"I think we've seen over time with the development of the non-state actor -- the criminal cyber market -- is that capabilities that were once reserved for state actors are available on the dark web for purchase," Mieke Eoyang, deputy assistant Secretary of Defense for Cyber Policy, told DOD News.
Respondents almost evenly reported that North Korea and Iran developing nuclear weapons was the second most critical threat, followed by international terrorism. Iran ranked higher by a percentage point at 74%. The nuclear capabilities of North Korea and Iran have remained high on the list of threats, though Gallup notes that this year's marks fall nearly 10% short of their record-high responses in past years.
The Department of Defense shares in the concerns about cyberterrorism. In a 2022 report, the department said that while state actors like China and Russia are commonly considered the most likely adversaries in cyber warfare, independent criminal organizations also pose a significant threat.
"I think we've seen over time with the development of the non-state actor -- the criminal cyber market -- is that capabilities that were once reserved for state actors are available on the dark web for purchase," Mieke Eoyang, deputy assistant Secretary of Defense for Cyber Policy, told DOD News.
Respondents almost evenly reported that North Korea and Iran developing nuclear weapons was the second most critical threat, followed by international terrorism. Iran ranked higher by a percentage point at 74%. The nuclear capabilities of North Korea and Iran have remained high on the list of threats, though Gallup notes that this year's marks fall nearly 10% short of their record-high responses in past years.
RELATEDRecord number of Americans dissatisfied with gun laws, according to Gallup poll
The topics that saw the most dramatic changes in this year's survey were the military power of China, immigration and climate change. Political biases showed in how people responded to these topics, with Republicans more likely to see China and immigration as a critical threat and Democrats perceiving climate change as a greater threat.
Immigration and climate change had the deepest disparity between political parties. Eighty-four percent of Republican respondents said immigration was a critical threat compared to 20% of Democrats. Conversely, 85% of Democrats said the same about climate change compared to 21% of Republicans.
More than 40 percent of Americans support banning TikTok: poll
Forty-one percent of Americans in a new poll say they support the federal government banning the video-sharing app TikTok as the platform comes under congressional scrutiny over user safety and data security concerns.
A new Washington Post poll found just 25 percent of Americans say they oppose a potential TikTok ban, while 34 percent say they’re unsure.
People who have used TikTok in the last month and daily TikTok users were less likely to support a ban, at 21 percent and 17 percent, respectively.
Nearly three-quarters of respondents (71 percent) said they’re concerned that TikTok’s parent company ByteDance is based in China, a fact that’s spurred U.S. lawmakers to scrutinize the popular app over concerns that the government in Beijing could gain access to American user data.
That group includes 36 percent who said they’re “very” concerned and 35 percent who said they’re “somewhat” concerned. Nine percent report being “not at all” concerned, and 20 percent say they’re “not too” concerned, according to the poll.
The poll also found 65 percent of Americans think it’s likely TikTok is “collecting personal data on Americans for the Chinese government.” Fifty-six percent think it’s likely the app is “letting the Chinese government control content U.S. users see on TikTok.”
The app has been banned from government phones due to the security concerns, and Congress has been talking about a potential federal ban.
Republicans have criticized the Biden administration for not taking action on the perceived threats. Last week, the Biden administration said it would ban TikTok in the U.S. if ByteDance does not sell its stake to an American company.
At least five dead, more than 80,000 without power amid latest California stormsHouse Intel working group formed to push for surveillance statute’s renewal
Nearly three-quarters of Americans surveyed think it’s likely TikTok is allowing the spread of false information (73 percent) and causing harm to teens’ mental health (72 percent).
TikTok CEO Shou Chew is set to appear before Congress on Thursday amid the intensifying scrutiny.
Taken March 17-18, the Washington Post poll surveyed 1,027 U.S. adults and had a margin of error of plus or minus 3.5 percentage points.
BY JULIA MUELLER - 03/22/23
(AP Photo/Kiichiro Sato, File)
(AP Photo/Kiichiro Sato, File)
Forty-one percent of Americans in a new poll say they support the federal government banning the video-sharing app TikTok as the platform comes under congressional scrutiny over user safety and data security concerns.
A new Washington Post poll found just 25 percent of Americans say they oppose a potential TikTok ban, while 34 percent say they’re unsure.
People who have used TikTok in the last month and daily TikTok users were less likely to support a ban, at 21 percent and 17 percent, respectively.
Nearly three-quarters of respondents (71 percent) said they’re concerned that TikTok’s parent company ByteDance is based in China, a fact that’s spurred U.S. lawmakers to scrutinize the popular app over concerns that the government in Beijing could gain access to American user data.
That group includes 36 percent who said they’re “very” concerned and 35 percent who said they’re “somewhat” concerned. Nine percent report being “not at all” concerned, and 20 percent say they’re “not too” concerned, according to the poll.
The poll also found 65 percent of Americans think it’s likely TikTok is “collecting personal data on Americans for the Chinese government.” Fifty-six percent think it’s likely the app is “letting the Chinese government control content U.S. users see on TikTok.”
The app has been banned from government phones due to the security concerns, and Congress has been talking about a potential federal ban.
Republicans have criticized the Biden administration for not taking action on the perceived threats. Last week, the Biden administration said it would ban TikTok in the U.S. if ByteDance does not sell its stake to an American company.
At least five dead, more than 80,000 without power amid latest California stormsHouse Intel working group formed to push for surveillance statute’s renewal
Nearly three-quarters of Americans surveyed think it’s likely TikTok is allowing the spread of false information (73 percent) and causing harm to teens’ mental health (72 percent).
TikTok CEO Shou Chew is set to appear before Congress on Thursday amid the intensifying scrutiny.
Taken March 17-18, the Washington Post poll surveyed 1,027 U.S. adults and had a margin of error of plus or minus 3.5 percentage points.
BY TARA D. SONENSHINE,
OPINION CONTRIBUTOR
THE HILL
- 03/22/23
TikTok logo is seen on a cell phone on Oct. 14, 2022, in Boston. The Kentucky Senate passed a measure Friday, Feb. 10, 2023, to ban TikTok from state government-issued devices, reflecting bipartisan concerns about the Chinese-owned social media app. (AP Photo/Michael Dwyer, File)
In the preface to “Life After the TikTok Ban,” author Donovan Clifton opens by writing, “TikTok is here to stay for most of us here in the United States.” I beg to differ.
The book was written in 2021, which in the world of social media technologies is a lifetime ago. Consider what has happened to this Chinese-made social media platform in just the last few days. The U.S. Department of Justice is investigating the surveillance of American citizens by ByteDance, the parent company of TikTok.
Reportedly, the investigation centers on whether this Chinese company has been spying on several journalists who cover the technology sector, and an admission by ByteDance that its employees had inappropriately obtained the data of TikTok users.
Congress is preparing to hear from the chief executive officer (CEO) of TikTok, Shou Zi Chew, this week.
And already the CEO has made a video appeal to TikTok’s 150 million American users and offered up new content guidelines to prevent “deep-fakes,” election interference and security risks, promising to allay concerns about its AI-powered technology.
In just three years, TikTok surpassed its American rivals, garnering 1 billion users. What began as just a lip-synching platform called Musical.ly grew into a multi-billion-dollar empire.
As Chris Stokel-Walker writes in “TikTok Boom,” “TikTok has mutated into something of a proxy war over the future of this technology we rely on in our everyday lives.”
For proponents of global engagement and cultural diplomacy, as I am, TikTok is an ideal way to share and learn about how others sing, dance and express themselves and their cultures. And competition for Silicon Valley from China is not necessarily a bad thing.
But – and this is a big “but” – there has been little real transparency about the algorithms used for TikTok, and how data is being collected, stored, scraped, used and disseminated. Investigative reporters and authors have tried, unsuccessfully over the years, to answer the question: Does TikTok, a private Chinese company owned by ByteDance, share data with the Chinese government and, if so, to what end?
President Biden, who met with TikTok executives during his presidential campaign, pushed a plan to require TikTok’s Chinese owners to divest from the app. Simply banning TikTok may sound easy, but it hasn’t driven the company out of business despite repeated attempts.
First came the assault on TikTok by former President Trump, who in 2020 went to war against the social media app, in part because of national security concerns about China getting hold of TikTok user data and using it against the United States.
The Senate banned the use of TikTok by federal employees on government devices. Individual U.S. states, many of them led by Republican governors, began to take matters into their own hands.
Gov. Kristi Noem (R-S.D.) enacted a ban on TikTok across state government-issued devices, blaming China for “manipulating the American people.” Other states started instituting or considering bans based on data security. Indiana is suing the platform for pushing inappropriate content onto children. And some public colleges are banning the app.
In the summer of 2020, TikTok was banned in India, along with 50 other apps. Despite its massive popularity with over 200 million users, the Indian government declared it essentially illegal. (Interestingly, it was just at a time when India and China were squabbling over border issues.)
Afghanistan, under the Taliban, has also banned TikTok, citing its violation of its strict interpretation of Islamic law. Neighboring Pakistan has had an on-again, off-again, relationship with the social media app with bans imposed and then lifted. Bangladesh banned it. Indonesia banned it and then lifted the bans in another back-and-forth approach.
And then there’s China, where TikTok is not allowed at home but its owners are free to distribute its content abroad, if content managers stay within certain unwritten guidelines such as avoiding a focus on controversial topics like Taiwan or Tibet.
For TikTok to survive, it will have to demonstrate a willingness to do more than just issue vague statements and gloss over details about its data collection. It will have to distance itself from the very country that birthed it and risk alienating the Chinese Communist Party, which views control over the internet as critical to its own security. That is asking a lot.
The rise of China and Chinese tech is now challenging Silicon Valley at a time of rising geopolitical tensions over Taiwan, Chinese balloons flying over America and ongoing tensions over Ukraine and China’s relationship with Russia, not to mention arguments over the origins of COVID-19 and the degree to which China shared information in those early pandemic days.Venezuela’s oil, power and purgesArizona death penalty case will determine whether a private citizen can compel an execution
For Americans, TikTok reaches a major share of young people who could be turned off by politics if the social media app is banned.
In the end, the answer for America might lie in a broad new look at comprehensive legislation to ensure data security and privacy, like what the Europeans have done. Picking off TikTok is a short-term solution, but there will always be another social media clock ticking.
Tara D. Sonenshine is the Edward R. Murrow Professor of Public Diplomacy and Public Affairs at the Fletcher School of Law and Diplomacy at Tufts University.
TikTok logo is seen on a cell phone on Oct. 14, 2022, in Boston. The Kentucky Senate passed a measure Friday, Feb. 10, 2023, to ban TikTok from state government-issued devices, reflecting bipartisan concerns about the Chinese-owned social media app. (AP Photo/Michael Dwyer, File)
In the preface to “Life After the TikTok Ban,” author Donovan Clifton opens by writing, “TikTok is here to stay for most of us here in the United States.” I beg to differ.
The book was written in 2021, which in the world of social media technologies is a lifetime ago. Consider what has happened to this Chinese-made social media platform in just the last few days. The U.S. Department of Justice is investigating the surveillance of American citizens by ByteDance, the parent company of TikTok.
Reportedly, the investigation centers on whether this Chinese company has been spying on several journalists who cover the technology sector, and an admission by ByteDance that its employees had inappropriately obtained the data of TikTok users.
Congress is preparing to hear from the chief executive officer (CEO) of TikTok, Shou Zi Chew, this week.
And already the CEO has made a video appeal to TikTok’s 150 million American users and offered up new content guidelines to prevent “deep-fakes,” election interference and security risks, promising to allay concerns about its AI-powered technology.
In just three years, TikTok surpassed its American rivals, garnering 1 billion users. What began as just a lip-synching platform called Musical.ly grew into a multi-billion-dollar empire.
As Chris Stokel-Walker writes in “TikTok Boom,” “TikTok has mutated into something of a proxy war over the future of this technology we rely on in our everyday lives.”
For proponents of global engagement and cultural diplomacy, as I am, TikTok is an ideal way to share and learn about how others sing, dance and express themselves and their cultures. And competition for Silicon Valley from China is not necessarily a bad thing.
But – and this is a big “but” – there has been little real transparency about the algorithms used for TikTok, and how data is being collected, stored, scraped, used and disseminated. Investigative reporters and authors have tried, unsuccessfully over the years, to answer the question: Does TikTok, a private Chinese company owned by ByteDance, share data with the Chinese government and, if so, to what end?
President Biden, who met with TikTok executives during his presidential campaign, pushed a plan to require TikTok’s Chinese owners to divest from the app. Simply banning TikTok may sound easy, but it hasn’t driven the company out of business despite repeated attempts.
First came the assault on TikTok by former President Trump, who in 2020 went to war against the social media app, in part because of national security concerns about China getting hold of TikTok user data and using it against the United States.
The Senate banned the use of TikTok by federal employees on government devices. Individual U.S. states, many of them led by Republican governors, began to take matters into their own hands.
Gov. Kristi Noem (R-S.D.) enacted a ban on TikTok across state government-issued devices, blaming China for “manipulating the American people.” Other states started instituting or considering bans based on data security. Indiana is suing the platform for pushing inappropriate content onto children. And some public colleges are banning the app.
In the summer of 2020, TikTok was banned in India, along with 50 other apps. Despite its massive popularity with over 200 million users, the Indian government declared it essentially illegal. (Interestingly, it was just at a time when India and China were squabbling over border issues.)
Afghanistan, under the Taliban, has also banned TikTok, citing its violation of its strict interpretation of Islamic law. Neighboring Pakistan has had an on-again, off-again, relationship with the social media app with bans imposed and then lifted. Bangladesh banned it. Indonesia banned it and then lifted the bans in another back-and-forth approach.
And then there’s China, where TikTok is not allowed at home but its owners are free to distribute its content abroad, if content managers stay within certain unwritten guidelines such as avoiding a focus on controversial topics like Taiwan or Tibet.
For TikTok to survive, it will have to demonstrate a willingness to do more than just issue vague statements and gloss over details about its data collection. It will have to distance itself from the very country that birthed it and risk alienating the Chinese Communist Party, which views control over the internet as critical to its own security. That is asking a lot.
The rise of China and Chinese tech is now challenging Silicon Valley at a time of rising geopolitical tensions over Taiwan, Chinese balloons flying over America and ongoing tensions over Ukraine and China’s relationship with Russia, not to mention arguments over the origins of COVID-19 and the degree to which China shared information in those early pandemic days.Venezuela’s oil, power and purgesArizona death penalty case will determine whether a private citizen can compel an execution
For Americans, TikTok reaches a major share of young people who could be turned off by politics if the social media app is banned.
In the end, the answer for America might lie in a broad new look at comprehensive legislation to ensure data security and privacy, like what the Europeans have done. Picking off TikTok is a short-term solution, but there will always be another social media clock ticking.
Tara D. Sonenshine is the Edward R. Murrow Professor of Public Diplomacy and Public Affairs at the Fletcher School of Law and Diplomacy at Tufts University.
Friday, March 03, 2023
What is gender-affirming health care? 'Trans refuge' bill would help kids get it
Nicole Ki and Sam Stroozas
March 2, 2023
From left to right: Hannah Edwards, Hildie Edwards, Dahlia Edwards and Dave Edwards. Hildie was Grand Marshall at a local pride parade.
Courtesy of the Edwards family
Minnesota’s Legislature is considering a bill that would make the state a safe haven for transgender youth seeking health care. That means trans youth traveling from other states would be protected in seeking gender-affirming health care in Minnesota.
Parents Hao and Gretchen Nguyen, who have a 6-year-old trans daughter and spoke in support of the bill at a hearing last month, say it’s a big deal for trans youth in Minnesota and across the country.
“It should be as simple as it is for Hao and I to take Asher to the doctor for every parent,” said Gretchen Nguyen. “It shouldn’t matter where they are. I also see this as helping to affirm those that are here and making sure that they’re secure in the fact that their representatives have their back.”
But what exactly is the bill seeking to protect? We asked parents, a doctor and the state’s first openly trans legislator what gender-affirming care means. Here are some of the questions they answered.
What is gender-affirming care?
Gender-affirming health care is specialized health care that meets the needs of transgender and gender-diverse youth and their families, according to Dr. Angela Kade Goepferd, chief education officer and medical director of Children’s Minnesota’s gender health program.
That often includes annual pediatric visits where a doctor will check in with a child on what they’re thinking and how they’re feeling, track their mental and physical development and offer support to families navigating school, sports, community activities and social settings.
“It’s knowing for a kid in a family that they can go to a place where everyone there has experience working with kids and families who are transgender and gender-diverse, and knows how to support their family in terms of the questions they’re having, conflict within their family and knows how to support their kids in their school system,” said Goepferd.
In the first visit, Goepferd typically fields questions from kids and parents wondering what to do. The questions are often “What’s next, whether that’s a younger child and the parents are wondering, should we talk about this? Should we not talk about it? How should we talk about it?”
Or, if the child is asking to be called a different name, “Should we change it at school? Should we not change it?”
Much of the national discourse around health care for trans kids and teens has focused on medication and surgery, but Goepferd, who has worked with LGBTQ youth for 16 years, emphasized medications are not a part of gender-affirming care at Children’s Minnesota until kids reach puberty, typically between 12 and 16.
“Once adolescents reach puberty, or the second stage of puberty, they may become eligible for reversible treatments to pause their puberty while they either wait for the emotional and physical developmental maturity to participate in the decision around hormones, or just give them some more time to explore with their therapist and family what the best outcome might be for them going forward,” Goepferd said.
Goepferd added that Children’s Minnesota does not perform surgical procedures on anyone under 18 as part of gender-affirming care, and said in general “it is rare that anyone under the age of 18 accesses surgical procedures as a part of their gender-affirming care.”
From left, Hao Nguyen, Ronin Nguyen, Gretchen Nguyen and Asher Nguyen pose for a photo.
Courtesy of Gretchen Nguyen
What does gender-affirming care look like?
Parents say gender-affirming care is similar to routine pediatric visits most kids go to, with some added questions on gender identity.
“It's similar to other pediatric care in that the doctors are answering questions that aren't necessarily like, ‘Is my child's arm broken or not?,” said Gretchen Nguyen.
Many families have to leave their primary pediatrician to seek expertise in gender-affirming care, like the Nguyens.
“The pediatrician kind of had nothing for me,” said Gretchen. “She was just like, ‘sometimes that happens and kids grow out of it.’”
For the Nguyens’ 6-year-old trans daughter, Asher, the gender health clinic at Children’s Minnesota is a safe place. Asher’s correct pronouns are used and the Nguyens can ask about Asher’s development, when it’s appropriate to talk about puberty blockers and resources they can use to affirm her gender identity and inform Asher’s future decisions once she gets older.
“There’s really no anxiety for her when she gets there,” said Hao. “Fast forward five years from now, it’s nice for her to have the same doctor who understands this very specific issue. So when we talk about gender-affirming care, I think creating these safe spaces to inform and educate decisions later that the child’s really comfortable with is part of that.”
Others, like Hannah Edwards and her 12-year-old daughter, Hildie, are at the stage to start exploring medication options, such as hormone blockers.
Since age 8, Edwards’ daughter Hildie has seen a pediatrician specializing in gender-affirming care. After several visits and conversations with her counselor, doctor and family, Hildie decided to start hormone blockers.
“The peace of mind that I saw it give Hildie was incredible,” said Edwards. “She went from obsessively thinking and worrying about the changes that were starting to happen to her body to just kind of getting to be a kid for a while longer. That was a huge blessing.”
Hildie Edwards poses at a Pride parade.
Courtesy of the Edwards family
Why do advocates say it’s important for trans kids to have access to gender-affirming health care?
Goepferd, who has seen a rise in the demand for gender-affirming care across the nation, said the trans refuge bill is about saving young people’s lives.
“We’re in the middle of a mental health crisis in this country,” said Goepferd. “Our children, particularly our teenagers, have higher rates of depression, anxiety and suicidality than it ever had, before the American Academy of Pediatrics declared mental health as a crisis for kids.”
According to the 2022 Minnesota Student Survey, of the 10 percent of students surveyed that identified as non-cisgender, 65 percent reported having long-term mental health, behavioral or emotional problems.
Because kids with transgender and gender-diverse identities often experience stigma and discrimination, Goepferd said they will have higher rates of anxiety, depression and suicidality.
“What the research tells us is that when those kids have access to gender-affirming care, to supportive adults, to resources, they do better,” said Goepferd. “They have a more positive sense of self and have less anxiety, depression and suicidality symptoms.”
Medical societies, like the American Medical Association and Children’s Hospital Association, support gender-affirming care because research shows access to this care improves the health and overall well-being of trans youth.
A video of Hao Nguyen speaking in support of his daughter at a hearing for the bill went viral on TikTok and garnered thousands of comments. The comments gave him insight into the impact the bill could have.
“I read all of them,” said Hao. “They’re grown Ashers who are now in their lives, sitting at their homes, in their beds or in their jobs, listening to this testimony. Their comments are stuff like ‘I wish I had a safe place like this. I wish I had a safe place in that family like this. I wish I had a safe state that’s going to do something like this. I wish I wasn’t so afraid to be in the state that I’m in.’”
What is the trans refuge bill?
Rep. Leigh Finke, DFL-St. Paul, who is the sponsor of the trans refuge bill (HF146), said that in simple terms, the bill would protect folks seeking gender-affirming health care. While gender-affirming health care has not been banned in Minnesota, it has been banned in neighboring states, such as South Dakota where Gov. Kristi Noem signed a bill in February banning both surgical and non-surgical gender-affirming treatments for minors in the state.
Finke said the need will only increase as other states continue to ban care. She said Minnesota would be the fourth state to become a trans refuge state.
“The law would make it so that people who live in states who have banned or restricted gender-affirming care can come to Minnesota to access that care and be protected from the laws that govern their home states,” Finke said.
Finke said many of the stories she has heard discuss the impact of care on trans youth and the danger that they may face when the care is unprotected and can be removed at any point.
“Even if your state is trying to ban health care, you’re at risk by simply existing in that state. That’s what I am hearing people say: I’m not going to wait — we need to go somewhere that is safe for my child right now.”
In line with anti-trans arguments nationwide, several Minnesota legislators and organizations have questioned the impact of minors using hormone blockers or cross-sex hormones, even though the bill itself does not attempt to legislate that.
In the House Judiciary Finance and Civil Law Committee meeting on Feb. 21, Rep. Matt Grossell, R-Clearbrook, asked about partially irreversible physical changes that can happen while receiving gender-affirming care, such as facial hair growth for trans men and breast development for trans women.
“Some of these youth may be left with some partially irreversible things that they would be scarred with for life,” Grossell said.
Goepferd was present at the hearing and said that bodily changes associated with gender affirming care happen “very slowly, over time” and that a child would be “well over 18 before they were experiencing significant changes that could be considered permanent.”
“When we force transgender children to go through a puberty that does not align with their identity, they experience significant mental health distress, and that is what we are trying to prevent,” Goepferd said.
Another line of criticism focused on the bill language, which modifies existing law about court jurisdiction involving children. The bill would make seeking gender-affirming care a factor in some assessments for whether a Minnesota court has jurisdiction to make an initial determination in child-custody cases. It also would give courts temporary emergency jurisdiction if a child is here because they have been unable to get gender-affirming health care somewhere else.
“Simply put, the custody provisions of the bill are allowing temporary jurisdiction in the state of Minnesota for custody cases to be heard. It doesn’t change anything about how a custody case would be heard in the state of Minnesota,” Finke said.
Rep. Peggy Scott, R-Andover, said in the committee meeting that she sees the bill as “an assault on parental rights,” saying she has concerns on “the whole custody piece” of the bill. Scott brought up an example of parents living in different states, one in favor of gender affirming care and one against.
“I feel like it gives one parent an advantage over the other in cases where there is some shared parenting going on,” Scott said.
“The idea that there are custody cases where both parents can't have their opportunity to be heard sounds like a very serious problem in a custodial court system,” Finke said, “but I don't think that has anything to do with gender-affirming care.”
Hildie Edwards, a 12-year-old transgender girl, testifying at a Senate Judiciary Committee hearing for the trans refuge bill on Feb. 10.
Screenshot via video
“Emergency jurisdiction is necessary in this bill because what we are doing, what we are saying is that parents have a right to receive gender-affirming care if they live in South Dakota. And if South Dakota is not going to allow those parents to provide for the best care for their child, then Minnesota can do that, and if that's going to lead to custodial decisions, then we need to be able to have temporary emergency custody in the state of Minnesota for those parents to have their ability to provide for their children,” Finke said.
The bill also says people would not be arrested in or extradited from Minnesota for giving or receiving gender-affirming health care, even if it is considered a crime in another state.
Scott asked for the bill to be sent back to the Committee on Health and Finance but the motion failed.
A companion version of the bill, SF 63, was heard in the Minnesota Senate Judiciary Committee Feb. 10, and laid over for final action at a later committee meeting and could become part of a larger bill.
Nicole Ki and Sam Stroozas
March 2, 2023
From left to right: Hannah Edwards, Hildie Edwards, Dahlia Edwards and Dave Edwards. Hildie was Grand Marshall at a local pride parade.
Courtesy of the Edwards family
Minnesota’s Legislature is considering a bill that would make the state a safe haven for transgender youth seeking health care. That means trans youth traveling from other states would be protected in seeking gender-affirming health care in Minnesota.
Parents Hao and Gretchen Nguyen, who have a 6-year-old trans daughter and spoke in support of the bill at a hearing last month, say it’s a big deal for trans youth in Minnesota and across the country.
“It should be as simple as it is for Hao and I to take Asher to the doctor for every parent,” said Gretchen Nguyen. “It shouldn’t matter where they are. I also see this as helping to affirm those that are here and making sure that they’re secure in the fact that their representatives have their back.”
But what exactly is the bill seeking to protect? We asked parents, a doctor and the state’s first openly trans legislator what gender-affirming care means. Here are some of the questions they answered.
What is gender-affirming care?
Gender-affirming health care is specialized health care that meets the needs of transgender and gender-diverse youth and their families, according to Dr. Angela Kade Goepferd, chief education officer and medical director of Children’s Minnesota’s gender health program.
That often includes annual pediatric visits where a doctor will check in with a child on what they’re thinking and how they’re feeling, track their mental and physical development and offer support to families navigating school, sports, community activities and social settings.
“It’s knowing for a kid in a family that they can go to a place where everyone there has experience working with kids and families who are transgender and gender-diverse, and knows how to support their family in terms of the questions they’re having, conflict within their family and knows how to support their kids in their school system,” said Goepferd.
In the first visit, Goepferd typically fields questions from kids and parents wondering what to do. The questions are often “What’s next, whether that’s a younger child and the parents are wondering, should we talk about this? Should we not talk about it? How should we talk about it?”
Or, if the child is asking to be called a different name, “Should we change it at school? Should we not change it?”
Much of the national discourse around health care for trans kids and teens has focused on medication and surgery, but Goepferd, who has worked with LGBTQ youth for 16 years, emphasized medications are not a part of gender-affirming care at Children’s Minnesota until kids reach puberty, typically between 12 and 16.
“Once adolescents reach puberty, or the second stage of puberty, they may become eligible for reversible treatments to pause their puberty while they either wait for the emotional and physical developmental maturity to participate in the decision around hormones, or just give them some more time to explore with their therapist and family what the best outcome might be for them going forward,” Goepferd said.
Goepferd added that Children’s Minnesota does not perform surgical procedures on anyone under 18 as part of gender-affirming care, and said in general “it is rare that anyone under the age of 18 accesses surgical procedures as a part of their gender-affirming care.”
Who does it impact?
Gender-affirming care impacts gender-diverse and transgender youth, who start to understand their gender identities at the age of 3 and 4, said Goepferd. Children’s Minnesota’s gender health program sees patients ranging from 4 to 20 years old.
In a 2022 survey of Minnesota students, the Minnesota Department of Health confirmed with MPR about 10 percent of students in eighth grade or higher identified as non-cisgender, which includes transgender, genderfluid, nonbinary and two-spirit identities.
“That’s not an insignificant number,” said Goepferd. “We in our program are probably somewhere around 150 new patients every year, and we’ve been open for almost four years now. So that’s a significant number of close to 600 patients that we’ve seen so far.”
The number of kids and teens traveling out of their states to seek gender-affirming care in more welcoming states like Minnesota are rising, said Goepferd. With the introduction of anti-transgender legislation across the country, Children’s Minnesota has seen an increase in calls from families and providers over the last two years with questions about getting gender-affirming care, or asking if they can transfer patients over to their gender health program.
The calls came from neighboring states like Montana and South Dakota, all over the Midwest and as far as southern states like Florida and Texas, said Goepferd. Some families have relocated to Minnesota seeking a safer environment for their trans kids and to be closer to gender-affirming care.
Gender-affirming care impacts gender-diverse and transgender youth, who start to understand their gender identities at the age of 3 and 4, said Goepferd. Children’s Minnesota’s gender health program sees patients ranging from 4 to 20 years old.
In a 2022 survey of Minnesota students, the Minnesota Department of Health confirmed with MPR about 10 percent of students in eighth grade or higher identified as non-cisgender, which includes transgender, genderfluid, nonbinary and two-spirit identities.
“That’s not an insignificant number,” said Goepferd. “We in our program are probably somewhere around 150 new patients every year, and we’ve been open for almost four years now. So that’s a significant number of close to 600 patients that we’ve seen so far.”
The number of kids and teens traveling out of their states to seek gender-affirming care in more welcoming states like Minnesota are rising, said Goepferd. With the introduction of anti-transgender legislation across the country, Children’s Minnesota has seen an increase in calls from families and providers over the last two years with questions about getting gender-affirming care, or asking if they can transfer patients over to their gender health program.
The calls came from neighboring states like Montana and South Dakota, all over the Midwest and as far as southern states like Florida and Texas, said Goepferd. Some families have relocated to Minnesota seeking a safer environment for their trans kids and to be closer to gender-affirming care.
From left, Hao Nguyen, Ronin Nguyen, Gretchen Nguyen and Asher Nguyen pose for a photo.
Courtesy of Gretchen Nguyen
What does gender-affirming care look like?
Parents say gender-affirming care is similar to routine pediatric visits most kids go to, with some added questions on gender identity.
“It's similar to other pediatric care in that the doctors are answering questions that aren't necessarily like, ‘Is my child's arm broken or not?,” said Gretchen Nguyen.
Many families have to leave their primary pediatrician to seek expertise in gender-affirming care, like the Nguyens.
“The pediatrician kind of had nothing for me,” said Gretchen. “She was just like, ‘sometimes that happens and kids grow out of it.’”
For the Nguyens’ 6-year-old trans daughter, Asher, the gender health clinic at Children’s Minnesota is a safe place. Asher’s correct pronouns are used and the Nguyens can ask about Asher’s development, when it’s appropriate to talk about puberty blockers and resources they can use to affirm her gender identity and inform Asher’s future decisions once she gets older.
“There’s really no anxiety for her when she gets there,” said Hao. “Fast forward five years from now, it’s nice for her to have the same doctor who understands this very specific issue. So when we talk about gender-affirming care, I think creating these safe spaces to inform and educate decisions later that the child’s really comfortable with is part of that.”
Others, like Hannah Edwards and her 12-year-old daughter, Hildie, are at the stage to start exploring medication options, such as hormone blockers.
Since age 8, Edwards’ daughter Hildie has seen a pediatrician specializing in gender-affirming care. After several visits and conversations with her counselor, doctor and family, Hildie decided to start hormone blockers.
“The peace of mind that I saw it give Hildie was incredible,” said Edwards. “She went from obsessively thinking and worrying about the changes that were starting to happen to her body to just kind of getting to be a kid for a while longer. That was a huge blessing.”
Hildie Edwards poses at a Pride parade.
Courtesy of the Edwards family
Why do advocates say it’s important for trans kids to have access to gender-affirming health care?
Goepferd, who has seen a rise in the demand for gender-affirming care across the nation, said the trans refuge bill is about saving young people’s lives.
“We’re in the middle of a mental health crisis in this country,” said Goepferd. “Our children, particularly our teenagers, have higher rates of depression, anxiety and suicidality than it ever had, before the American Academy of Pediatrics declared mental health as a crisis for kids.”
According to the 2022 Minnesota Student Survey, of the 10 percent of students surveyed that identified as non-cisgender, 65 percent reported having long-term mental health, behavioral or emotional problems.
Because kids with transgender and gender-diverse identities often experience stigma and discrimination, Goepferd said they will have higher rates of anxiety, depression and suicidality.
“What the research tells us is that when those kids have access to gender-affirming care, to supportive adults, to resources, they do better,” said Goepferd. “They have a more positive sense of self and have less anxiety, depression and suicidality symptoms.”
Medical societies, like the American Medical Association and Children’s Hospital Association, support gender-affirming care because research shows access to this care improves the health and overall well-being of trans youth.
A video of Hao Nguyen speaking in support of his daughter at a hearing for the bill went viral on TikTok and garnered thousands of comments. The comments gave him insight into the impact the bill could have.
“I read all of them,” said Hao. “They’re grown Ashers who are now in their lives, sitting at their homes, in their beds or in their jobs, listening to this testimony. Their comments are stuff like ‘I wish I had a safe place like this. I wish I had a safe place in that family like this. I wish I had a safe state that’s going to do something like this. I wish I wasn’t so afraid to be in the state that I’m in.’”
What is the trans refuge bill?
Rep. Leigh Finke, DFL-St. Paul, who is the sponsor of the trans refuge bill (HF146), said that in simple terms, the bill would protect folks seeking gender-affirming health care. While gender-affirming health care has not been banned in Minnesota, it has been banned in neighboring states, such as South Dakota where Gov. Kristi Noem signed a bill in February banning both surgical and non-surgical gender-affirming treatments for minors in the state.
Finke said the need will only increase as other states continue to ban care. She said Minnesota would be the fourth state to become a trans refuge state.
“The law would make it so that people who live in states who have banned or restricted gender-affirming care can come to Minnesota to access that care and be protected from the laws that govern their home states,” Finke said.
Finke said many of the stories she has heard discuss the impact of care on trans youth and the danger that they may face when the care is unprotected and can be removed at any point.
“Even if your state is trying to ban health care, you’re at risk by simply existing in that state. That’s what I am hearing people say: I’m not going to wait — we need to go somewhere that is safe for my child right now.”
In line with anti-trans arguments nationwide, several Minnesota legislators and organizations have questioned the impact of minors using hormone blockers or cross-sex hormones, even though the bill itself does not attempt to legislate that.
In the House Judiciary Finance and Civil Law Committee meeting on Feb. 21, Rep. Matt Grossell, R-Clearbrook, asked about partially irreversible physical changes that can happen while receiving gender-affirming care, such as facial hair growth for trans men and breast development for trans women.
“Some of these youth may be left with some partially irreversible things that they would be scarred with for life,” Grossell said.
Goepferd was present at the hearing and said that bodily changes associated with gender affirming care happen “very slowly, over time” and that a child would be “well over 18 before they were experiencing significant changes that could be considered permanent.”
“When we force transgender children to go through a puberty that does not align with their identity, they experience significant mental health distress, and that is what we are trying to prevent,” Goepferd said.
Another line of criticism focused on the bill language, which modifies existing law about court jurisdiction involving children. The bill would make seeking gender-affirming care a factor in some assessments for whether a Minnesota court has jurisdiction to make an initial determination in child-custody cases. It also would give courts temporary emergency jurisdiction if a child is here because they have been unable to get gender-affirming health care somewhere else.
“Simply put, the custody provisions of the bill are allowing temporary jurisdiction in the state of Minnesota for custody cases to be heard. It doesn’t change anything about how a custody case would be heard in the state of Minnesota,” Finke said.
Rep. Peggy Scott, R-Andover, said in the committee meeting that she sees the bill as “an assault on parental rights,” saying she has concerns on “the whole custody piece” of the bill. Scott brought up an example of parents living in different states, one in favor of gender affirming care and one against.
“I feel like it gives one parent an advantage over the other in cases where there is some shared parenting going on,” Scott said.
“The idea that there are custody cases where both parents can't have their opportunity to be heard sounds like a very serious problem in a custodial court system,” Finke said, “but I don't think that has anything to do with gender-affirming care.”
Hildie Edwards, a 12-year-old transgender girl, testifying at a Senate Judiciary Committee hearing for the trans refuge bill on Feb. 10.
Screenshot via video
“Emergency jurisdiction is necessary in this bill because what we are doing, what we are saying is that parents have a right to receive gender-affirming care if they live in South Dakota. And if South Dakota is not going to allow those parents to provide for the best care for their child, then Minnesota can do that, and if that's going to lead to custodial decisions, then we need to be able to have temporary emergency custody in the state of Minnesota for those parents to have their ability to provide for their children,” Finke said.
The bill also says people would not be arrested in or extradited from Minnesota for giving or receiving gender-affirming health care, even if it is considered a crime in another state.
Scott asked for the bill to be sent back to the Committee on Health and Finance but the motion failed.
A companion version of the bill, SF 63, was heard in the Minnesota Senate Judiciary Committee Feb. 10, and laid over for final action at a later committee meeting and could become part of a larger bill.
Related reading
Saturday, February 11, 2023
Medication abortion could get harder to obtain – or easier: There's a new wave of post-Dobbs lawsuits on abortion pills
Naomi Cahn, Professor of Law, University of Virginia
Protesters in Raleigh, N.C., object to the Supreme Court’s Dobbs ruling on June 25, 2022. Peter Zay/Anadolu Agency via Getty Images
In another pending lawsuit, Bryant v. Stein, obstetrician-gynecologist Amy Bryant sued officials in North Carolina on similar grounds. Although North Carolina has not banned abortion, it imposes a number of restrictions, including a 72-hour waiting period before accessing medical or surgical abortions.
Bryant argues that the restrictions exceed the FDA requirements for dispensing mifepristone and are therefore preempted by federal law.
There is limited precedent in this area.
In one case, the manufacturer of an opioid – Zohydro – challenged a Massachusetts ban of the drug, even though the FDA had approved it. The federal court ruled for the manufacturer because the ban would “obstruct the FDA’s Congressionally-given charge.”
That 2014 opinion might suggest that GenBioPro will succeed. On the other hand, a court might distinguish the two cases: Massachusetts banned Zohydro on public health grounds, which is squarely within the FDA’s authority, while West Virginia bans abortions on moral grounds – to protect fetal life – which is outside the FDA’s purview.
In the North Carolina case, the state does not ban mifepristone; it just imposes more restrictions than the FDA requires. Therefore, it is uncertain whether the Zohydro reasoning would be adopted.
A 2008 Supreme Court case, however, might be relevant.
In Wyeth v. Levine, a drugmaker claimed that FDA labeling requirements for a drug made by Wyeth, which was used to prevent allergies and motion sickness, preempted Vermont’s stricter labeling requirements. The Supreme Court rejected that argument. It concluded instead that allowing states to require stronger warnings didn’t interfere with Congress’ purpose in entrusting the FDA with drug labeling decisions.
Wyeth is not precisely like Bryant, however.
Whereas Wyeth dealt with labeling requirements, Bryant deals with regulations that affect access to a drug. Nevertheless, the Wyeth precedent could allow a court to permit states to impose stronger restrictions on access to mifepristone – as long as they fall short of banning the drug outright.
Until now, most abortion drugs have been dispensed in person at clinics.
Banning mifepristone
Another pending lawsuit may threaten the FDA’s authority to authorize any sales of mifepristone in the United States.
In Alliance for Hippocratic Medicine v. FDA, a group of abortion opponents asked a U.S. district court in November 2022 to force the FDA to stop allowing mifepristone sales anywhere in the United States. The lawsuit argues that the FDA “chose politics over science” and “exceeded its regulatory authority” in various ways, including allegedly disregarding “substantial evidence” that medication abortion is riskier than surgical abortions.
The consequences could be quite significant, and the issue could even end up on the Supreme Court’s docket in the future. Nevertheless, there are compelling legal reasons why this lawsuit should fail.
Some of the same organizations have tried to challenge the FDA’s approval of mifepristone before – without success. And in 2008, the Government Accountability Office found no irregularities in the FDA’s approval and oversight of mifepristone.
In contradiction to the plaintiffs’ safety argument, numerous studies have shown mifepristone to be a safe and effective drug.
Nevertheless, U.S. District Court Judge Matthew Kacsmaryk, who sits in Amarillo, Texas, and is hearing this case regarding whether the FDA should rescind its approval of mifepristone, has not been supportive of reproductive rights in the past. Thus, it is possible that the court could try to stop the FDA from allowing mifepristone to be sold in that part of Texas or even, possibly, across the entire nation.
If the court prevents the sale of mifepristone nationwide, medication abortions would only be possible with the other pill, misoprostol, which is also approved for other purposes. Recent data suggests that this one-drug approach to medication abortions may safely and effectively induce abortion.
Pills in interstate commerce
In addition to questions of whether the FDA’s authority can override state-imposed abortion restrictions, there’s a second issue concerning the ability to sell the pills through interstate commerce.
As the Supreme Court has explained, the Constitution grants Congress the authority to regulate “things in interstate commerce,” as well as “those activities that substantially affect interstate commerce.”
Thus, in the GenBioPrio lawsuit pending in West Virginia, the company argues that state efforts to restrict sale of the pill are unconstitutional.
An organization that opposes abortion filed a lawsuit in a court located in Amarillo, Texas, that seeks to revoke the FDA’s approval of mifepristone.
Naomi Cahn, Professor of Law, University of Virginia
and Sonia Suter, Professor of Law, George Washington University
Thu, February 9, 2023
Legal battles are being waged over mifepristone, one of two drugs used in medication abortion.
Thu, February 9, 2023
Legal battles are being waged over mifepristone, one of two drugs used in medication abortion.
Robyn Beck/AFP via Getty Images
Medication abortion now accounts for more than half of all abortions in the United States.
Typically, patients take a two different pills: first mifepristone, then misoprostol.
Even though this option has been legally available for more than two decades, two recent events have raised legal questions about it. First, the Supreme Court’s Dobbs v. Jackson Women’s Health ruling overturned the constitutional right to abortion recognized in 1973 in Roe v. Wade. Second, in January 2023, the Food and Drug Administration decided that certified U.S. pharmacies could sell mifepristone by prescription.
The result is a raft of new legal battles over access to medication abortion.
Some congressional lawmakers seek to protect the right to access the pills through pharmacies and telehealth in states where abortion remains legal. At least three lawsuits are pending, and some states that have banned abortion altogether or have restricted access to it are vowing to block the new federal rules. South Dakota Governor Kristi Noem, for example, has threatened to prosecute any pharmacist who sells the pills in her state.
As experts on reproductive health and justice, we’re trying to untangle when and where mifepristone might be available and what these contradictory trends signal.
Prescribing abortion drugs
Who has the authority to determine when, how or whether abortion medication can be prescribed and sold?
Under its long-held, congressionally granted authority to regulate pharmaceutical products, the FDA approved mifepristone in 2000 after an extensive review demonstrated that the drug was safe and effective for early pregnancy termination.
From the beginning, the sale of mifepristone was tied to several safety requirements known as a risk evaluation and mitigation strategy. Initially, the drug had to be dispensed by certified medical providers in person.
But in late 2021, the FDA concluded that was no longer necessary for patient safety. Today, the pill, in its original or generic form, is approved for use up to 10 weeks’ gestation and can be dispensed by a certified prescriber or pharmacy.
Recent lawsuits challenge the scope of the FDA’s authority to regulate the sale of mifepristone.
In one, GenBioPro, a drug company that makes generic mifepristone, sued officials in West Virginia, claiming that the state’s abortion ban impedes its sales. GenBioPro argues that the ban contradicts FDA’s approval of and safety requirements for mifepristone, setting up a conflict between federal and state law.
In short, the drugmaker argues that the federal regulations override West Virginia’s abortion restrictions. West Virginia Attorney General Patrick Morrisey, however, plans to defend the abortion ban vigorously because “the U.S. Supreme Court has made it clear that regulating abortion is a state issue.”
Medication abortion now accounts for more than half of all abortions in the United States.
Typically, patients take a two different pills: first mifepristone, then misoprostol.
Even though this option has been legally available for more than two decades, two recent events have raised legal questions about it. First, the Supreme Court’s Dobbs v. Jackson Women’s Health ruling overturned the constitutional right to abortion recognized in 1973 in Roe v. Wade. Second, in January 2023, the Food and Drug Administration decided that certified U.S. pharmacies could sell mifepristone by prescription.
The result is a raft of new legal battles over access to medication abortion.
Some congressional lawmakers seek to protect the right to access the pills through pharmacies and telehealth in states where abortion remains legal. At least three lawsuits are pending, and some states that have banned abortion altogether or have restricted access to it are vowing to block the new federal rules. South Dakota Governor Kristi Noem, for example, has threatened to prosecute any pharmacist who sells the pills in her state.
As experts on reproductive health and justice, we’re trying to untangle when and where mifepristone might be available and what these contradictory trends signal.
Prescribing abortion drugs
Who has the authority to determine when, how or whether abortion medication can be prescribed and sold?
Under its long-held, congressionally granted authority to regulate pharmaceutical products, the FDA approved mifepristone in 2000 after an extensive review demonstrated that the drug was safe and effective for early pregnancy termination.
From the beginning, the sale of mifepristone was tied to several safety requirements known as a risk evaluation and mitigation strategy. Initially, the drug had to be dispensed by certified medical providers in person.
But in late 2021, the FDA concluded that was no longer necessary for patient safety. Today, the pill, in its original or generic form, is approved for use up to 10 weeks’ gestation and can be dispensed by a certified prescriber or pharmacy.
Recent lawsuits challenge the scope of the FDA’s authority to regulate the sale of mifepristone.
In one, GenBioPro, a drug company that makes generic mifepristone, sued officials in West Virginia, claiming that the state’s abortion ban impedes its sales. GenBioPro argues that the ban contradicts FDA’s approval of and safety requirements for mifepristone, setting up a conflict between federal and state law.
In short, the drugmaker argues that the federal regulations override West Virginia’s abortion restrictions. West Virginia Attorney General Patrick Morrisey, however, plans to defend the abortion ban vigorously because “the U.S. Supreme Court has made it clear that regulating abortion is a state issue.”
Protesters in Raleigh, N.C., object to the Supreme Court’s Dobbs ruling on June 25, 2022. Peter Zay/Anadolu Agency via Getty Images
In another pending lawsuit, Bryant v. Stein, obstetrician-gynecologist Amy Bryant sued officials in North Carolina on similar grounds. Although North Carolina has not banned abortion, it imposes a number of restrictions, including a 72-hour waiting period before accessing medical or surgical abortions.
Bryant argues that the restrictions exceed the FDA requirements for dispensing mifepristone and are therefore preempted by federal law.
There is limited precedent in this area.
In one case, the manufacturer of an opioid – Zohydro – challenged a Massachusetts ban of the drug, even though the FDA had approved it. The federal court ruled for the manufacturer because the ban would “obstruct the FDA’s Congressionally-given charge.”
That 2014 opinion might suggest that GenBioPro will succeed. On the other hand, a court might distinguish the two cases: Massachusetts banned Zohydro on public health grounds, which is squarely within the FDA’s authority, while West Virginia bans abortions on moral grounds – to protect fetal life – which is outside the FDA’s purview.
In the North Carolina case, the state does not ban mifepristone; it just imposes more restrictions than the FDA requires. Therefore, it is uncertain whether the Zohydro reasoning would be adopted.
A 2008 Supreme Court case, however, might be relevant.
In Wyeth v. Levine, a drugmaker claimed that FDA labeling requirements for a drug made by Wyeth, which was used to prevent allergies and motion sickness, preempted Vermont’s stricter labeling requirements. The Supreme Court rejected that argument. It concluded instead that allowing states to require stronger warnings didn’t interfere with Congress’ purpose in entrusting the FDA with drug labeling decisions.
Wyeth is not precisely like Bryant, however.
Whereas Wyeth dealt with labeling requirements, Bryant deals with regulations that affect access to a drug. Nevertheless, the Wyeth precedent could allow a court to permit states to impose stronger restrictions on access to mifepristone – as long as they fall short of banning the drug outright.
Until now, most abortion drugs have been dispensed in person at clinics.
Banning mifepristone
Another pending lawsuit may threaten the FDA’s authority to authorize any sales of mifepristone in the United States.
In Alliance for Hippocratic Medicine v. FDA, a group of abortion opponents asked a U.S. district court in November 2022 to force the FDA to stop allowing mifepristone sales anywhere in the United States. The lawsuit argues that the FDA “chose politics over science” and “exceeded its regulatory authority” in various ways, including allegedly disregarding “substantial evidence” that medication abortion is riskier than surgical abortions.
The consequences could be quite significant, and the issue could even end up on the Supreme Court’s docket in the future. Nevertheless, there are compelling legal reasons why this lawsuit should fail.
Some of the same organizations have tried to challenge the FDA’s approval of mifepristone before – without success. And in 2008, the Government Accountability Office found no irregularities in the FDA’s approval and oversight of mifepristone.
In contradiction to the plaintiffs’ safety argument, numerous studies have shown mifepristone to be a safe and effective drug.
Nevertheless, U.S. District Court Judge Matthew Kacsmaryk, who sits in Amarillo, Texas, and is hearing this case regarding whether the FDA should rescind its approval of mifepristone, has not been supportive of reproductive rights in the past. Thus, it is possible that the court could try to stop the FDA from allowing mifepristone to be sold in that part of Texas or even, possibly, across the entire nation.
If the court prevents the sale of mifepristone nationwide, medication abortions would only be possible with the other pill, misoprostol, which is also approved for other purposes. Recent data suggests that this one-drug approach to medication abortions may safely and effectively induce abortion.
Pills in interstate commerce
In addition to questions of whether the FDA’s authority can override state-imposed abortion restrictions, there’s a second issue concerning the ability to sell the pills through interstate commerce.
As the Supreme Court has explained, the Constitution grants Congress the authority to regulate “things in interstate commerce,” as well as “those activities that substantially affect interstate commerce.”
Thus, in the GenBioPrio lawsuit pending in West Virginia, the company argues that state efforts to restrict sale of the pill are unconstitutional.
An organization that opposes abortion filed a lawsuit in a court located in Amarillo, Texas, that seeks to revoke the FDA’s approval of mifepristone.
Mailing abortion pills
Many people are also taking abortion pills they get through the mail. In response to that trend, 20 Republican state attorneys general recently threatened pharmacies with “legal consequences” if they mail and distribute mifepristone.
An 1873 law, the Comstock Act, is central to the issue of whether it is legal to mail abortion pills. That law makes it a crime to use the mail for any “lewd, lascivious, indecent, filthy or vile article” as well as any “article, instrument, substance, drug, medicine or thing which is advertised or described in a manner calculated to lead another to use of apply it for producing abortion.”
When the Comstock Act was enacted, of course, modern delivery services like FedEx and UPS did not exist. But the law also prohibits any “express company” from engaging in the same acts.
The U.S. Postal Service asked the Justice Department whether abortion pills can be mailed under the Comstock Act, and it responded with a carefully worded 21-page opinion in late December 2022. The opinion concludes that mailing the abortion pills is not illegal so long as the sender “lacks the intent that the recipient of the drugs will use them unlawfully.”
As the opinion pointed out, recipients could use the drugs for a variety of reasons that would be legal in every state. For example, the combination can “treat a miscarriage,” and misoprostol can prevent and treat gastric ulcers.
Regardless of how Judge Kacsmaryk rules, we expect to see medication abortion remain available in states that don’t have abortion bans. But we also are certain that legal challenges over abortion access will continue.
This article is republished from The Conversation, an independent nonprofit news site dedicated to sharing ideas from academic experts.
It was written by: Naomi Cahn, University of Virginia and Sonia Suter, George Washington University.
Read more:
What the FDA’s rule changes allowing the abortion pill mifepristone to be dispensed by pharmacies mean in practice – 5 questions answered
Abortion pills are safe to prescribe without in-person exams, new research finds
Many people are also taking abortion pills they get through the mail. In response to that trend, 20 Republican state attorneys general recently threatened pharmacies with “legal consequences” if they mail and distribute mifepristone.
An 1873 law, the Comstock Act, is central to the issue of whether it is legal to mail abortion pills. That law makes it a crime to use the mail for any “lewd, lascivious, indecent, filthy or vile article” as well as any “article, instrument, substance, drug, medicine or thing which is advertised or described in a manner calculated to lead another to use of apply it for producing abortion.”
When the Comstock Act was enacted, of course, modern delivery services like FedEx and UPS did not exist. But the law also prohibits any “express company” from engaging in the same acts.
The U.S. Postal Service asked the Justice Department whether abortion pills can be mailed under the Comstock Act, and it responded with a carefully worded 21-page opinion in late December 2022. The opinion concludes that mailing the abortion pills is not illegal so long as the sender “lacks the intent that the recipient of the drugs will use them unlawfully.”
As the opinion pointed out, recipients could use the drugs for a variety of reasons that would be legal in every state. For example, the combination can “treat a miscarriage,” and misoprostol can prevent and treat gastric ulcers.
Regardless of how Judge Kacsmaryk rules, we expect to see medication abortion remain available in states that don’t have abortion bans. But we also are certain that legal challenges over abortion access will continue.
This article is republished from The Conversation, an independent nonprofit news site dedicated to sharing ideas from academic experts.
It was written by: Naomi Cahn, University of Virginia and Sonia Suter, George Washington University.
Read more:
What the FDA’s rule changes allowing the abortion pill mifepristone to be dispensed by pharmacies mean in practice – 5 questions answered
Abortion pills are safe to prescribe without in-person exams, new research finds
Tuesday, January 24, 2023
VEEP
Kamala Harris Subtly Emerges as Powerful White House Asset“And I said it before and I will say it again,” she added. “How dare they?”
Philip Elliott
TIME
Mon, January 23, 2023
50th commemoration of the Supreme Court's Roe v. Wade decision in Tallahassee
Vice President Kamala Harris poses for photos with participants at the 50th commemoration of the Supreme Court's Roe v. Wade decision in Tallahassee Fla., on January 22, 2023.
Mon, January 23, 2023
50th commemoration of the Supreme Court's Roe v. Wade decision in Tallahassee
Vice President Kamala Harris poses for photos with participants at the 50th commemoration of the Supreme Court's Roe v. Wade decision in Tallahassee Fla., on January 22, 2023.
Credit - Peter Zay—Anadolu Agency via Getty Images
As she started her closing cadence in front of an enthusiastic crowd, it was clear Vice President Kamala Harris was in her element—and remains both a misunderstood and potentially potent force in Democratic politics.
”Know this: President Biden and I agree, and we will never back down,” Harris said to applause in Tallahassee on Sunday, the 50th anniversary of the Roe v. Wade decision that once guaranteed the federal right to abortion. “We will not back down. We know this fight will not be won until we secure this right for every American.”
As Harris thundered through her remarks, with American flags behind her and supporters before her, she enjoyed that quality that has become all too rare in politics: credibility. Despite all of the political headwinds against her on the issue, Harris convinced many in the crowd that her promises were not only plausible, but within reach. “Congress must pass a bill that protects freedom and liberty,” she said.
The scheduled speech on a sleepy Sunday far from Washington—but in the backyard of both Florida Gov. Ron DeSantis and Donald Trump—would do little to move the national debate on federal abortion rights, which fell in June with a crash emanating from the Supreme Court. But Harris’ remarks and the reception—including 32 applause interruptions by the White House transcript’s count—served as a reminder that, even with plenty of bumps and detours during her first two years as a history-making Vice President, she still can bring the heat. And, in that, her fellow Democrats might slow their seemingly endless criticism of the first woman to hold the job, as well as the first person of Black or South Asian descent to earn it.
Harris, by all accounts, didn’t exactly launch her time as President Joe Biden’s understudy with ease. It seemed every quarter brought with it a new Harris Resets story in the political pages. In the administration’s early days, she largely filled her offices with veterans of the campaign—Biden’s, not hers. In fact, most of her high-profile aides from her Senate office and short-lived presidential bid scattered throughout the administration, landing perfectly admirable posts but not in her inner circle. The result was high turnover on her team, as well as a series of embarrassing stories about her treatment of aides.
Then, there was the scheduling challenge. Few Vice Presidents have had to contend with an evenly split Senate. Because of her ability to break tie votes in that chamber, Harris had to often make sure she was a quick motorcade from the Capitol. She has so far cast 26 such tied votes—or roughly 9% of all tie-breaking votes cast in the Senate since 1789. As such, she spent a ton of time in her office just off the Senate floor, often doubling as a deciding vote and informal congressional liaison to her former colleagues.
But, with Republicans now stuck at 49 votes, Harris’ 101st vote won’t be needed as often. (Of course, errant Democrats like Sen. Joe Manchin or Democrat-turned-independent Sen. Kyrsten Sinema can still gum up the math.) Now less encumbered by the Senate vote schedule, Harris is looking forward to getting back on the road, helping to sell the Biden team’s record and leading the charge on goals like securing voting rights and abortion rights—neither of which are likely to advance much under a Republican House—and selling the merits of legislation passed over the last two years, such as an infrastructure package and a climate change agenda.
Then there are questions of her future ambitions—always a fraught discussion that in D.C. can easily devolve into coded conversations about race and gender, two factors that simply cannot be ignored when it comes to Harris. Her defenders aren’t wrong to point out that the first woman of color in her role faces the double-whammy that separately dogged Barack Obama and Hillary Clinton. Harris’ original bid for the presidency ended before Iowa’s lead-off caucuses. By all accounts, she served as a capable and loyal running-mate.
Personally, Biden has great admiration for Harris, who served as state attorney general in California concurrent to the late Beau Biden’s time in the role in Delaware. As a former VP himself, Biden has sought to give Harris a portfolio commensurate with her talents, including the intractable troubles at the U.S.-Mexican border, voting rights, and abortion rights. Harris’ apologists grimly note those are all massive issues, each of them likely impossible for one person to significantly address; yet her boosters say they match Harris’ abilities to untangle knots.
Still, the relationship between Biden and Harris is complicated, made more so when Biden seemed like an uncertain contender in 2024. With Biden seemingly ready to launch his re-election bid, Harris’ dreams for a promotion are on ice. After all, no one challenges a sitting President with any meaningful success, especially not from inside the tent. But it does set up the test for Harris: if she is the party’s heir apparent—and not, say, Transportation Secretary Pete Buttigieg or Rep. Alexandria Ocasio-Cortez—Harris needs to rack up some successes to point to, whether they come due in 2024 or 2028. Biden may end up professing neutrality, but that gets tricky if he sees any suggestion of disloyalty.
All of which explains why Harris has made abortion rights a central piece of her political identity. Since Roe fell, she has met with leaders from 38 states, including lawmakers from 18 states. She’s been subtly making herself the voice with a megaphone no one can ignore.
During her speech on Sunday, Harris announced the Biden administration would protect access to mifepristone, the abortion pill. The Food and Drug Administration earlier this month finalized a rule that allows women to obtain abortion pills via telehealth consultations. Against this backdrop, Florida lawmakers are considering moving to ban abortions after 12 weeks—down from 15 there.
“Even in states that protect reproductive rights, like New Jersey, Illinois, Oregon, even there people live in fear of what might be next, because Republicans in Congress are now calling for a nationwide abortion ban,” Harris said. “Even from the moment of conception, the right of every woman in every state in this country to make decisions about her own body is on the line.”
“And I said it before and I will say it again,” she added. “How dare they?”
Such outrage over the fall of Roe powered Democratic candidates to unexpectedly strong showings in the midterm elections. Democrats defied history, holding steady in the Senate and only barely losing the majority in the House. Many point to her campaign travel schedule as proof that Harris played no small role in that accomplishment. By the time votes were being tallied, a full 27% of Americans counted abortion as the most important issue for their vote, second only to inflation. It was a surefire winner for Democrats, with those counting abortion as their most important issue breaking by a walloping 53 points. And among the broader public, according to exit polls, 59% of voters last year said abortion should remain legal.
If you’re Harris and seeing these numbers while still considering your next move, such data points are reason to lean-in on abortion rights. It has the added bonus of coming from a place of sincerity.
As she started her closing cadence in front of an enthusiastic crowd, it was clear Vice President Kamala Harris was in her element—and remains both a misunderstood and potentially potent force in Democratic politics.
”Know this: President Biden and I agree, and we will never back down,” Harris said to applause in Tallahassee on Sunday, the 50th anniversary of the Roe v. Wade decision that once guaranteed the federal right to abortion. “We will not back down. We know this fight will not be won until we secure this right for every American.”
As Harris thundered through her remarks, with American flags behind her and supporters before her, she enjoyed that quality that has become all too rare in politics: credibility. Despite all of the political headwinds against her on the issue, Harris convinced many in the crowd that her promises were not only plausible, but within reach. “Congress must pass a bill that protects freedom and liberty,” she said.
The scheduled speech on a sleepy Sunday far from Washington—but in the backyard of both Florida Gov. Ron DeSantis and Donald Trump—would do little to move the national debate on federal abortion rights, which fell in June with a crash emanating from the Supreme Court. But Harris’ remarks and the reception—including 32 applause interruptions by the White House transcript’s count—served as a reminder that, even with plenty of bumps and detours during her first two years as a history-making Vice President, she still can bring the heat. And, in that, her fellow Democrats might slow their seemingly endless criticism of the first woman to hold the job, as well as the first person of Black or South Asian descent to earn it.
Harris, by all accounts, didn’t exactly launch her time as President Joe Biden’s understudy with ease. It seemed every quarter brought with it a new Harris Resets story in the political pages. In the administration’s early days, she largely filled her offices with veterans of the campaign—Biden’s, not hers. In fact, most of her high-profile aides from her Senate office and short-lived presidential bid scattered throughout the administration, landing perfectly admirable posts but not in her inner circle. The result was high turnover on her team, as well as a series of embarrassing stories about her treatment of aides.
Then, there was the scheduling challenge. Few Vice Presidents have had to contend with an evenly split Senate. Because of her ability to break tie votes in that chamber, Harris had to often make sure she was a quick motorcade from the Capitol. She has so far cast 26 such tied votes—or roughly 9% of all tie-breaking votes cast in the Senate since 1789. As such, she spent a ton of time in her office just off the Senate floor, often doubling as a deciding vote and informal congressional liaison to her former colleagues.
But, with Republicans now stuck at 49 votes, Harris’ 101st vote won’t be needed as often. (Of course, errant Democrats like Sen. Joe Manchin or Democrat-turned-independent Sen. Kyrsten Sinema can still gum up the math.) Now less encumbered by the Senate vote schedule, Harris is looking forward to getting back on the road, helping to sell the Biden team’s record and leading the charge on goals like securing voting rights and abortion rights—neither of which are likely to advance much under a Republican House—and selling the merits of legislation passed over the last two years, such as an infrastructure package and a climate change agenda.
Then there are questions of her future ambitions—always a fraught discussion that in D.C. can easily devolve into coded conversations about race and gender, two factors that simply cannot be ignored when it comes to Harris. Her defenders aren’t wrong to point out that the first woman of color in her role faces the double-whammy that separately dogged Barack Obama and Hillary Clinton. Harris’ original bid for the presidency ended before Iowa’s lead-off caucuses. By all accounts, she served as a capable and loyal running-mate.
Personally, Biden has great admiration for Harris, who served as state attorney general in California concurrent to the late Beau Biden’s time in the role in Delaware. As a former VP himself, Biden has sought to give Harris a portfolio commensurate with her talents, including the intractable troubles at the U.S.-Mexican border, voting rights, and abortion rights. Harris’ apologists grimly note those are all massive issues, each of them likely impossible for one person to significantly address; yet her boosters say they match Harris’ abilities to untangle knots.
Still, the relationship between Biden and Harris is complicated, made more so when Biden seemed like an uncertain contender in 2024. With Biden seemingly ready to launch his re-election bid, Harris’ dreams for a promotion are on ice. After all, no one challenges a sitting President with any meaningful success, especially not from inside the tent. But it does set up the test for Harris: if she is the party’s heir apparent—and not, say, Transportation Secretary Pete Buttigieg or Rep. Alexandria Ocasio-Cortez—Harris needs to rack up some successes to point to, whether they come due in 2024 or 2028. Biden may end up professing neutrality, but that gets tricky if he sees any suggestion of disloyalty.
All of which explains why Harris has made abortion rights a central piece of her political identity. Since Roe fell, she has met with leaders from 38 states, including lawmakers from 18 states. She’s been subtly making herself the voice with a megaphone no one can ignore.
During her speech on Sunday, Harris announced the Biden administration would protect access to mifepristone, the abortion pill. The Food and Drug Administration earlier this month finalized a rule that allows women to obtain abortion pills via telehealth consultations. Against this backdrop, Florida lawmakers are considering moving to ban abortions after 12 weeks—down from 15 there.
“Even in states that protect reproductive rights, like New Jersey, Illinois, Oregon, even there people live in fear of what might be next, because Republicans in Congress are now calling for a nationwide abortion ban,” Harris said. “Even from the moment of conception, the right of every woman in every state in this country to make decisions about her own body is on the line.”
“And I said it before and I will say it again,” she added. “How dare they?”
Such outrage over the fall of Roe powered Democratic candidates to unexpectedly strong showings in the midterm elections. Democrats defied history, holding steady in the Senate and only barely losing the majority in the House. Many point to her campaign travel schedule as proof that Harris played no small role in that accomplishment. By the time votes were being tallied, a full 27% of Americans counted abortion as the most important issue for their vote, second only to inflation. It was a surefire winner for Democrats, with those counting abortion as their most important issue breaking by a walloping 53 points. And among the broader public, according to exit polls, 59% of voters last year said abortion should remain legal.
If you’re Harris and seeing these numbers while still considering your next move, such data points are reason to lean-in on abortion rights. It has the added bonus of coming from a place of sincerity.
Kamala Harris swipes at DeSantis using his 'vanguard of freedom' quote, on the governor's home turf, as she announces new moves on abortion pill
Kimberly Leonard
Sun, January 22, 2023
Republican Gov. Ron DeSantis, speaks to supporters Tuesday, August 23, 2022, in Hialeah, Florida.
Former Florida Agriculture Commissioner Nikki Fried ran for the Democratic nomination for governor in 2022. SHE COULD HAVE BEAT DESANTIS UNLIKE USED TIRE CRISTI
Florida has other ways of expanding abortion rights
Abortion rights proved to be a liability for Republicans in the November midterms.
In early January, DeSantis was also attacked from the right for his abortion policies. Ian Fury, South Dakota governor Kristi Noem's spokesman, criticized DeSantis for "hiding behind a 15-week ban" in comments to National Review.
"Does he believe that 14-week-old babies don't have a right to live?" Fury asked.
Senior Biden administration officials said during a phone call with reporters Wednesday that the Biden team picked Florida for Harris to make her speech about abortion rights given the state's 15-week abortion ban, which doesn't have exceptions for rape and incest.
Still, they added that Florida was "a place that offers greater access than its neighbors" because surrounding states have abortion bans that begin even earlier in pregnancy.
Reproductive rights groups are working to put the issue of abortion before Florida voters through a 2024 ballot measure. Fried told Insider that advocates were still early in the process as they worked to get the precise, legal language of the ballot correct. After that, the work of gathering signatures will kick off.
Fried plans to be involved in any way she can, whether through fundraising or holding press conferences, she told Insider.
"We still have a fight ahead of us to protect a woman's right to choose," Fried said. "We are not going to let go. We are going to keep fighting for this issue and we are going to organize to be at the forefront, and we are not going to back down."
Kimberly Leonard
Sun, January 22, 2023
In this article:
Vice President Kamala Harris listens as Japanese Prime Minister Fumio Kishida speaks to reporters before attending a breakfast at the Vice Presidents residence at the Naval Observatory on January 13, 2023 in Washington, DC.
Vice President Kamala Harris listens as Japanese Prime Minister Fumio Kishida speaks to reporters before attending a breakfast at the Vice Presidents residence at the Naval Observatory on January 13, 2023 in Washington, DC.
Anna Moneymaker/Getty Images
Harris said federal officials will work to make the abortion pill more widely available.
She did in Tallahassee at a time when DeSantis is a leading potential 2024 White House contender.
Harris' invoked DeSantis-favorite themes of "freedom and liberty."
Vice President Kamala Harris directly hit Gov. Ron DeSantis of Florida over his "freedom and liberty" rhetoric and policies during a landmark abortion rights speech on Sunday in Tallahassee, showing a willingness by the Biden administration to take on the Republican rising star directly.
Her remarks signal that Democrats are working to flip the "freedom" script against Republicans, who have in recent years heralded it as their own amid Biden administration-imposed COVID restrictions.
None have done so more so than DeSantis, who called his forthcoming agenda for Florida the "Freedom Blueprint" and frequently refers to his home state as "the free state of Florida" or "the freest state."
"Can we truly be free if so-called leaders claim to be — I quote, 'on the vanguard of freedom' while they dare to restrict the rights of the American people and attack the very foundations of freedom?" said Harris, who didn't use DeSantis' name but was quoting directly from his 2022 State of the State address.
Harris's speech — right in DeSantis' home state by the US's first female vice president — comes just days after Florida health officials sent a letter to pharmacies warning them not to dispense the abortion pill mifepristone.
The vice president, who has been at the forefront voice for the administration's on abortion rights, announced that President Joe Biden would be signing a memorandum to make abortion pills easier to access. It'll have federal officials consider new ways for patients to get mifepristone, a medication that ends a pregnancy through 10 weeks of gestation. It would also direct those agencies to find ways for patients to access abortion "free from harassment, threats, or violence."
"Can we truly be free if a woman cannot make decisions about her own body? Can we truly be free if a doctor cannot care for her patients? Can we truly be free if families cannot make intimate decisions about the course of their own lives?" Harris, speaking delivered at a concert and nightclub venue the Moon, said.
Harris' speech follows a letter from Florida's Agency for Healthcare Administration, which said pharmacies were not allowed to dispense the abortion pill because under state law a doctor must be the one to give it to patients, after an initial meeting 24 hours earlier.
Seventeen other states have similar prescribing laws as Florida. But the Sunshine State is unique in that DeSantis may be only months away from declaring a 2024 presidential run. A Suffolk University poll released in early January shows DeSantis may have the edge on defeating Biden if he's the GOP nominee.
Democrats have warned a national abortion ban is possible if Republicans control the White House and Congress. "People live in fear of what might be next," Harris said during her remarks.
Congressional Republicans haven't coalesced behind a national abortion ban, though some such as Republican Sen. Marco Rubio of Florida have backed a national 15-week ban.
This month the Biden administration, through the Food and Drug Administration, allowed major pharmacy retailers such as CVS Health and Walgreens to provide patients with the abortion pill when they have a prescription, as long as the pharmacies complete a certification process.
Previously, patients could legally get the abortion pill through the mail after a visit with a doctor over telehealth, or when a doctor gave it to them at a clinic. It's not clear whether state laws will be able to override the FDA's decision, and a court ruling may be necessary to settle the answer to that question, reported Stat News.
More than half of abortions in the US are done with medication instead of surgery. Patients often will take another pill, called misoprostol, to trigger a miscarriage.
Sunday would have marked the 50th anniversary of Roe v. Wade, the Supreme Court ruling that guaranteed a national right to abortion. The conservative supermajority Supreme Court overturned the 1973 decision last summer, and since then some states have banned abortion and others have increased access.
Harris said federal officials will work to make the abortion pill more widely available.
She did in Tallahassee at a time when DeSantis is a leading potential 2024 White House contender.
Harris' invoked DeSantis-favorite themes of "freedom and liberty."
Vice President Kamala Harris directly hit Gov. Ron DeSantis of Florida over his "freedom and liberty" rhetoric and policies during a landmark abortion rights speech on Sunday in Tallahassee, showing a willingness by the Biden administration to take on the Republican rising star directly.
Her remarks signal that Democrats are working to flip the "freedom" script against Republicans, who have in recent years heralded it as their own amid Biden administration-imposed COVID restrictions.
None have done so more so than DeSantis, who called his forthcoming agenda for Florida the "Freedom Blueprint" and frequently refers to his home state as "the free state of Florida" or "the freest state."
"Can we truly be free if so-called leaders claim to be — I quote, 'on the vanguard of freedom' while they dare to restrict the rights of the American people and attack the very foundations of freedom?" said Harris, who didn't use DeSantis' name but was quoting directly from his 2022 State of the State address.
Harris's speech — right in DeSantis' home state by the US's first female vice president — comes just days after Florida health officials sent a letter to pharmacies warning them not to dispense the abortion pill mifepristone.
The vice president, who has been at the forefront voice for the administration's on abortion rights, announced that President Joe Biden would be signing a memorandum to make abortion pills easier to access. It'll have federal officials consider new ways for patients to get mifepristone, a medication that ends a pregnancy through 10 weeks of gestation. It would also direct those agencies to find ways for patients to access abortion "free from harassment, threats, or violence."
"Can we truly be free if a woman cannot make decisions about her own body? Can we truly be free if a doctor cannot care for her patients? Can we truly be free if families cannot make intimate decisions about the course of their own lives?" Harris, speaking delivered at a concert and nightclub venue the Moon, said.
Harris' speech follows a letter from Florida's Agency for Healthcare Administration, which said pharmacies were not allowed to dispense the abortion pill because under state law a doctor must be the one to give it to patients, after an initial meeting 24 hours earlier.
Seventeen other states have similar prescribing laws as Florida. But the Sunshine State is unique in that DeSantis may be only months away from declaring a 2024 presidential run. A Suffolk University poll released in early January shows DeSantis may have the edge on defeating Biden if he's the GOP nominee.
Democrats have warned a national abortion ban is possible if Republicans control the White House and Congress. "People live in fear of what might be next," Harris said during her remarks.
Congressional Republicans haven't coalesced behind a national abortion ban, though some such as Republican Sen. Marco Rubio of Florida have backed a national 15-week ban.
This month the Biden administration, through the Food and Drug Administration, allowed major pharmacy retailers such as CVS Health and Walgreens to provide patients with the abortion pill when they have a prescription, as long as the pharmacies complete a certification process.
Previously, patients could legally get the abortion pill through the mail after a visit with a doctor over telehealth, or when a doctor gave it to them at a clinic. It's not clear whether state laws will be able to override the FDA's decision, and a court ruling may be necessary to settle the answer to that question, reported Stat News.
More than half of abortions in the US are done with medication instead of surgery. Patients often will take another pill, called misoprostol, to trigger a miscarriage.
Sunday would have marked the 50th anniversary of Roe v. Wade, the Supreme Court ruling that guaranteed a national right to abortion. The conservative supermajority Supreme Court overturned the 1973 decision last summer, and since then some states have banned abortion and others have increased access.
Republican Gov. Ron DeSantis, speaks to supporters Tuesday, August 23, 2022, in Hialeah, Florida.
Gaston De Cardenas, File/AP Photo
It's unclear how Florida will restrict abortion next
DeSantis has been gradually rolling out his agenda in recent weeks, though abortion is one area where he hasn't offered specifics. Asked about which abortion restrictions he'd be willing to sign into law, the governor has said only that he would "expand pro-life protections."
State lawmakers won't be meeting over the issue until March at the earliest when the legislature will begin its session. Florida Senate President Kathleen Passidomo, a Republican, said she would be open to restricting abortions to 12 weeks, but that a new law must include exceptions for rape and incest.
Florida already makes it illegal to have an abortion after 15 weeks through a measure DeSantis signed into law, though it's before the state Supreme Court.
Nikki Fried, Florida's former agriculture commissioner who lost the Democratic gubernatorial nomination to Charlie Crist, told Insider she feared DeSantis would go further to restrict abortion rights during this forthcoming legislative session to appeal to GOP presidential primary voters.
Stephanie Loraine Piñeiro, co-executive director of Florida Access Network, which helps coordinate patient travel, lodging, and expenses related to abortion, told Insider that she was worried Florida would force a complete ban on medication abortion.
"Our dignity, bodily autonomy, and right to self-determination should be protected and we ask this administration to enact immediate measures to protect and expand access to abortion care," Piñeiro, who attended Harris' speech, said.
During her remarks Sunday, Harris urged Congress to vote for the Women's Health Protection Act, saying it would "protect freedom and liberty." The bill has no chance of passage because Republicans control the US House.
Instead, the House passed legislation that would criminalize doctors who fail to provide neonatal care following a botched abortion late in pregnancy. It won't be taken up in the Democratic-controlled Senate, who — like doctors who perform late-pregnancy abortions — have argued that later abortions occur mainly in cases of severe fetal anomalies.
No robust data exists on the reasons couples choose third-trimester abortions, and such cases make up less than 1% of total abortions in the US, show studies from the Centers for Disease Control and Prevention.
The DeSantis War Room mocked Harris on Twitter for talking about "freedom" after having speech attendees sign a letter attesting they were fully vaccinated against COVID-19.
The Republican Party of Florida directly addressed the abortion issue and called Harris a "far-left radical."
"Democrats are proudly cheerleading barbaric policies to allow unrestricted abortions — including infanticide," RPOF said. "That's all anyone needs to know."
The Women's Health Protection Act that the Biden administration backs does not allow for post-birth termination but until fetal viability, which is generally understood to be at about 24 weeks into a pregnancy. It also allows abortions after viability for "health" reasons but doesn't specify whether this means physical, psychological, or emotional health, or whether someone's age can also be a factor.
DeSantis has been gradually rolling out his agenda in recent weeks, though abortion is one area where he hasn't offered specifics. Asked about which abortion restrictions he'd be willing to sign into law, the governor has said only that he would "expand pro-life protections."
State lawmakers won't be meeting over the issue until March at the earliest when the legislature will begin its session. Florida Senate President Kathleen Passidomo, a Republican, said she would be open to restricting abortions to 12 weeks, but that a new law must include exceptions for rape and incest.
Florida already makes it illegal to have an abortion after 15 weeks through a measure DeSantis signed into law, though it's before the state Supreme Court.
Nikki Fried, Florida's former agriculture commissioner who lost the Democratic gubernatorial nomination to Charlie Crist, told Insider she feared DeSantis would go further to restrict abortion rights during this forthcoming legislative session to appeal to GOP presidential primary voters.
Stephanie Loraine Piñeiro, co-executive director of Florida Access Network, which helps coordinate patient travel, lodging, and expenses related to abortion, told Insider that she was worried Florida would force a complete ban on medication abortion.
"Our dignity, bodily autonomy, and right to self-determination should be protected and we ask this administration to enact immediate measures to protect and expand access to abortion care," Piñeiro, who attended Harris' speech, said.
During her remarks Sunday, Harris urged Congress to vote for the Women's Health Protection Act, saying it would "protect freedom and liberty." The bill has no chance of passage because Republicans control the US House.
Instead, the House passed legislation that would criminalize doctors who fail to provide neonatal care following a botched abortion late in pregnancy. It won't be taken up in the Democratic-controlled Senate, who — like doctors who perform late-pregnancy abortions — have argued that later abortions occur mainly in cases of severe fetal anomalies.
No robust data exists on the reasons couples choose third-trimester abortions, and such cases make up less than 1% of total abortions in the US, show studies from the Centers for Disease Control and Prevention.
The DeSantis War Room mocked Harris on Twitter for talking about "freedom" after having speech attendees sign a letter attesting they were fully vaccinated against COVID-19.
The Republican Party of Florida directly addressed the abortion issue and called Harris a "far-left radical."
"Democrats are proudly cheerleading barbaric policies to allow unrestricted abortions — including infanticide," RPOF said. "That's all anyone needs to know."
The Women's Health Protection Act that the Biden administration backs does not allow for post-birth termination but until fetal viability, which is generally understood to be at about 24 weeks into a pregnancy. It also allows abortions after viability for "health" reasons but doesn't specify whether this means physical, psychological, or emotional health, or whether someone's age can also be a factor.
Former Florida Agriculture Commissioner Nikki Fried ran for the Democratic nomination for governor in 2022. SHE COULD HAVE BEAT DESANTIS UNLIKE USED TIRE CRISTI
Wilfredo Lee/AP Photo
Florida has other ways of expanding abortion rights
Abortion rights proved to be a liability for Republicans in the November midterms.
In early January, DeSantis was also attacked from the right for his abortion policies. Ian Fury, South Dakota governor Kristi Noem's spokesman, criticized DeSantis for "hiding behind a 15-week ban" in comments to National Review.
"Does he believe that 14-week-old babies don't have a right to live?" Fury asked.
Senior Biden administration officials said during a phone call with reporters Wednesday that the Biden team picked Florida for Harris to make her speech about abortion rights given the state's 15-week abortion ban, which doesn't have exceptions for rape and incest.
Still, they added that Florida was "a place that offers greater access than its neighbors" because surrounding states have abortion bans that begin even earlier in pregnancy.
Reproductive rights groups are working to put the issue of abortion before Florida voters through a 2024 ballot measure. Fried told Insider that advocates were still early in the process as they worked to get the precise, legal language of the ballot correct. After that, the work of gathering signatures will kick off.
Fried plans to be involved in any way she can, whether through fundraising or holding press conferences, she told Insider.
"We still have a fight ahead of us to protect a woman's right to choose," Fried said. "We are not going to let go. We are going to keep fighting for this issue and we are going to organize to be at the forefront, and we are not going to back down."
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