Tag Archive for: ideology

The Turnaway Study: A Lesson in Politically Incentivised and Twisted Science

Pro-choice ideology has been allowed to infect research on mental health outcomes for women who have had abortions.


Given decades of legal and quasi-legal abortions in developed countries involving millions of women, there should be many studies with various findings on the impact of what was, until “shout your abortion” politics came along, generally regarded as a complex decision for a woman. And yet the Anglo-American lay reader is likely to find only one.

It’s called the Turnaway Study, conducted at the University of San Francisco California in 2008-2010. Mainstream media outlets have been broadcasting its results for nearly a decade, and research articles generated from the same core sample of women have been published in droves.

The study has been touted by academics, professional organisations, and journalists alike as the abortion study to end all studies, offering definitive answers to hotly debated questions on how abortion benefits contemporary women psychologically, relationally, physically and in terms of life satisfaction — among a host of other quality of life indicators.

Not quite, according to Priscilla Coleman, retired Professor of Human Development and Family Studies at Bowling Green State University in Ohio. Coleman has been studying the psychology of abortion decision-making and mental health outcomes associated with abortion for nearly 30 years. Last month she published “The Turnaway Study: A Case of Self-Correction in Science Upended by Political Motivation and Unvetted Findings” in the top-ranked psychology journal, Frontiers in Psychology.

Focusing on Turnaway’s mental health findings, Coleman pulls back the curtain, revealing the details of this large-scale effort to use science to manufacture a false narrative about abortion being preferable to delivering an unintended pregnancy, and as essential for preserving the well-being of women.

The publication of her article is timely given the overturn of Roe v Wade and likely use of Turnaway findings in the raging battles at state level.

More than 50 peer-reviewed spinoffs can’t be wrong?

In the Frontiers in Psychology article, Coleman quotes a January 2022 Kaiser Health News interview with the study’s principal investigator, Diana Greene Foster.

“Data from the Turnaway Study has resulted in the publication of more than 50 peer-reviewed studies, and the answer to nearly all the questions asked, said Foster, is that the women who got abortions fared better in respect to economics and health, including their mental health, compared with those who did not have abortions.”

Better mental health? According to Coleman, these results dramatically contradict a wealth of data from large, methodologically sophisticated studies demonstrating that abortion is associated with a statistically significant increased risk for mental health problems including depression, anxiety, substance abuse, and suicide. She wanted to understand why.

Motivation and funding

Coleman began by examining the investigators’ incentive for embarking on the study. She soon discovered that the funding came from Warren Buffett, who provided a minimum of $88,000,000 to the University of California San Francisco (UCSF), funds directly supporting researchers who had expressed abortion-rights political views.

A research unit called Advancing New Standards in Reproductive Health (ANSIRH) within UCSF’s Bixby Center for Global Reproductive Health housed Turnaway. Research conducted within the centre was aimed at debunking common justifications for abortion restrictions, including increased risks for serious, long-lasting mental health challenges.

Critical analysis of the study’s Operating Procedures Manual and publications led Coleman to identify numerous methodological shortcomings. For a start, the study investigators never describe the plan for sampling women, the precise size of the population, or the manner for selecting sites within the various cities.

The Turnaway women

Participants from three different groups were recruited for Turnaway: (1) women whose pregnancies were past clinic gestational limits for performing abortions and were not permitted a wanted abortion (“Turnaway Group”); (2) women whose pregnancies were close to the clinic gestational limit and had an abortion; and finally, (3) women who had an abortion in the first trimester.

The women were recruited over three years in 21 states at 29 abortion clinics with different gestational age limits. The clinics performed over 2000 abortions a year on average. Coleman calculates that the potential pool of women could have been as high as 162,000. However, only 7,486 women were screened for the study, and of those only 3,045 were approached to participate in it. Ultimately the number of those participating was 1,199. Why only 41% of those screened were asked to participate was not explained by the study authors, says Coleman.

“This is potentially very problematic, because those not screened in or not approached could have been systematically different from those who were screened in or approached relative to background characteristics, situational factors and/or how they presented before, during, or immediately after the abortion experience.”

Further, although “1000” is the number of participants usually cited by the authors, the actual number of women who completed the initial interview (“baseline measures”) was 877. And the total percentage of women who completed the 5-year study was 516 — a mere 16.9% of those approached.

If Coleman’s figure of 162,000 women for the potential population for the study is used, the 516 who actually completed it would amount to a miniscule 0.32% of them. Even at 10% of her population estimate, the final sample of 516 participants would be 3.18% of the total abortions performed at the 29 clinics over three years. As Coleman observes:

“The Turnaway Study researchers attempted to make generalized claims about women seeking abortion when the study itself likely did not even consider over 95% of women receiving abortions at the facilities included in the study. Given the extremely small percentage of women from the population represented in the sample, generalizations are precluded.”

Among the other methodological problems of Turnaway highlighted in Coleman’s article are the following:

  1. Those who underwent abortions near gestational limits included patients whose pregnancies ranged from 10 to 27 weeks gestation, even though women’s reasons for aborting and their psychological responses vary greatly at different times across pregnancy. For this reason, they should not have been grouped together.
  2. Many of the complex outcomes are measured far too simplistically, with anxiety and depression scales containing only six items and self-esteem and life satisfaction only 2 items. Capturing all the components of complex internal states is impossible with so few items and goes against established protocol for reliable and valid assessments.
  3. In many of the analyses, the authors failed to control for abortions that took place before or after the target abortion. This is problematic because previous studies have shown more than one abortion increases a woman’s risk for mental health problems beyond that incurred from a single abortion.

The studies you never hear about — except to dismiss them

Yet, there are well-designed studies coming to different conclusions from those of the Turnaway authors, and Coleman provides the reader with an up-to-date synopsis of some of the strongest of them. She notes:

“The science linking abortion to elevated risk for mental health challenges is published in prominent journals, with dozens of large, prospective studies incorporating comparison groups and additional sophisticated control techniques, enhancing confidence in the published findings. This extensive literature has shown that abortion increases risk for mental health problems including substance abuse, anxiety, depression, suicidal ideation, and suicide.”

She summarises the results of systematic reviews of literature, including her own, demonstrating this effect and provides overviews of some of the most sophisticated empirical studies published in recent years. There is a table (reproduced at the end of this article) in the Frontiers article highlighting key findings from several large-scale studies, all of which revealed increased risks of psychological problems associated with abortion, in contrast to Turnaway.

And yet professional groups such as the American Psychological Association (in 2008), the Royal College of Psychiatrists (in 2011) and the American Academies of Sciences (in 2018) have published reviews of the literature on abortion and mental health that dismiss findings like Coleman’s and support the “no negative effect” line.

In the last part of her article, Coleman examines these reviews and details a litany of methodological problems with them that include, among others: missing or elusive selection criteria that resulted in selective reporting of studies, shifting standards of evaluation based on study results, failure to conduct a quantitative synthesis or meta-analysis, sweeping conclusions based on very few or a single study, and factual errors. She comes out fighting:

“Journals opening their doors to allow virtually uncontested publication of some of the poorest work in the field, media outlets seizing the information that they believe the public desires, and abortion providers and their advocates using the data in attempts to remove and prevent installation of abortion restrictions: this is the status of mainstream science on the psychology of abortion in our world in 2022.”

Coleman concludes:

“[W]ith widespread dissemination of misinformation generated from studies like the Turnaway Study, hundreds of thousands of women considering an abortion are likely unaware of the expansive literature demonstrating abortion is a significant risk factor for post-abortion psychological distress and mental health detriments.

The science revealing the potential for serious, debilitating mental health consequences underscores the necessity of providing women with up-to-date information on the risks from the most rigorous scientific studies.”

Study Results
Gong, X., Hao, J., Tao, F., Zhang, J., Wang, H., & Xu, R. (2013). Pregnancy loss and anxiety and depression during subsequent pregnancies: Data from the C-ABC study. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 166(1), 30–36. Large Chinese study (over 20,000 women), 7683 of whom had an abortion. Abortion was related to increased risk of depression (OR: 1.381) and anxiety (OR: 1.211) in the first trimester of a later pregnancy after controlling for age, education, pre-pregnancy MBI, income, and residence. The comparison group was women experiencing a first pregnancy.
Gissler, M., Karalis, E., & Ulander, V.M. (2015). Decreased suicide rate after induced abortion, after the Current Care Guidelines in Finland 1987-2012. Scand J Public Health, 43(1), 99-101. Examined suicide post-abortion between 1987 and 2012 in Finland. A 2-fold increased risk of suicide was observed even after new guidelines required post-abortion follow-up sessions at 2-3 weeks to monitor women’s mental health.
Jacob, L., Gerhard, C., Kostev, K., & Kalder, M. (2019). Association between induced abortion, spontaneous abortion, and infertility respectively and the risk of psychiatric disorders in 57,770 women followed in gynecological practices in Germany. Journal of Affective Disorders, 251, 107–113. Case-control study from the Disease Analyzer Database (IQVIA). Induced abortion was positively associated with the elevated risk of psychiatric disorders (ORs ranging from 1.75 to 2.01).
Jacob, L., Kostev, K., Gerhard, C., & Kalder, M. (2019). Relationship between induced abortion and the incidence of depression, anxiety disorder, adjustment disorder, and somatoform disorder in Germany. Journal of Psychiatric Research, 114, 75–79. Examined women with a first abortion in 281 gynecological practices in Germany. Included 17581 women with an abortion experience and 17581 matched controls who had a live birth. Induced abortion predicted depression (HR=1.34), adjustment disorder (HR=1.45), and somatoform disorder (HR=1.56) across the 10-year study period.
Lega, I., Maraschini, A., D’Aloja, P., Andreozzi, S., Spettoli, D., Giangreco, M., Vichi, M., Loghi, M., Donati, S., & Regional Maternal Mortality Working Group (2020). Maternal suicide in Italy. Archives of Women’s Mental Health, 23(2), 199–206. Data were gathered from 10 regions in Italy. The suicide rate was 1.18 per 100,000 among women who gave birth (n = 2,876,193) and 2.77 among women who aborted (n = 650,549), a statistically significant difference.
Luo, M., Jiang, X., Wang, Y., Wang, Z., Shen, Q., Li, R., & Cai, Y. (2018). Association between induced abortion and suicidal ideation among unmarried female migrant workers in three metropolitan cities in China: A cross-sectional study. BMC Public Health, 18(1), 625. Examined 5115 unmarried females from Shanghai, Beijing, and Guangzhou. Abortion was associated with nearly double the odds of suicidal ideation (OR = 1.89) after adjustment for numerous controls (age, education, years in the working place, tobacco use, alcohol consumption, daily internet use, attitude towards premarital pregnancy, multiple induced abortion, self-esteem, loneliness, depression, and anxiety disorders.) The association was stronger in those aged > 25 (OR = 3.37), among women with > 5 years in the work force (OR = 2.98), in the non-anxiety group (OR = 2.28, and in the non-depression group (OR = 2.94).
McCarthy, F. P., Moss-Morris, R., Khashan, A. S., North, R. A., Baker, P. N., Dekker, G., Poston, L., McCowan, L., Walker, J. J., Kenny, L. C., & O’Donoghue, K. (2015). Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy. BJOG: An International Journal of Obstetrics and Gynaecology, 122(13), 1757–1764. Women with one prior abortion had elevated stress (adjusted mean difference=0.65) and depression (aOR= 1.25) at 15 weeks of gestation. Women with two prior abortions had increased perceived stress (adjusted mean difference=1.43) and depression (aOR=1.67).
Sullins D. P. (2016). Abortion, substance abuse and mental health in early adulthood: Thirteen-year longitudinal evidence from the United States. SAGE Open Medicine, 4, In a US sample, after extensive control for other pregnancy outcomes and sociodemographic variables, abortion was associated with increased overall risk of mental health disorders (OR:1.45). A Population Attributable Risk analysis showed 8.7% of the prevalence of mental disorders was attributable to abortion.
Wie, J. H., Nam, S. K., Ko, H. S., Shin, J. C., Park, I. Y., & Lee, Y. (2019). The association between abortion experience and postmenopausal suicidal ideation and mental health: Results from the 5th Korean National Health and Nutrition Examination Survey (KNHANES V). Taiwanese Journal of Obstetrics & Gynecology, 58(1), 153–158. After adjusting for several demographic controls, women who had three abortions experienced elevated risk for suicidal ideation (OR: 1.510). This level of risk was significant even after controlling for depression (OR: 1.391). Risk of depressive mood in daily life was likewise elevated with more abortions even after controlling for depression (OR: 1.657).

AUTHOR

Carolyn Moynihan

Carolyn Moynihan is the former deputy editor of MercatorNet More by Carolyn Moynihan.

RELATED ARTICLE: Dobbs, seen from an outpost of America’s informal empire

EDITORS NOTE: This FEE column is republished with permission. ©All rights reserved.

$30K a year, and my kid can’t tell the difference between a boy and a girl

Parents must hold their local school systems accountable for what is taught to their children.


Everything has a price.

Like every American family, our family runs a constant cost/benefit analysis on our lives. There are the small decisions: is it worth the time to drive to Target for the cheaper diapers? Or should I just get the pricier ones at the grocery store? And there are the bigger ones: like, should I live in the suburbs and pay lower taxes but more for car expenses and gas? Or flip that decision?

For our family, one of the toughest decisions was where to send our kids to school. We could send them across the street to the poorly performing public school for free. They’d meet a wide variety of kids and learn some valuable self-advocacy skills, but they would not be academically challenged. For $30k, I could send them to the nearby private school, where they’d benefit from engaged teachers, kids, and families. We’d have to drop the music lessons and fancy trips, but hey — I don’t like Disneyland anyway.

So, with some scholarships, sacrifices, and family assistance, we made the choice to send our kids to a fancy private school. The benefits have been great: warm, caring, patient teachers; outstanding academics; beautiful buildings; even a pretty good lunch. But there’s been a hidden cost, beyond the incredibly painful tuition bills: my kids can’t tell the difference between a boy and a girl.

This seems shocking, I know. How can a concept so obvious, so instinctual that nearly every 2-year-old on the planet can master it, be an idea that my very expensively-educated children don’t understand?

Simple-minded educators

Because some teachers don’t understand it. Because some administrators don’t understand it. And this is where I have to remind myself of something true: half the world is dumber than average.

I know this sounds incredibly snobby. I know this sounds judgmental and awful, but this is true. And this fact helps me take a breath, find some compassion, and slow down.

These teachers are good people. They are kind. They like kids, and want the best for children. They believe that education can make the world a better place. And additionally, they were hired for their people skills: they are empathetic, good communicators, patient, and open-minded. Those are exactly the skills my tuition dollars are paying for.

But these teachers are not well-trained critical thinkers. They were not hired for their ability to analyse complex research studies, nor to follow the various paths of different complex scenarios. They are not philosophers, ethicists, or religious scholars. They are not lawyers or developmental psychologists. They are not endocrinologists or pediatricians. They are experts at connecting to kids and explaining the types of K-12 content that kids should learn. Thank god for teachers and their talents and skills. Our society needs them. But they are not the experts here. They are just trying to do their jobs.

So when faced with the concept of “gender identity” — the idea that “people have an innate feeling of being female or male,” the typical teacher will say “Sure — that makes sense. I’m female, I know it. That’s not a controversial idea.”

When faced with the diagnostic definition of “gender dysphoria”, the idea that “some people have great distress with their biological sex, and wish they were the opposite sex,” these teachers say, “Sure — I know about Jazz Jennings and Caitlyn Jenner. That’s a real thing.”

When faced with the fact of “Disorders of Sexual Development” (formerly known as Intersex conditions), the scientifically observed and natural phenomena of various biological sexual characteristics and markers, teachers say, “Yep — I learned about that once.”

And when urged to consider the negative impacts of the difficulty of being an outlier, and the impacts of social isolation and/or ostracism, the teachers say, “Not on my watch. My cousin was gay and poorly treated. I won’t let any of my kids be bullied or left out.”

So when teachers combine all these ideas and impressions and blend them into their natural “be nice” personalities and “open-minded” natures, they are primed to become believers and advocates of transgender ideology. If Johnny likes skirts and thinks he’s really a girl inside, who are we to judge? We really can’t blame the teachers. They were born this way.

So our society has laid yet another burden of expectation on teachers. They must educate kids, they must socialise kids, they must address and resolve the emotional and behavioural dysfunctions of these kids. And now they must be responsible for nurturing, protecting, and advocating for the “internal feeling of being female or male” for a kid, otherwise they’ll be held responsible for the kid’s ostracism.

This is nuts. These teachers don’t stand a chance.

To the top

So we can’t fight the teachers. We’ve got to get the administrators and school boards to stop, listen, and think. These people were hired to be critical thinkers, to balance different opinions, to consider the different consequences of different choices. They still aren’t likely to read the studies or think through the ethical or philosophical consequences of different complex scenarios, but they are primed to consider one thing above all: legal threats.

Right now, principals and school boards are hiding behind the guidelines that WPATH (an activist-led organisation), the American Psychological Association, the National Association of School Psychologists, and the National Association of Secondary School Principals have created. These organisations have good intentions, but they are also human and flawed (and remember — half their members are below average). Even the ACLU seems to have lost its mind on this topic.

I suggest American parents adopt the “Maya Forstater Approach.” This strategy, based on the case in England, relies on fundamental and constitutional American legal rights: free speech and free religion. I don’t care if you haven’t been to church ever. This is what you say to your school board:

“For scientific, religious, and social reasons, I do not believe that you can change your sex, and I do not want my children to be taught “gender identity”, the belief that you have a gendered soul, and that your gender soul feelings trump your biology. How is your school protecting my family’s religious beliefs and our right to be free from compelled speech?”

Ask your school’s principal this question every Fall. Send it as a statement to your kids’ teachers every fall. Tell them to inform you of any lesson on gender identity before it happens so that your children can have a substitute lesson. Ask them what their policy on requesting pronouns is, so that your child does not feel compelled to use certain speech. Ask them how they balance different opinions on this topic in the community.

I can guarantee you they do not see this as a religious issue, but as a social justice issue. Say the magic words “freedom of religion/freedom from religion” and “freedom of speech” and see if that works. We’ve got a long history of protecting underdogs in this country, and right now the culture glorifies the status of victim. Use this knowledge wisely.

And here’s the thing: this is going to cost you. Be ready. Do the cost/benefit analysis. Whether your kids are getting a free public education or an expensive private one, when you ruffle the feathers of the principal, the winds blow. Then again, if you remain silent, your kid may not understand that sex never changes. Be prepared. Everything has a cost.

This article has been republished from Parents with Inconvenient Truths about Trans (PITT).

BY

Anonymous author

In exceptional circumstances, MercatorNet allows contributors to publish articles anonymously. Sometimes the author’s privacy or safety might be at risk. More by Anonymous author.

RELATED ARTICLE: “Without Logos, the West is lost”

EDITORS NOTE: This MercatorNet column is republished with permission. ©All rights reserved.

Ideology, hidden obstacle to reason

I was recently surprised to note that a prominent British libertarian had sent out a bulk email suggesting that leaving the EU would not be much of a boon to the UK since such would not necessarily provide more “liberty” for Brits. Thus, he contends that UK “leaders” have the same totalitarian mindset as the EU “leaders” and the Brexit (exit of the UK from the EU) would not help matters. He mentioned that the UK government has at times exceeded even the legal limitations on power provided by the authoritarian EU and that offended Brits may occasionally benefit from European Court decisions that overturn excesses of UK authorities and judges. Since the European Court is an essential component of the EU, leaving the EU would therefore supposedly remove this supposed benefit.

This email did not contain the words Muslim or Islam. Yet the Islamization of the UK is one of the main concerns of those who support the Brexit.

I had tried to show my UK reader list how simply rolling over and playing dead, ie, not voting in the upcoming referendum or voting YES to stay in the EU was not an option, for one thing because it sends a signal to the EU top rank that the people of Europe have finally given up and are willing to acquiesce to total tyranny.

An article in The Atlantic reveals one very important reason why EU membership is a bad deal for the UK and all other industrial members, to whit:

“EU countries are legally barred from limiting immigration from other member states, a decision that has had a great effect on migration patterns on the continent.”

Now it is certainly true that the usurpers who have seized the internal UK reins of power (essentially Parliament and Downing Street) by deceit are, like the EU bureaucrats, also inclined to flood the UK with still more Muslims, a rapidly growing group that receives an inordinately high percentage of social assistance or welfare (as reported here and here) and which in polls is found to favor sharia law and jihad.

In 2014, Daniel Greenfield, discussing a recent poll in London, wrote:

“There are about 1 million Muslim settlers in London where they make up 12 percent of the population. These figures suggest that the vast majority of them, perhaps as high as 80 percent, support ISIS.”

A NO vote on the referendum would be a signal to the Brussels oligarchs that the people are no longer the lemmings they once were and will not take rampant Islamisation lying down.

It should not surprise anyone that libertarians tend to be more liberal on the issue of immigration. Their ideology teaches essentially that all humans must have the maximum freedom possible and is refractory to considerations of reality. The freedom to cross someone else’s border and gain access to another country’s welfare rolls could be seen as the ultimate in libertarian policy. US libertarians counter the fears of ordinary mortals by contending that welfare would be forbidden in a libertarian society, but their immigration positions ignore the fact that welfare is part of the current US reality, over which libertarians have little or no control, and the current socialist context is the one in which they propose to implement their immigration positions. Like their British counterparts, they therefore generally see even illegal immigration as either a non-threat or a boon. They believe that they could soon operate in a perfect world with no impediments whatsoever to individual freedom.

The trouble with this thinking — in case you are one of the few who need this pointed out to you — is that there really are two kinds of freedom, or liberty (liberté) as the French revolutionaries, ideological second cousins to today’s libertarians, called it.

ONE kind is individual freedom.

The SECOND is more subtle and easier to overlook, and that is, national sovereignty, ie, the freedom of a nation to chart and navigate its own course without interference from other nations or entities.

Today’s libertarians almost never talk about the second kind of liberty because to them, national sovereignty is an obstacle to individual liberty at all costs, which is the non-negotiable centerpiece of their creed. And non-negotiable here means reality be damned.

Ironically, however, this neglect of national sovereignty actually severely curbs individual liberty as well, at least in the real world down here beneath the rarefied stratosphere in which libertarianism thrives.

For example, if 80% of an indigenous population desires freedom of choice in its national lawmaking, then a rigid libertarian policy of legal residency for all and sundry may well lead to veritable inundation of this indigenous population with hordes of people who tolerate and even welcome totalitarianism. After all, to them, totalitarianism is their free choice. Once these hordes reach a critical percentage of the population, the tipping point will be passed and that one-time majority will now be subjected to the will of the newly arrived hordes. And here’s the real kicker: the libertarians who persuaded their unsuspecting countrymen to accept these hordes will now also be enslaved along with the rest. So much for liberté.

Worst of all, the above is not by any means just a hypothetical example. There is a projection that the UK will become a Muslim state by 2050, and while this has been poo-pooed by the Establishment media, The Commentator writes:

“This projection is based on reasonably good data. Between 2004 and 2008, the Muslim population of the UK grew at an annual rate of 6.7 percent, making Muslims 4 percent of the population in 2008. Extrapolating from those figures would mean that the Muslim population in 2020 would be 8 percent, 15 percent in 2030, 28 percent in 2040 and finally, in 2050, the Muslim population of the UK would exceed 50 percent of the total population.”

Thus the rigid and doctrinaire libertarianism with liberty as its Grail, is from the outset on a course of ineluctable self-destruction.

History presents us with a parade of ideologies, all of which have failed one after the other. Yet some flaw in the character of Homo sapiens leads us invariably to put aside our perception of reality, our built-in logic and reason, and even our sense of self-preservation in favor of untested ideologies propped up by high-sounding rhetoric. Somehow, our species never seems to notice that, precisely because ideologies supersede and subtly supplant reason and the perception of reality, all ideologies will eventually fail, always, just as they always have in the past.

The question is: Can we ever come to understand this simple fact and overcome this flaw in our DNA?