Focus 580; Issues in Womens Health

In this hour of focus 580 will be talking about women's health and how it is that the way we think about women's health and women's involvement in their own health care has changed over the past several decades. It was back in 1970 that the landmark women's health book Our Bodies Ourselves was first published. It is now gone through many printings. It has been translated into something like 20 languages and there are books that are modeled on this book that have been produced in other countries. The focus has changed a little bit over time at least in the sense that topics have been added. When the first book came out it was very much focused on reproductive health and sexuality. But after that a number of other topics were added things like environmental health meant a pause aging. In 1988 a major update of the book was produced and included a number of new topics including things like finding good sources of health care information for women online problems resulting from

violence and overwork. Even the concerns about girls increasing use of tobacco. This version of the book titled Our Bodies Ourselves for the new century came out in. And is available now out there in the bookstores if you would like to look at it published by Touchstone books. This morning in this part of focus we'll be talking with a guest who has been involved in this effort for some time. Judy Nourse Egan is senior program officer with the Boston Women's Health Book collective and part of our reason for talking with her is to mention the fact that she will be here in Champaign Urbana this weekend she'll be speaking at the annual awards dinner of the champagne County health care consumers. That'll be on Saturday the 19th and they tell us that there are still tickets available for the dinner. If you would like to attend. So for more information you can call them at 3 5 2 6 5 3 3. And of course as we talk here in this part of focus 580 with Judy North Sea again questions are welcome questions comments all we ask people is that they just try to be brief so

we can keep things moving along. Come down as many different callers as we'd like to call in but Anybody's welcome. Join the conversation here in Champaign Urbana 3 3 3 9 4 5 5. Also toll free 800 to 2 2 9 4 5 5. Missy and hello hello it's a pleasure to join you today. Well I'm really pleased that you could be with us. Perhaps you could talk a little bit about how it is that this whole thing got started and how our bodies ourselves came to be. Well you have to imagine in the late 60s that there were no books about women's health care and most women had a fairly disturbing experiences with their physicians who were most often male most often condescending and paternalistic and not because they were bad people but because their training encouraged that kind of behavior. And it was in part because of a conference held in Boston a women's liberation conference that brought some women together to talk about health and sexuality issues and their

decision to continue to meet that the seeds were planted for Our Bodies Ourselves women continued to me decided they wanted to. Figure out how you choose a good doctor and realized they were so ignorant they didn't understand the most basic things about anatomy and physiology and medical health care and so they began to research issues and the woman who'd had a postpartum depression looked at that the woman who had a bad experience with a sexually transmitted disease which was called venereal disease at that point. Look at that someone who'd had a bad birthing experience looked at the prevailing obstetrical practices someone who had an illegal abortion and didn't understand even what an abortion really was. Look at that issue and people basically came together and shared stories as well as the practical information they had gathered from going to the local medical library at Harvard. Now we can also talk to the few physicians and nurses who were receptive and responsive and said This is terrific that you want to educate yourself and I'll help you. There was no intent to write a book in the beginning but the women

ended up mimeograph ing these peepers that they developed in the course of meetings and conversations inserting people's personal experiences and this combination of factual description and personal experience became the hallmark of Our Bodies Ourselves and in 170 with the support of the New England free press the local radical publisher. The book was published as women in their bodies. Subsequently our bodies ourselves and we've seen about seven major additions since then and of course the book has grown to be fatter than a phone book. It's a remarkable phenomenon I think and amazing that it should have could have started the way that it did. As a very kind of local and grassroots and maybe personal sort of effort and have drawn have grown into such a phenomenon that not only would it have sold so many copies here in the United States but it would have inspired other kinds of books like it. And in all these different languages all these different places.

Yes in fact it was incredible how much there was a need for this information even as a little newsprint 120 page booklet. It sold about 250000 copies by word of mouth. That's why the commercial publishers got interested. And since the first commercial publication of our bodies are sold in 1973 we've seen about four and a half million copies sold here in around the world in 20 some odd editions and right now women don't carry our media Indonesia China and Thailand to debt. There's even a lot Docky edition and little booklets in the works. Poland. And other countries Senegal a French speaking Africa is an Arabic edition that hopefully will be updated. The first was done by women in Egypt. Many of the books and books that were basically takeoff from our bodies or so they were adapted to meet the cultural and linguistic needs of a particular region. Many of these have changed they have been reissued. They reflect the growing awareness of women's

health groups around the world there is quite a strong international women's health movement and it's very exciting to see this kind of activism to see the kind of information that women's groups are now developing and sharing my own ethnic heritage is Armenian so I'm quite excited to see that the Armenian EDITION will be printed the coming few weeks and then I will have a copy in Hanson. Let me maybe I'll just here quickly introduce Again our guest We're talking with Judy no see again she's senior program officer with the Boston Women's Health Book collective the group that produced our bodies ourselves in 1070 has. And now as we've explained has gone through many printings it has grown. It's been translated into other languages and has been a real force and women taking charge of their own health care questions certainly welcome 3 3 3 W while all toll free 800 1:58 WLM. I'd like to talk about maybe some of the things that have changed and some that have not. Over this time one big change

certainly and not something just that touches women but I think touches everyone is that people are. More involved in their own health care. They have been advised that they should question their doctors they should ask questions if they're not sure why they're doing certain things they should ask they should learn about their bodies they should if they have particular health problems they should learn about those and now there are lots and lots of places to get that kind of information given that. Fact that people are at least we think that they're more involved in their own health care. Has that been a change for the positive as far as women and their health is concerned. Well as with many things this is a double edged sword. It is true there are many more sources of information. The problem is that some of the sorts of the industry generated they're really more about selling a product or procedure then providing you with the information that you need to make the best choice for yourself. So the consumer it's

sort of a copy I am sure that has to be adopted here the consumer the user the lay person has to be very careful to know the source of the information on the Internet there are fabulous sources of women's health information and our own website w w w dot our bodies or selves dot org leads you to many of the sites We've vetted them. Most of them a noncommercial many of them a government or academic sites and they provide excellent information. We even include a few commercial sites which have been particularly good but many many sites that don't look commercial really are in terms of the Genesis. Who pays for them and they don't necessarily provide balanced information. We have a serious problem now with so called direct to consumer advertising of prescription drugs. And since 1997 the pharmaceutical industry has been spending a huge. Huge amount of money on advertising these products directly to consumers. In 1999 it was about 1.8 billion in the year 2000 it was about 2.5 billion and it certainly is working many of the drugs that did not sell as well as

they are now are selling at a brisk pace and it's not necessarily because people need these drugs. Sometimes older drugs that are less expensive worked just as well and then they don't. But the person who's buying this new product may not necessarily be buying the right drug for that particular condition. One of our favorite examples now is the promotion of Prozac. You know one of the selective serotonin re-uptake inhibitor which has been repackaged is something called Saraf and for so-called PM DD Premenstrual Dysphoric Disorder and of course many younger women are looking at the ads which are very misleading and thinking oh if I'm just a little bloated if I'm just having an irritable day I snapped at my friend or my partner or my roommate I should run off and get some paraffin to calm me down. The ads are being told as the FDA catches up with the companies that misleadingly represent their drugs. But there is not necessarily a remedial ad campaign conducted only several of those are required annually. Some many many members of the public are misled by these so-called

ads and they're all over the Internet the wall they're all over magazines and they're now all beginning to be all over television as well. It's very difficult when there's no real penalty to be applied to a drug company that misleadingly represents that drug. It's really difficult to see that this behavior will change or to expect it will change since there's no real penalty to be paid. We do hope that consumers women in particular will be more savvy about the sources of information. Books like Our Bodies Ourselves don't get widely promoted but because they're so trusted because they're so accurate because we spend a lot of time working with researchers with both professionals and lay persons to be sure that the information is both accessible and accurate. They generate consistent sales but they're not enormous because there are no blockbuster media campaigns we don't have huge budgets to make sure that we get on to Oprah or some of the big talk shows. And in fact in my own experience recently I've noticed that the.

Authors who are going to be critical of mainstream media particularly advertising media do not get a platform as readily as those who do not make such political statements. It's a fair amount of media that is self-censorship taking place right now. It's very subtle. It's not something you can prove. But those authors who tend to be more outspoken about things such as inordinate influence of advertising in the drug industry they don't see themselves on the talk shows as frequently or as readily as other spokespersons who tend to be less political. You know another of the contre of the criticisms that's been leveled at the health care system certainly in the past is that it's skews male that not only are a lot of a lot of the doctors male but people who are doing medical research was male. And if you set aside things that are specifically obstetric and gynaecological in nature a lot of the research was based on research that had been done on man. Do you take

up a problem like heart disease for example. It was very much geared toward men because it was thought of as being a men's disease. The research was done on men. Men were more aggressively treated when women came in if they presented with some. Some of those symptoms. Often doctors would dismiss that by saying well that you're a woman. Guys have heart attacks women don't have heart attacks and this is something that and I wonder to what extent things like that have started to change. There is some truth in that and there are areas where we extrapolated from research on men to women in ways that were not appropriate. However sometimes this has been over exam it's been over exaggerated. The truth is we are doing a lot more research on women's issues right now and our Office of Research on women's health quite ably directed by Dr. Vivian can and has been helping to coordinate research or National Institutes of Health so that the different institutes try to keep in touch with each other try to make sure that there are there are

sort of synergistic effects and where people are in good touch and making sure that if there's research being done on kidney disorders or autoimmune disorders that the appropriate Institute is in touch with other. It might have an interest in this area. We certainly have seen some areas ignored some of these autoimmune disorders like Sjogren's Syndrome in scleroderma and fibromyalgia lupus. They disproportionately affect women. In the case of lupus 90 percent of the people who deal with this condition are female. So it's been good to see an increase in interest in those areas. The Chronic Fatigue and Immune Dysfunction Syndrome known as my alter conceptual myelitis in Europe and in some medical circles here had been for a long period ignored or suggested to be primarily a psychological problem. And I think it's much more complicated than that there are many dimensions to this condition we don't understand and we I thing research coordinated at the federal level that will move us further along where very happy to see this and I think

because of the women's health movement and. Obviously because of the interest of the industry pharmaceutical industry and health care industry we've certainly had a lot of lobbying for more dollars to fund research breast cancer research dollars have increased substantially because of the advocacy work of breast cancer activist groups and some of them have been very sophisticated saying we just don't need more dollars thrown at new chemotherapy and radiation regimens we need dollars thrown at true prevention research we need to understand better what are the causes of breast cancer. We do not understand that well at all right now and we need to see if we can tease some of these issues out are there environmental factors we need to better understand some of the women's advocacy groups wanted to study organic farming more closely that is happening very creative funding allocation was made several years ago when the Department of Defense set aside over 200 million dollars for breast cancer research and

this was largely because of advocacy work and some senators who were very creative and figure out how to get more dollars allocated for this issue. One of the national groups the National Breast Cancer Coalition is in Florida where the organizing grassroots organizations to lobby their local. Folks who set policy both at the hospital level the research level the government let it level to make sure that the issues that we care about get addressed the clinical trials are conducted properly and adequately that we don't for example see a lot of women rushing into bone marrow transplants is this what they call the BMT Plus high dosage chemotherapy so that women were going late stage breast cancer. We're engaging in a treatment whose benefits have not been adequately demonstrated. And they were choosing such treatments in instead of being randomized to an important federal clinical trial federally funded clinical trial for that we could understand

whether or not this made sense. And I think this autologous stem cell rescue approach the bone marrow transplantation. But a high dosage of chemotherapy has been shown not to be particularly effective at this point. Many many women under went this expensive procedure thinking that it really did hold out a benefit for them when we didn't have that evidence. And many of us are trying to make sure that we don't let claims be made for procedures for drugs for therapies that may look promising at the outset but haven't been adequately assessed and we need to do that before we start making claims and encouraging women to engage in these practices or take these drugs in advance of their demonstrated benefit. We're getting that close to the midpoint of the program here I do again want to introduce our guest. And we're speaking this morning with Judy nor Sieg and she is a senior program officer at the Boston Women's Health Book collective and also is co author of Our Bodies

Ourselves for the new century which was published in. Nine hundred ninety eight major revision an update of this classic book on women's health Our Bodies Ourselves which was their first published in 1970 and I do again want to mention the fact that she will be here in Champaign Urbana this weekend she'll be speaking at the annual awards dinner of the champagne County health care consumers on Saturday. There are still tickets available we're told and if you would like to attend the dinner all you need to do is call the health care consumers 3 5 2 6 5 3 3. And if you have questions and you'd like to be in on the conversation here this morning. Three three three W I L L or 9 4 5 5 toll free 800. Two two two w i l o. You know here on this show on this radio show for something like 17 years or maybe a bit more we've been doing a show on women's health. Every month. Wonderful. And with the same guest all these years a woman who is in practice here in our area and who teaches at med school.

And one thing that that is very very striking it when you look at the kinds of things we've talked about over the years and the kind of questions women have answered there has been a a like a tectonic shift toward the concerns of women who are approaching at or past menopause. Right. And we've certainly talked a lot about hormone replacement and I know this isn't an area of some kind. Percy it's a very big subject but I wonder how it is you think about the issue and how it is. We've talked about the issue of the needs of women at menopause and after menopause. Well the most important message about hormone therapy is that it's not for every woman. And the decision whether or not to use hormone therapy is not a simple one. The best reference we have seen is something put out by the National Women's Health Network called taking hormones and women's health. It's available from them in

Washington D.C. And they also have an excellent Web site called the Women's Health Network dot org. This is a publication that's been updated every couple of years brings the latest information from the National Institutes of Health also has some material about alternative approaches to dealing with menopausal discomforts addresses osteoporosis. The question of heart disease the benefits of hormones obesity heart conditions and as you know the data have been changing over the last few years and then there's a it's not a simple picture. There are certainly benefits but there are certainly risks. There are also questions that women need to ask themselves about whether they are. In their individual circumstances at higher risk for osteoporosis some women can know that others can't. Certainly with respect to heart disease there is a hereditary component there's a huge lifestyle component and many of us can know from our history from our own lifestyle whether factors in our lives put us at increased risk if we lead sedentary lives if we drink a lot of alcohol if we smoke

we are thin boned. You know there are things like that that will certainly put us at higher risk for developing brittle bones and and at an earlier stage of our calcium intake has been low. We've had certain conditions that have been problematic if we've taken progestins over the long periods some women who've taken Depo Provera for example an injectable contraceptive have seen that their bone mass has diminished measurably. These kinds of things weigh in on whether or not we're likely to be at higher risk. There are benefits. There are risks. You have to get all the information and make an important and considered decision yourself. One of the things that's so interesting about hormone therapy is that many women have simply voted with their feet in terms of how they felt a phenomenon that is not well understood is that some women get an estrogen or an estrogen progestin. Prescription go buy the product and they find it they either feel so much better or they continue using it because they like how they feel taking hormones or they start feeling rotten and they just

decide I don't care about your pro-suicide don't care about the future because if I feel this rotten There's no point. So many many women have simply decided to use or not use estrogen based on how they've made them feel or combined hormone therapy. And there is a difference. For some women definitely they feel worth when the progestin is added. Of course it's added because it reduces the likelihood of individual cancer developing. But some women seem not to react well to the progesterone component. Not well understood but certainly a phenomenon that many many women have reported. So even after one decides that she may want to try hormone therapy and thinks it might benefit her she may be in that group of women who does not feel good on hormone therapy and doesn't like the way she wakes up in the morning or feel during the day and sometimes their mood alterations. And that might weigh in as a bigger factor than anything else about a future risk.

So it's a very personal matter it has to be an individual matter. And we. And. Women to become well informed there are actually several good websites. The new National Women's Health Network and our website our bodies are dot org lead viewers to very good resources on this hormone therapy question and the whole issue of how to deal with men to pause and reduce the likelihood of bones becoming brittle losing their or their bone losing ones bone mass. Obviously having enough exercise adequate calcium intake making sure you get those dark green leafy vegetables in your diet early on not just at midlife but early on when we're laying down our bone mass. These things are very important. They're also important for just how we feel. Diet and exercise are so crucial to an overall sense of well-being not just heart health and some things about the future but very much how we feel in the present. I think that the doctor that we've at all these years has said very much the same sort of things that you have and in responding to questions from callers about what they

should do it seems that she has said so many many times I've heard her say Well one of the first things you have to do is sit down to decide what it is you're trying to achieve. Right. And as a way to answering that question or in the process of answering the question you do have to ask a lot of questions about well what you have to have a good medical history you have to know about kind of where what your risk of certain things are you got to know about. Well if you're concerned about bone loss what's your Where is your are your bones now. And all of that it seems that bearing in mind that maybe one of People's big complaints is that they don't get enough time with their doctor whether. Particularly women who are in managed care situations are going to actually be able to spend enough time with their doctor to have this kind of detailed conversation about who they are and where they are and what their where they're trying to to get to not just doctors I mean now more and more women are seeking information I think in some cases getting better information from Nurse practitioners from midwives from nurses that they meet in various

settings. But all of these practitioners are struggling with the fact that women are increasingly influenced by media images movies television not just the advertising but the images that really draw me into women's heads the idea that we've got to be thin unhelpfully thin so they're going on dangerous diets. They're engaging in dangerous cosmetic surgery practices and many and also taking diet and amphetamines and other diet drugs that are really quite unsafe and they're having to struggle with this obsession with thinness even though many physicians know this is not a good thing. How do you respond to that when women come in and ask for certain products or want to look a certain way that may not even be healthful. They also have to deal with the fact many younger women think fat in the diet is bad while fats are critical there. There are good fats that we have to have in our diet and not you know the the the deep fried fatty food with all the saturated hydrogenated fats. But even some. Saturated fats are important not

necessarily the kind that we've been eating some naturally occurring saturated fats aren't bad for us. This is not a simple issue but a young woman who is trying to take all the fat out of her diet is probably headed for some serious trouble. We need these fats and for for example omega 3 fatty acids are not produced by the body from other substances. They have to come from the food we eat and these are critical facts in the development reproductive development. And women generally don't understand this because the sources of information about diet are sometimes misleading and there is a big hype about low fat and no fat that is generated a whole generation of younger women that in some cases don't have the right kind of fat in their diet but they really truly need it seems it seems unfortunate and maybe I guess we really shouldn't be surprised because of the power of the mass media that that is at this point still in 2001 that women should be beating up on themselves so

much because of their bodies and because somehow somebody has created a completely unrealistic ideal and said This is what you're supposed to look like and if you don't there's something wrong with you that if you don't you need to buy this product well. Exactly and yes it's if you don't look like this we're going to we've got something that we can fix you and whether it's something in a pill or whether it's cosmetic surgery or you know whatever it is that that's there definitely is is that maybe that's the issue that it's that people have found that they can make a lot of money capitalizing on women's unhappiness about the way that they look. And it's a pity we see so much attention to things like that. And so relatively little attention to things like sexually transmitted infections Clemente is a serious problem for younger women human papilloma violent factions going to react continues to be a problem and then of course there's HIV AIDS. And we have taken a long time to

generate sufficient interest in both the not for profit Well it's mainly in the for profit sector but in doing research on new products like microbicides that women could use themselves to protect themselves from contracting HIV and other sexually transmissible organisms. This is a huge epidemic in this country and not enough general media attention is given to the importance of protecting ourselves from a whole host of organisms and viruses that damage our health and well-being and sometimes cost us our lives. How do you think about or how do we encourage people to think about the issue of there. The fact that the culture it seems is increasingly sexualized and that young girls sometimes very young girls are just steeped in this and and that we've got real concerns there's real reason to be concerned about sexual activity in younger kids and for a variety of reasons sexually transmitted disease being one of them. How does one confront that this

aspect of the culture that seems to be of real concern and also something that is so big that it's difficult to get a hold of and in any way turn around this is a very tough one because there is so much violence and so much sex unsafe sex violence sex inappropriate in terms of relationships being portrayed as. Oppressive and exploitive and very few what I'd call positive role models for younger girls and boys offsetting the mass media barrage is a very difficult thing it's not easy to do it in one session in a classroom part of a sex ed program. It really has to be something we bring into our homes into our community groups into regular discussions with healthcare providers to the extent we can influence scriptwriters and people who are engaged in mass media messaging. That's great. I myself have a recommendation for anyone who cares about this issue because I do think it's a really serious

problem and that is get some of the very inexpensive videos that exist. Show them in your home in your school and generate some discussion among younger women in and keep the discussion going. The National Now Foundation has produced an excellent 18 minute video that only cost $10. And it's called Redefining liberation and it looks at the health effects on women of tobacco alcohol and fashion industry advertising. And it does it in such a compelling way that I seen a wonderful conversations develop and continue among high school and college age women not necessarily for younger girls but that is something that any one of us can do we can get it to our physics teacher in the local high school. It's very appropriate really generates good discussion and I think a heightened awareness of the need for media literacy among young men and women who have grown up with a slew of media messages. The minority of which have been positive. And so that's the first step. Encourage media literacy for those who

are teachers who are in the social services things there's an excellent video put out by the king which documentary films groups here in Cambridge Massachusetts. And that is cold beyond Killing Us Softly the strength to resist and it has many interviews with middle school girls. It really explores how young girls lose their voice how it happens in society their interviews with Carol Gilligan and Gail Dines and she and several very prominent spokespersons and analysts who looked at mass media and its particular impact on the girl then young boys as well as we all are. Check to these messages and when looking at these videos I think are very insightful very hard hitting and thinking about what it means in Iran lives what we might do it the first step. But there's no quick fix obviously we have a huge media industry that's sending out a slew of messages that are antithetical to what many of us believe in. You know I think we have to remember that Britney

Spears is the first real sex pot who was or I should say sex idol who was marketed explicitly to seven year olds in this country. For that we never saw such marketing and 7 year old that was the exact plan and they succeeded. So if you were polled by some of the behaviors and aspirations and ideals and I and thoughts and feelings expressed by younger girls some of it very explicitly massage honest you can understand it better if you see what kinds of marketing in advertising and media images young girls have been exposed to especially if they consume a lot of mass media. You know it was not all that long ago certainly within our lifetime that the predominant message that women got about their sexuality was you shit you're supposed to be a virgin when you get married and then when you get married you're going to have sex with this guy and this is the only guy you're going to have sex with for the rest of your life. Very different of course in the message that man got. And one of the things that that happened. As a result of the women's movement and it's not just the

women's movement but we sort of swept away that idea and we said to women that they have a right to be sexual beings there's nothing wrong with having sexual desire and looking for sexual satisfaction. And sometimes I don't know nothing wrong with it in fact I wonder if that is what about India. And yet at the same time I think then now in some respects that the women's movement has taken a hit on this because some people have said See now here's the proverbial Pandora's box we've opened it up and now we sexuality is sort of out of control and now we've got this problem with seven year old girls who want to be Britney Spears. You know how does one strike some cook some kind of a balance. Here between you know what's what's healthy and what is excessive. Well first of all it's patently untrue that the women's movement has had anything to do with what I've been talking about in fact the women's movement had been struggling against this kind of offensive massaging this to media imagery the women's movement was

very rightfully looking at the question of reproductive and sexual health more broadly looking at the importance of mutually respectful sexual relationships relationships where women in and outside of marriage can express themselves be satisfied engage in loving relationships or relationships at least with satisfying in some way not harmful exploitive oppressive and ways that many relationships have been and continue to be for women. It is very different from. Anything you would see in terms of what I call these more exploitive messages that are out there and to blame the women's movement for that is is ridiculous. And there's no evidence to support a link between anything the women's movement has done and what we're seeing right now. What we're seeing right now is that things like pornography and much of this negative imagery and this kind of advertising it sells products it sells videos and magazines and it makes somebody money and anything that makes money in

this country you know is a go. I must say that I think we win the prize in the world for putting the amassing of financial resources above and beyond practically everything else in terms of culture. Even Europeans look at this culture askance and say you know why is it that money is so glorified in this country above and beyond so much else. Sexual pleasure can and still ought to be the goal of many of us. And in the women's health movement we have supported the pursuit affects the pleasure it needs to be obviously done in a way that preserves our health and well-being with the reality of AIDS and HIV and other sexually transmitted organisms. One has to be really mindful about sexual relationships. It's not a simple thing and it's important to be informed and educated and to be careful. But that doesn't mean you are going to be miserable or don't have to be involved at all with partners in terms of having sexual relationships.

Abstinence only sex education does not work for the most part and if in fact they think doing us a great disservice and I'm quite disturbed to see greater and greater amount of federal money going towards abstinence only programs that don't give young people the kind of information and support they truly need to be responsible and loving in their sexual relationships with others. We have a caller somebody from a car phone so I want to make them wait any longer will go right there line one. Hello. Hi I'd like to make a general comment. I listen to the show all the time and the most intelligent thing I hear on any of the mass media both 10 o'clock 11 o'clock hour and I listen to a lot of professionals an academician talking about the future of society and and how we can correct things and I for the make the comment that that it would be useful to listen to the song The Times They are

changing by Bob Dylan in which he says Anders to out the way and don't criticize what you can't understand. Your sons and your daughters are beyond your command. The times they are changing and the more words the point is m s and I teach a lot of students and I'm in 50 plus years of age. And I agree that the world is going to hell in a handbasket. But in general. We can wish for times to be the way they were as New York Times reported yesterday Ozzie and Harriet are dead both literally and as in the Suir diety. And basically we can talk about what we want people to do but it's not going to have any effect on the young people they're going the way they're going. And I'm glad that we issue warnings about where we're going. But I really don't see that there is a lot of hope in trying to modify behavior and trying to get people to adopt ideals that existed yesterday let alone many years

ago. And. I just I just don't see that we can actually control the future. And I just want to make that kind of general comment I enjoy listening to the conversations you have with all your interviewer and interviewee. And but I don't see that I can that will actually ever going to accomplish anything. Thank you. Well I appreciate the comment Ms. Or C Give me a comment on that. Were not easy. And for me it's not about changing new behaviors and new fads. I mean that there's a lot that goes on that you know might not be my cup of tea but it's not something that you know strikes me as good or bad it's different like people want to have their hair purple or red or piercing in different parts of the body oftentimes there are risks but you know there's fashion statements that people can make that are different from those before the end. The thing is that what young people are exposed to these very violent and I

think really destructive media messages by the way they're not set by a lot of positive role models. Sometimes I think that this is this is now. Something that's put out there by young people many many of the folks who foot the bill to put the stuff out there are in my age bracket they're in their 50s and they're making money on the stuff. And it's really not about what young people themselves want and I think that's fine and I do believe in the ambit of this tipping point fairy that you know has been written and talked about and sometimes a very small group of young people can create a fad that spreads in the media picks up on it and we're not going to control that. But there is a certain amount that's being controlled and not by young people but by those who control what they're exposed to. If you analyze what's out there in the media now you do not see the variety you saw 10 20 years ago. You see the media controlled by about 5 to 7 large corporations and the message is getting now we're now in the range of options for a living behaving being there not like what they used to be and I think this is a serious

problem if you don't have diversity in behavior and ideas and viewpoints and young people basically grow up with a narrow view of what possibilities are out there what you know what people do with their lives. It's going to affect us all and I am not surprised that so many communities are seeing rising rates of violence against women rising rates of other kinds of problems and we certainly want to do something about that and I see lots of younger people who are activists just like we were activists 30 years ago. They're using the Internet to not getting on mass media with their messages but they're using the Internet. They're creating active campaigns to deal with threats to the environment. They're trying to do something about the debt of many third world countries they're part of the Jubilee 2000 effort. They very effectively organized to challenge the WTO the World Trade Organization and descended upon Seattle with a very effectively organized protest that really surprised many people but the use of the Internet the sophisticated communications

ability that younger people have now even though they don't have access to the mainstream media has certainly generated an awareness and a consciousness that is seeing that you know it's seeing us all now with a resurgence of student based activism No. Some of it might not always be that to the point and some of it might not always be getting at the. Maybe the true sources of our you know but this certainly is an intention to do something about it and I think that's good. We have a couple minutes left we have two callers who will try to get at least one if not both. First in line is champagne wine. Hello yes I have a quick question I hope we haven't covered this already. Can you give us a recommendation of a book to give teenagers a sort of sex education look I have a niece and nephew and have been looking for something good I haven't found anything I liked yet even while there is a wonderful book that was produced by members of our group the Boston Women's Health to collect if it's in the spirit of Our Bodies Ourselves. But it's geared to 11 12 13 14 15 16 year olds depending

on their level of sophistication it's called changing bodies changing lives. But if you're looking at something force boys to me boys too. Yes. It's for boys and girls. OK. And it deals with everything that a young person might be coping with. There's also something put out called Teen voices. It's a fabulous magazine put out in Boston but it's national distribution and they have their own website. And it is glossy It looks like 17 but it's got very different kinds of messages and it covers all the issues that young people would be interested in that this is geared to young women mainly. OK. Also two other magazines new moon and. Blue Jean magazine they deal with younger age groups and if you don't already 17 maybe she's too old for these things the 17 year old might like changing bodies changing lives. OK with a lot of these issues right younger people something called it's

perfectly normal it's a more cartoony approach by Robie Harris more like 9 to 11 year old absent of some of the bookstores is that kind of thing. Yeah I want something it's good and they're on birth control because these are people whose parents do not tell them about the stuff. Well our bodies ourselves is the best thing on birth control. OK. You know if it's a 17 year old who needs birth control I'd go to that that's a very long and there are a chapter and we lead you to websites with more information Ok I'll probably go for that. Yes we thank you. You know emergency contraception information in terms of right lead you to a website. Right. All right well thank you very much for the call. And I think we're going to have to stop there my apologies we have one caller we can't take but before we go I do want to mention again one more time that our guest with us part of focus Judy nor CNN senior program officer at the Boston Women's Health Book collective will be the speaker this weekend at the new awards dinner of the champagne County health care consumers. Saturday May 19th. There are still still tickets available. You can call them at 3 5

2 6 5 3 3 and find out more about that. In addition Judy Norse again is one of the authors of Our Bodies Ourselves for the new century. A major update of this classic that was first published in one thousand seventy. Now this version came out in May of 1900. It is available now it's in paper by Touchstone books. Certainly should be out there in the bookstore. Again we want to say to you thanks very much for talking with us was my pleasure. Happy to join you.