These days, nearly everyone is crying "fake news!" Not least of all President Trump, who may have been the beneficiary of certain untrue news stories during the campaign, but has perhaps awoken to the potential nightmare of living in a world in which baseless claims, unhinged from facts, or demonstrable reality, can pass for truth.
But for many in the medical and scientific communities, the preponderance of fake news predates not only Golden Shower Gate, but the 2016 election itself. Bad information about women's health — especially around sexual health, abortion, and reproductive care — has been making the world worse for women for years.
While I was reporting a recent feature on reproductive health care access in the United States under Trump, several of the doctors and historians I spoke to talked about about the damage done by the pervasive anti-scientific attitude that has worked its way not just into conversation but into law and medical policy.
Five states require that doctors give patients information suggesting a link between abortion and the occurrence of breast cancer, a link that the American Cancer Society and the American Congress of Obstetricians and Gynecologists have refuted. In other states, physicians are forced to offer other medical information that they know to be false about abortion potentially causing infertility, depression, suicidal thoughts, and PTSD. If they do not offer this false information, doctors risk losing their licenses.
"I can't think of any other form of medicine where we are told to make things up," said Adam Jacobs, head of the family-planning division at Mt. Sinai in New York. "It's okay to do this only with regard to women's reproductive health."
In recent years, false information around women's reproductive health has found its way into federal law, via 2003's Partial-Birth Abortion Ban, passed by Congress and upheld by the Supreme Court in the 2007 case Gonzales v. Carhart. Despite the name of the bill, there is no such medical procedure as a "partial-birth abortion." It's a term made up by a member of the National Right to Life Committee meant to invoke a grisly, visceral image of what is a very rare form of late-term abortion called "intact dilation and extraction." Yet the Partial-Birth Abortion Ban Act is now law.
More recently, anti-abortion activists have been promulgating the notion that 20 weeks is the gestational point at which a fetus can feel pain, despite there being no persuasive medical evidence that this is the case. In fact, the American Congress of Obstetricians and Gynecologists says that the neural anatomy of the fetus is not developed enough to transmit the sensation of pain until late in the third trimester, past the 27th week. But the 20-week claim has led to a spate of state laws, many of which require doctors to falsely inform women that the fetus may be able to feel pain, and some, like Utah's, that mandate that women having abortions at 20 weeks take anesthesia, not for themselves but for the fetus. And of course, purported fetal-pain concerns are often cited by those who seek to ban abortions entirely after 20 weeks gestation. Restrictive laws, rooted in fake science.
Many pro-fact Americans had been heartened by last summer's Supreme Court ruling in Whole Woman's Health v. Hellerstedt, precisely because it put a judicial roadblock between false science and legislative restriction on reproductive health. "Whole Woman's Health was a really joyous day," said Carol Sanger, a legal historian and author of the upcoming book About Abortion. "In part because it meant that the state was going to have to be put to the test of having to show facts, to prove that a rule corresponded to women's actual health needs." The precedent affirmed by Hellerstedt will be used to challenge Targeted Regulation of Abortion Providers (TRAP) laws that restrict abortion access based on needless requirements for width of hallways or hospital-admitting privileges. But Sanger worries that under a Trump administration, anti-abortion activists will find ways to work around the ruling. "We are now in this post-truth age, where you take the facts you want and that's going to be good enough."
The fact that anti-abortion forces made the headway they did — hundreds of restrictive laws passed state legislatures — during the administration of Barack Obama, a fundamentally rational leader, makes fears about what could happen under the irrational stewardship of Donald Trump more intense. Trump appointed to the position of health care adviser a woman named Katy Talento, who has written that hormonal birth control causes cancer and miscarriage and that the longer a woman stays on the pill, the more likely she is to "ruin [her] uterus." For the record: None of that is true. What is true is that Katy Talento will be advising the president on health care.
Doctors know the larger impact of this false information. Amanda Lerman, an adolescent medicine specialist in Philadelphia, saw for herself the lasting effects of a stray piece of loony misinformation.
Lerman was working with adolescents during the 2012 presidential campaign when Republican candidate Michele Bachmann, then a congresswoman from Minnesota, told a story on the Today show about a young woman she claimed had become cognitively impaired after taking Gardasil, the vaccine for HPV. For the next year, Lerman says, she had patients and parents asking her about Bachmann's claim, worried that they were hurting their kids instead of helping them. "What Michele Bachmann said was about as shaky and incredible as anything a politician could say," said Lerman. "It was one story, with no support, and she was just a random politician; she wasn't even winning at the time she said it! Yet patients and their parents asked me about it three times a week."
It's a reminder that the scourge of fake news is not just a means to certain policy ends, like abortion restriction and the inequalities they perpetuate, but key to an even larger project that Trump, his party, and his supporters seem to be undertaking: the rollback of rational thought itself.