Unisex in the Health Services

" You go in there and it's like going to the veterinarian. "

" But do they give moral lectures to dogs? "

-South House conversation

UNIVERSITY Health Services is finally showing an awareness of the female fraction of "the Harvard Family." In response to a change in the Massachusetts birth control law and to what Dr. Sholem Postel called "milieu-pressure," gynecological services, sex counseling and abortion referrals are being coordinated and publicized. The move stems from a January 18 meeting between Health Services doctors, President Bunting, Dean Elliot and two Radcliffe resident tutors. No student were present.

The meeting was the result of a conversation between Bunting and Farnsworth during which Bunting suggested that the Health Services should look upon its responsibilities as "educational" in the area of sexuality. Farnsworth subsequently called the meeting.

To date, the only concrete result of the meeting is a mimeographed sheet giving a central phone number where information on both the medical and psychological services provided can be obtained. A firm policy of anonymity for anyone using the newly coordinated services is in effect. Notations of visits are not entered in regular Health Services records unless a prescription is issued. Although the doctors involved will keep their own records as protection against malpractice suits, these cannot be released to anyone without the patient's permission. At the meeting, Farnsworth mentioned that he had $500 that had been given to aid a "wayward girl." It was suggested that this be used to print a booklet containing birth control information.

The Health Services carefully insists that this publicity does not constitute an expansion of service, but is merely a clarification of services already available.

Under the present abortion statute, only "therapeutic" abortions are legal in Massachusetts. Certification by two physicians that carrying the pregnancy to term constitutes a grave risk, either physical or psychological, to the mother is required. The cost of a therapeutic abortion is covered by the Blue Shield/Blue Cross medical plans for undergraduates, graduate students and faculty. In addition to covering legal in-state abortions, the Health Services will refer cases to New York clinics. In that case, expenses up to the cost of a therapeutic abortion in Massachusetts, which is set for doctors subscribing to the plan, is covered by the Comprehensive Medical Plan. Any costs over that must be borne by the woman.

The old state law blocking dispersal of birth control prescriptions to unmarried women was overturned on constitutional grounds in the First U.S. District Court of Appeals on July 6, 1970. The decision is currently being appealed in the State Supreme Court. Susan Block, a Currier House tutor, suggests, however, that the change in UHS practice is due less to reinterpretation of the law than to "negative feedback" towards the Health Services from women through out the University.

Reactions to the UHS position have been generally favorable.

Judy Lazerson and Susan Block, who went to the January meeting "expecting no response" left it with the impression that the Health Services staff "had really thought it out." Mrs. Block mentioned the doctor's willingness to talk to groups of students and hoped that "a real response" would be forthcoming "to make sure they realize what students need." Farnsworth, Mrs. Block said, "very much doesn't want to be disliked" and was "amenable to pressure."

President Bunting and Dean Elliot, while somewhat anxious about the image of the Radcliffe student body, clearly supported the apparent trend towards liberalized services. "I get the feeling," said one person who attended the meeting, "that she [Dean Elliot] didn't want the doctors to think that everybody at Radcliffe needed birth control."

Dr. Graham B. Blaine, head of Psychiatric Services, called it a change from one "non-policy" to another. In other words, the options available are still determined by the individual doctor but the names of those physicians more or less guaranteed to provide services to women are being advertised. "We may be playing too much the blushing virgin," Blaine admitted. "We might be a little more aggressive."

Under the present system, several internists do the simple gynecological examinations and refer cases to Dr. Somers H. Sturgis, consulting gynecologist, when necessary.

One of the most consistent demands from Radcliffe students has been for a staff of full-time gynecologists at the Health Services. The Health Services takes the position that gynecology is basically a surgical specialty, that no surgeons are retained at the Health Services and that internists are competent to provide basic gynecological care.

With no new services being offered by the Health Services, Radcliffe students have put RUS funds to use. A sex counseling and information service is now in operation in Currier House, and a loan/grant program which would provide term-time grants for projects women cannot get funds for anywhere else, and confidential personal loans that could be used to cover abortion costs.

THE QUESTION of whether sex-related services will be expanded with the introduction of the more inclusive Comprehensive Medical Plan remains an open one. The opening of Stillman and the Health Services to dependents of employees, students and faculty, proposed by the Ad Hoc University Health Services Committee, would affect mostly women. However, the plan is subject to ratification by Farnsworth's successor, who has not yet been announced. The University's current financial squeeze may postpone implementation of the plan indefinitely.

Widespread dissatisfaction with the gynecological care offered by the Health Services among University women has gradually filtered back to Stillman. Holmes resident Linda Law-rence posted a sheet listing Health Services doctors a year ago, inviting "positive comments" after she had heard many complaints. The list is up in several Radcliffe dorms again this year. "Please," she said, "This is not a blacklist," but is intended simply to channel women to sympathetic doctors. "Why should a person get a lecture from a doctor who feels he has a right to do it and that's where his morals are?" she added.

On November 6, the Committee on the Status of Women held open hearings on health care. Farnsworth and Dr. Eleanor Shore from the Health Services were present along with spokeswomen for Medical School women and graduate women. Testimony from undergraduate women was also read.

The quality of gynecological care at the Health Services came up continually during the hearings. A large part of the transcript is taken up by the recitation of experiences women had had or had heard about. Unfortunately at the time most of these incidents were brought up, Farns-worth was not present. Farlier in the hearings, however, he responded to queries regarding the financial obstacles to increased gynecological. obstetric and pediatric care. "It seems to me that ... the way resources have been allocated is more in terms of men's needs than women's," remarked a member of the committee.

"We could do what you want done, if and when we get our plans for the care of all dependents through," Farnsworth answered. "The reason why it isn't here is not lack of money per se, although indirectly it is ... whether it will be set back another year, another two vears, I don't know ... there's no design on anybody's part to favor one sex over another. (I'm a little partial to women as a matter of fact, being a male...)"

"It bothers me a bit that women who study and work at Harvard have to wait to get their services until wives of men who study and work at Harvard get theirs," rejoined the committee member.

"What's that again?" said Farns-worth.

Later in the hearings, Professor R. A. Rothestein commented on Farns-worth's testimony. "I think the most important point about that is that questions are never really asked. The decisions are made, and rarely are the students or faculty or others affected asked in advance how they want resources allocated." Rothstein also said that "the assumption that somehow gynecological problems are something extraordinary is a misperception. My wife ... was told by one physician that ... we couldn't just hire one, we'd have to hire several" (gynecologists). Farnsworth, however, called the hiring of a full-time gynecologist "impractical from a medical point of view."

RECENTLY, however. Dr. Sturgis said that "we very much need a full time gynecologist even to take care of the referrals. In fact," he added. "I'd be glad to do it full time." The staff has enough general practitioners well-qualified for gynecological practice to take care of gynecological exams, pap tests and minor infections for Harvard's 13.000 women. "But," he said, "I'm already booked halfway through May." A recurring criticism of the present set-up at the Health Services is that women can rarely see Dr. Sturgis without waiting several weeks for an appointment and are referred to another doctor in the area. Medical plans cover the first $25 in such cases. but if a woman continues to see another doctor, it is at her own expense.

A spokeswoman from the Medical School brought up the "lack of psychotherapists who, according to somepatients, are incapable of helping them with the problems they face as women students training in a man's profession." She referred to an article by Blaine in the 1967 Radcliffe Quarterly.

"How well does Dr. Blaine understand this conflict?" she asked rhetorically. "He quotes Helena Deutch's classic book on the psychology of women. 'The intellectualized woman is masculinized and her warm intuitive knowledge has yielded to bold unproductive thinking.' Dr. Deutch's indictment, Dr. Blaine says, probably should not be applied to the average undergraduate. Only, perhaps, to the exclusively intellectual graduate student who contemptuously refers to her married colleagues as mouse wives. Blaine does not explain while ... [she] will be unmarried. But it should be evident that young women, married and unmarried, who are devoted to scholarly work, will receive doubtful help from psychiatrists who believe as Dr. Blaine does, that a Radcliffe A.B. ought to mean that a girl has fulfilled her criteria necessary for acceptance into the world of educated women, a world quite different because of her temperament and her life plan from that of educated men."

Although the new publicity about sex-related services may be construed as an admission of inadequate care for women in the past, the Health Services continues to insist that its notoriety is based on exaggeration and misunderstanding. General support at Radcliffe for the reorganized services is still tinged with skepticism, however. A glance into the future at a tight budget and indefinite postponement of expanded medical coverage lends weight to this response.