Tuesday, October 1, 2019

Monthly Horoscope: Libra, October 2019

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Happy solar return, Libra! Your season is here, and you’re feeling revitalized, especially after such a confusing September. Though last month wrapped up with a new moon in your sign and you’re ready for a fresh start, October starts on a very intense note.

On October 1, Venus—your ruling planet—in Libra clashes with Pluto in Capricorn; two days later, Pluto ends its retrograde on October 3. On a good day, Pluto—the lord of the underworld—is the planet of rebirth and transformation. On a bad day, Pluto is obsessive, possessive, sneaky, and power hungry. As gentle Venus and creepy Pluto clash early this month, you're finding you need to set firmer boundaries in your private life. As things are feeling intense at home, and memories from the past may be bubbling to the surface, watch out for jealousy, be mindful not to repress your feelings, and confront the things that might be upsetting you. Stop keeping people's secrets and watch out for manipulators!

Early October is a powerful time to connect with your ancestors and energetically cleanse your home. Pluto’s change in direction on October 3 creates a potent energy in your personal life, and real change is taking place in the structures in your home and family life that seemed to be have been set in stone aeons ago.

  • A home-cleansing kit could help you clear any negative energy from your space.
  • Feng shui is all about encouraging a good flow of energy in your living spaces. These wind chimes could help bring more tranquility to your home.
  • Jealousy is a fickle queen, but luckily there are things you can do to teach your body to chill out during a bout of jealousy.

Messenger planet Mercury enters Scorpio on October 3 bringing news about money, while warrior planet Mars enters your sign, Libra, on October 4, inspiring you to fight for causes you believe in. On October 7, Mercury opposes electric Uranus in Taurus and the sun clashes with Saturn in Capricorn, bringing more surprising news, especially in the realm of money. Unfortunately, you might be feeling blocked at this time as you reach obstacles. Emotional liberation has been a theme for you lately, and the end of summer found you feeling so free, but this autumn finds you learning about new limitations—or old ones that you weren't aware of yet—that you now have to navigate. The best thing you can do right now is to act responsibly.

  • Since things are feeling intense at home early this month, enchant your bedroom with some sacred incense.
  • Don’t lose track of any extra cash you’re receiving this month! A practical and cute wallet will hold all of your cards, cash, and coins in one spot.

Financial blessings arrive as your ruling planet Venus enters Scorpio on October 8; however, Venus opposes Uranus on October 12, bringing a bit of chaos—now isn't the time to make investments or commitments! Uranus is the planet of unpredictability, and as it's opposed by darling Venus, you may find that your tastes have changed: you might find that something you thought was valuable actually isn't, or something you didn't care for before becomes appealing! This can be an exciting energy, even though unexpected events may occur, especially when it comes to your finances.

A big release also takes this month, thanks to the full moon in Aries on October 13. Aries is your opposite sign on the zodiac wheel, and this full moon brings a major climax in your relationships. A turning point is here: While you are the polite, fair, popular air sign everyone gets along with, fiery Aries hasn't attended charm school and isn't afraid of a confrontation. This is a perfect time for you to vent and get all your feelings out! Be honest, especially with yourself. A confrontation may indeed take place, but if you have unkind words to share, do so in the privacy of your journal (and rip the pages up afterwards!).

Emotional release doesn't need to mean the end of a relationship. That said, some relationships may indeed end at this time. They have run their course, and it's time for you to turn your attention elsewhere. All in all, as much as this full moon is inspiring you to "let go," you also find yourself expanding in exciting ways as the sun connects with lucky planet Jupiter, creating an atmosphere of growth and bringing you the information you’ve been seeking.

Mercury makes a helpful connection to Saturn and the sun clashes with Pluto on October 14, creating a supportive energy for communication despite the ego clashes that are sure to take place on this day. It's a great time to figure out plans concerning your living situation, finances, and security, as well as to discuss boundaries and standards with the people in your life. Be on the lookout for manipulators and control freaks this month!

An especially creative energy flows at work as Mercury makes a harmonious connection with dreamy Neptune on October 15—inspiration is flowing! Mercury and Pluto connect on October 19, bringing you the inside scoop you’ve been looking for. An intense conversation may take place, but you're approaching it with confidence and incisiveness. Your ruling planet Venus makes a helpful connection with Saturn on October 20, and a helpful energy flows for making commitments. Romance also flows as Venus harmonizes with Neptune on October 21, and this is also a fantastic time for creativity at work. In your spiritual practice, this is a juicy time to cast a spell for abundance, wealth, and creativity in your daily life.

  • A deck of spells for whenever your witchy mood takes over!
  • Take advantage of Venus’s connection to Neptune and plan a cozy date night in. Here’s a recipe for a classic spaghetti carbonara that you can cook together.
  • If you live with roommates, a cute chalkboard can help you organize your chores and make sure everyone’s chipping in to keep your space clean.

Scorpio season begins on October 23! The focus shifts from yourself to your stuff as you take stock of your belongings and rethink your budget. Scorpio season often finds you having conversations about worth and value (maybe it's time to ask for a raise!). Your ruling planet Venus makes a helpful connection with power planet Pluto on October 25, helping you get important people on your side and encouraging you to make requests. Mars clashes with Saturn and a new moon in Scorpio arrives on October 27, finding you setting firm limits and perhaps also facing a limitation or obstacle. A fresh start arrives in your finances, and whatever limit you face will show you what you still have to learn. The sun opposes Uranus on October 28, bringing surprises on the financial front again. You're also itching for freedom at this moment! It's time to confront any situation in your life that's draining your wallet. This is also a powerful time to pay off a debt and be liberated from the burden of owing someone something.

Mercury meets Venus on October 30, creating a fun, flirtatious atmosphere before Mercury retrograde begins on October 31, finding you rethinking quite a few conversations you've had about cash this month. Watch out for miscommunications and delays, and hold off on making expensive purchases. Be especially mindful of where you leave you money or wallet, and do your best not to misplace your belongings. Uranus brings quite a few surprises this month, so despite the frustration that Mercury retrograde may bring, its retrograde may help smooth over some of the unexpected events Uranus stirs up this October. Good luck this month, Libra, and see you in November!



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Streaming Exclusives Could Double Piracy Rates, Study Warns

Another new study indicates that piracy could increase dramatically if streaming content is fragmented across too many streaming services at too high a price point.

Broadband Genie, a UK broadband comparison website, conducted a survey of 1,500 consumers and found that 18 percent of respondents admitted to “often” or “occasionally” accessing content via illegal streams or file sharing services like BitTorrent.

The survey found that number would jump to 37 percent if users are inundated with too many content exclusives spread across too many services. 67 percent of those surveyed felt they already pay too much for television content, and 48 percent said that price remained the biggest problem with having multiple streaming services.

To be clear, the rise of cheaper, more flexible streaming alternatives is a huge improvement over the high cost of traditional cable TV, which for decades forced consumers to pay an average of $107 per month for bloated bundles of channels they often didn’t even watch. Historically terrible customer service and endless rate hikes only made things worse.

But with every broadcaster in your cable lineup is expected to launch its own streaming platform by 2022, companies are now engaged in a mad rush to lock down exclusives to their own platforms. As a result, users are increasingly being forced to hunt and peck through a growing roster of services and ever-shifting licensing agreements to find the content they’re looking for.

A fan of Star Trek? You’ll need to pay $6 to $10 a month for CBS All Access. Want to watch Stranger Things? That’s $9 to $16 for Netflix. The Office? $15 to Comcast. Fleabag? Another $9 to Amazon, please. The Handmaid’s Tale? $6 to Hulu; $12 if you don’t want ads.

Superficially, such exclusives make sense for companies looking to drive subscriptions by luring users in with must have content. But the tactic has a downside. A Deloitte study recently noted that nearly half (47 percent) of US consumers already suffer from “subscription fatigue,” and 56 percent were frustrated by quickly changing licensing deals.

While users can subscribe to and cancel different services to get access to the content they’re looking for, there remains a real risk that users will simply migrate back to piracy should accessing this content become too confusing and expensive, says Ernesto van der Sar, whose website TorrentFreak tracks piracy and the streaming industry.

“If people have to spend more money to satisfy their movie and TV consumption needs, a large group will either consume less or look for alternatives,” van der Sar told Motherboard. “A likely result is that more people will pirate on the side. The surge in pirate streaming boxes and illegal IPTV subscriptions suggests that this demand is already there.”

There’s some early evidence suggesting that may already be happening. After years of declines thanks to legitimate streaming services like Netflix, BitTorrent traffic has seen a subtle uptick in recent years as streaming sector fragmentation has grown.

“To get access to all of these services, it gets very expensive for a consumer, so they subscribe to one or two and pirate the rest.” Cam Cullen, VP of Global Marketing for network company Sandvine, said in a blog post last year.

It’s an ironic twist for a sector that spent years struggling to learn that the antidote for piracy is better, cheaper, legitimate services. Data indicates that piracy often acts as a sort of invisible competitor, setting the bar for consumer expectations. Fail to meet those expectations, and piracy increases. Whether this is “fair” to the entertainment sector doesn’t enter into it.

“Now that availability is no longer a problem in many markets, affordability and convenience are most important,” van der Sar said. He noted that one solution could ultimately be providing multiple services bundled through a single interface that helps simplify subscriptions and help track content, but it’s likely too early to know what this might look like in practice.

As countless streaming competitors rush toward the booming new market locking down exclusives to dominate the space, they’re understandably not spending much time thinking about the possible ramifications of flooding the field with too many pricey options—but there’s a number of indications that they probably should be.



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MTV Awkwardly Ripped Off 'Hot Ones', and Host Sean Evans Noticed

On Monday morning, actor and director Kevin Smith tweeted a link to his latest YouTube video, which was "an unnecessary knockoff show we invented" after being curved by Hot Ones. Smith said that he and his longtime co-star Jason Mewes asked about appearing on the First We Feast series, but they were turned down.

But instead of getting salty about it, Smith and Mewes filmed their own version of the show called "Not Ones"—produced by "First We Least"—which opens with a literal wink to the camera and a thumbs up. "There's a show online where they have famous people on and they eat increasingly hot food, and they talk about whatever they're working on," Smith explains, before Mewes starts sampling the hot sauces that he's lined up in the center of the table.

The two are promoting the Jay & Silent Bob Reboot and their Reboot Roadshow, but mostly they spent ten-ish minutes repeating the "Hot Ones" setup. While Mewes sampled a couple of different hot sauces, Smith asked him a series of questions about his life and career. (Smith also got the sauces in the wrong order, which meant that Mewes' unsuspecting salivary glands were hit with 1.5 million Scoville units with pretty much zero warning).

Their lowkey tribute was fine —and it was 1.5 million times better than Tusk—and it was also the second time in a week that Hot Ones was remade by somebody else. A few days ago, MTV posted its own knockoff called "Wild Sauce," which was sponsored by Wendy's, and yeah, Hot Ones noticed.

"How come when weirdos like MTV jack Hot Ones they do it all the way down to the shitty budget set?" host Sean Evans tweeted. He's not wrong: MTV's setup involves the same simple set, with a black background, black tablecloth, and multiple servings of hot sauce, obvs. (The biggest difference is that on "Wild Sauce," Charlie Clips and Conceited had to drink the sauce, which gross.)

MTV was appropriately roasted in the video's comments. "Ima have to call Hot Ones," one person wrote. "Y’all really just stole the idea from hot ones and thought no one would notice," another added. When reached for comment, an MTV spokesperson just pointed VICE to an almost year-old "Wild Sauce" segment with a completely different setup, which is supposed to prove… something.

The newest episode of Hot Ones—the real Hot Onesfeatures Ashton Kutcher, who said that he "legit lost his hearing" trying to power through this season's sauce selection. Now that's a spicy talk show.



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David Letterman's Sex Scandal Still Feels Unresolved 10 Years Later

On October 1, 2009, David Letterman came back from a commercial break on The Late Show and asked his audience if he could tell them a story. A few weeks earlier, he explained, he'd gotten into his car early one morning and found a mysterious package sitting in the backseat. Inside the package was a letter.

"It says that, 'I know that you do some terrible, terrible things. And I can prove that you do these terrible things,'" Letterman said on the air. "And sure enough, contained in the package was stuff to prove that I do terrible things."

The audience chuckled uncomfortably. At first, he wouldn't say what those "terrible things" were. He carefully omitted them, chronicling what happened next while leaving that critical piece of information unexplained.

Letterman told the audience that he immediately called his lawyer. Whoever had left him the package wanted $2 million to keep quiet about what they knew. He and his lawyer contacted the Manhattan District Attorney's Office, which informed them that the threat constituted blackmail. The lawyer met with Letterman's extortionist a few times, including at least one rendezvous which, unbeknownst to the criminal, was secretly recorded. Ultimately, the man was given a phony check for $2 million. On the afternoon of October 1, a few hours before that day's Late Show taping, the blackmailer was arrested.

The audience laughed and applauded throughout Letterman's monologue, which he peppered with jokes, self-effacing asides, and descriptions of how "terrified" he was about the ordeal. The whole thing felt a little like a stand-up routine. About seven minutes into the segment—having sufficiently positioned himself as the victim—Letterman finally revealed what "terrible, terrible things" his blackmailer knew about him.

"The creepy stuff was," Letterman said, "that I have had sex with women who work for me on this show."

He paused. The studio was silent.

"Now, my response to that is: Yes, I have. Would it be embarrassing if it were made public? Perhaps it would. Perhaps it would," Letterman said. "Especially for the women."

The crowd erupted in laughter and applause.

That's about all Letterman said on the matter. He cut to commercial break moments later, and brought out Woody Harrelson when he came back.

Over the next few days, details of Letterman's affairs came to light in the press. He had apparently been sleeping with Stephanie Birkitt, a 34-year-old who had gone from being an intern on The Late Show to Letterman's personal assistant and had appeared in countless segments, including as a correspondent at the Olympics. The blackmailer, Joe Halderman, was her boyfriend. Another woman, Holly Hester, told TMZ she dated Letterman when she was an intern on the Late Show and a student at NYU.

Letterman was married when he confessed to having sex with women who worked for him. He still is, to Regina Lasko. The two met when she was a production staffer on Late Night with David Letterman; at the time they started dating, he was already in a relationship with Merrill Markoe, his former head writer.

The Monday after he made his confession, Letterman spoke about his infidelities on-air again, apologizing to his staff and his wife.

“She has been horribly hurt by my behavior, and when something happens like that, if you hurt a person and it’s your responsibility, you try to fix it," Letterman said. "And at that point, there’s only two things that can happen: Either you’re going to make some progress and get it fixed, or you’re going to fall short and perhaps not get it fixed. So let me tell you, folks—I got my work cut out for me.”

After that, he never brought the incident up on The Late Show again.

The response to Letterman's confession was, essentially, a big, collective shrug. On The View, Barbara Walters lauded him for coming clean and getting out in front of the story, called him "a very attractive man," and emphasized that he hadn't been accused of sexual harassment. “Where do you meet people? In the workplace," she said. "It isn’t sexual harassment."

Writing for the New York Times, Maureen Dowd dismissed the notion that Letterman's behavior constituted anything too untoward, explaining that "the women who got involved with Letterman were not pressured."

"Sexual harassment entails pressuring or penalizing a staffer or making the office atmosphere hostile," she wrote. "There’s no evidence yet that Letterman was guilty of that."

Letterman may not have ever pressured staffers into having sex with him. But that doesn't necessarily mean his behavior deserves the kind of sweeping, all-is-forgiven pass it received.

Birkitt's star rose quickly at The Late Show. After being promoted to his assistant, she became a regular on-air talent, making more than 250 appearances on camera. According to an article in New York Magazine, which cited staffers who worked on the show during Birkitt's tenure, her personal relationship with Letterman was, essentially, an open secret.

How might other female staffers, who weren't sleeping with Letterman, have felt seeing Birkitt's career take off so successfully? Letterman never explicitly dangled sex as a means for promotion at The Late Show, at least not that we know of. But that doesn't mean that—in showing special attention to an employee he had a sexual relationship with—Letterman didn't create an uncomfortable, toxic environment for other women who worked for him.

According to Nell Scovell, who wrote for Late Night in the 1990s, the host did just that. Writing for Vanity Fair in 2009, she said Letterman's trysts with female staffers—which, apparently, weren't limited to just Hester and Birkitt—made working for him uncomfortable. So uncomfortable, in fact, that she ultimately "walked away from her dream job."

"There’s a subset of sexual harassment called sexual favoritism that, according to the Equal Employment Opportunity Commission, can lead to a 'hostile work environment,' often 'creating an atmosphere that is demeaning to women,'" Scovell wrote. "And that pretty much sums up my experience at Late Night with David Letterman."

She continued:

Without naming names or digging up decades-old dirt, let’s address the pertinent questions. Did Dave hit on me? No. Did he pay me enough extra attention that it was noted by another writer? Yes. Was I aware of rumors that Dave was having sexual relationships with female staffers? Yes. Was I aware that other high-level male employees were having sexual relationships with female staffers? Yes. Did these female staffers have access to information and wield power disproportionate to their job titles? Yes. Did that create a hostile work environment? Yes. Did I believe these female staffers were benefiting professionally from their personal relationships? Yes. Did that make me feel demeaned? Completely. Did I say anything at the time? Sadly, no.

Despite the fact that Scovell's piece ran just weeks after Letterman's on-air admission, it never seemed to gain much traction. At the time, virtually the only entity to back her up—to agree that having sex with some staffers and then showing them preferential treatment in the workplace is wrong—was the National Organization for Women.

"As 'the boss,' [Letterman] is responsible for setting the tone for his entire workplace—and he did that with sex," NOW wrote in a statement. "In any work environment, this places all employees—including employees who happen to be women—in an awkward, confusing, and demoralizing situation."

Why wasn't that a bigger part of the conversation? How did so many commentators, from an immensely popular talk show host to a Pulitzer-winning New York Times columnist, fail to see the problem with a powerful boss sleeping with his subordinates, who—according to another employee—then enjoyed professional privileges? And why—ten years later, at a time when Letterman has a new, big-budget talk show on Netflix—have we still not reckoned with those questions?

Let's imagine if Letterman had made the same confession today. In the post-#MeToo era, we might have reacted differently. So many stories that have come out about sexual misconduct, in Hollywood and beyond, involve fostering a "toxic workplace" for employees. Perhaps we didn't have the tools, in 2009—the collective vocabulary—to identify why Letterman's behavior might have been harmful and demeaning to his employees. As Scovell tells it, that behavior was harmful; it was demeaning. Perhaps, in 2009, we just didn't think it was a big deal.

There's a disturbing trend, when it comes to sexual misconduct, whereby if a celebrity committed some impropriety long enough before the Harvey Weinstein revelations came to light, they seem to escape judgment—at least for a time. Years after Woody Allen was accused of molesting Dylan Farrow as a child, he continues to make movies with major studios and A-list stars. Even though we've known about the infamous footage of R. Kelly having sex with an underage girl since 2002, he wasn't widely condemned until recently. By no means can we compare what they've done to Letterman's affairs; but we could argue that Letterman benefits from the same circumstances. The era in which he admitted to sleeping with women who worked for him, allegedly creating a hostile workplace for his female staffers, happened long enough ago that we've all but forgotten about it. And, in the process, we've tacitly forgiven him.

This isn't to say that Letterman should be cast out of Hollywood, or that he deserves to lose his deal with Netflix. His affairs, while confusing and demoralizing for some of the women who worked under him, appeared to be entirely consensual. But in 2019, it just seems strange, and perhaps unfair, that we've never taken a full accounting of what went on behind the scenes at The Late Show—and, at least publicly, neither has he.

Letterman admitted that he had sex with his employees. He apologized to his wife. But he never apologized to women like Scovell. He never engaged with the idea that he might have made his show an unfair and difficult place for women to work, a place where—intentionally or not—he signaled that having sex with the bosses was a way to get ahead.

As Letterman himself said back in 2009, "if you hurt a person and it’s your responsibility, you try to fix it." Ten years later, it’s worth asking whether he ever really tried hard enough.

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Most Postal Trucks Don't Have Air Conditioning. That's Bad News for Birth Control.

In July, a mail carrier in Phoenix, Arizona, claimed to have cooked a steak to an internal temperature of 142 degrees Fahrenheit—medium rare—on the dashboard of his delivery vehicle, which doesn't have air conditioning.

While it's fine for your credit card bills and other mail to get that hot, when medications are exposed to temperatures outside the range specified by manufacturers, called “temperature excursions,” they could lose their potency. For birth control pills, this could increase the chances of unplanned pregnancies.

The FDA-approved labels for common birth control formulations like Yasmin, Ortho Tri-Cyclen Lo, and Sprintec say that the pills should be stored between 68 and 77 degrees Fahrenheit, with excursions permitted up to 86 degrees. The Arizona steak got more than 50 degrees hotter than that.

Nearly 9.6 million women in the U.S. used birth control pills in 2014, according to the Guttmacher Institute, a research organization that supports sexual and reproductive rights. People are increasingly getting those pills delivered by mail: Mail-order pharmacies represented 15.2 percent of the total outpatient drug market in 2013. Now, in the age of telemedicine apps that prescribe and ship contraception around the country—including for people without insurance—even more women likely receive birth control pills through mail today.

The figure could rise further as birth control gets harder to access for low-income people. Due to the Trump Administration’s recent changes to the Title X family planning program, some people who don't have insurance and used to pay nothing for birth control at clinics are now facing costs of $120 a month, while others who paid $30 are stuck with $200 bills. Telemedicine apps like Nurx, Pill Club, and Hers ship you birth control for less than these amounts without insurance. As birth control gets more expensive at clinics that used to rely on federal funding, these apps could gain even more customers.

Postal workers are most at risk

About 70 percent of U.S. Postal Service (USPS) vehicles did not have air conditioning as of 2017, according to a report by the Center for Public Integrity.

The consequences of delivery vehicles lacking AC can be tragic. In July 2018, California mail carrier Peggy Frank was found dead in her non-air-conditioned mail truck on a 117-degree day; the coroner said she died from overheating. Congressman Tony CĂ¡rdenas introduced a bill in Frank's name that would require all delivery vehicles leased or owned by the Postal Service to have AC.

The mail carrier who documented the sun-cooked steak sent photos and other information to Arizona state representative Shawnna Bolick. Bolick issued a letter to the president of the postal worker’s union, the Postmaster General, and others on July 31 condemning the inhumane working conditions for Postal Service employees—several in the area had to be taken to the emergency room for heat stroke and heat exhaustion in the weeks prior. The photos and the letter went viral.

Yet despite the publicity and efforts to make a change, little has shifted. None of the three postal workers VICE interviewed reported having AC in present or past vehicles; none of them wanted to use their names for fear of retribution. Two Postal Service workers in Arizona reported regularly observing temperatures above 125 degrees Fahrenheit in their vehicles. A postal worker in New Mexico provided an image of a thermometer reading 119.5 degrees in his truck from August 7.

How does heat affect birth control pills and other medications?

“The Postal Service does not have a separate method to process/deliver prescription medications, including prescription medications that require temperature-controlled environments,” said Kim Frum, senior public relations representative for the Postal Service. Two of the Postal Service workers interviewed said even the vehicles used for interstate shipping lacked air conditioning, at least in cargo areas.

Things can get even worse inside mailboxes. A 1996 FDA study found that, on a 101-degree day, mailboxes can heat to 136 degrees. And though exposure to extreme heat is more common in southern states, the increasing frequency of heat waves poses challenges everywhere. (Heat isn’t the only problem for medications either—ultraviolet radiation, extreme cold, and varying humidity can also impact mail-order prescriptions.)

Understanding how temperature swings impact birth control pills is important for determining the potential risk in getting medicine shipped. Despite this, there are only a small number of studies exploring the issue.

“Oral contraceptives are a great example where there's not really any data looking specifically at keeping these medications at a high temperature for extended periods of time,” said Steve Dudley, a clinical toxicologist and director of the Arizona Poison and Drug Information Center at the University of Arizona College of Pharmacy. “Those [medications] are mostly hormones, like estrogen and progestin, and we do know, like all proteins, they are sensitive to heat for a prolonged period of time.” However, Dudley did explain that some medications, though not birth control pills specifically, have been proven to maintain potency even after prolonged exposure to extreme heat.

If your medications appear melted or discolored, he recommended not taking them and contacting your provider or the local poison center. But he warned that medicines could be degraded without any apparent physical change.

“If it's something that was left in the truck for a couple of hours, is it possible for there to be some loss of potency? Sure,” Dudley said. “Is it enough to make a clinically significant difference, assuming it’s just that couple of hours? Probably not, but, again, the issue becomes if it's been in transit for a week or so, or if it's being stored at home in a hot environment, then absolutely that can cause a loss of potency and decrease efficacy. The results can be pretty dramatic, especially when you're talking about somebody who is trying to prevent conception.”

With perfect use—that is, taking every single pill on time—birth control pills are 99 percent effective at preventing pregnancy, but with typical use, that figure drops to 91 percent. Some of that 8 percent gap in effectiveness could conceivably be due to heat-related damage to the pills. But we can't know without the proper research, nor will we know if birth control is failing more often because of the increase in reliance on the mail.

"Whether it's oral contraceptives or any other type of medications, that is a growing concern that's out there that's present through the increased use of mail-order," said Stephen Eckel, an associate dean at the University of North Carolina Chapel Hill Eshelman School of Pharmacy. He suggested mail-order pharmacies should draw on the traditional pharmaceutical supply chain’s experience in controlling and monitoring temperature.


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It's not just the the Postal Service that lacks AC

The iconic brown delivery vehicles of UPS are also without air conditioning. FedEx spokesman Jonathan Lyons declined to comment on whether its fleet has air conditioning in cargo areas. Daniel McGrath, DHL’s head of corporate communications & responsibility team in the Americas, told VICE that 95 percent of DHL delivery vehicles have AC, however, he added that in some cases air conditioning is only available in the main cabin and not where the mail is held. He did not provide the number of such vehicles with air conditioning in cargo areas.

Other parts of the shipping process could also potentially expose medications to temperature excursions. Matthew O’Connor, senior manager of public relations at UPS, said that cargo areas in most of UPS Inc.’s approximately 20,000 tractor-trailers are not air conditioned, though the ones on its airplanes are. FedEx, which handles Postal Service air transportation, did not confirm whether its airplanes are climate controlled or not.

A variety of climate-controlled transport and packaging options are available through DHL, UPS Inc., and FedEx, though senders, not customers, select the shipping method.

Two companies and one nonprofit that ship birth control pills—Nurx, Hers, and Planned Parenthood—do not use the climate-controlled options, which are more costly. This appears to be standard for most other companies providing mail-order birth control pills. Nurx ships in plastic mailing bags while Planned Parenthood Direct and Hers ship in bubble mailers. Elizabeth Clark, Planned Parenthood’s director of health media, said on a press call that birth control pills can generally withstand up to 104 degrees, though she did not provide a source for this statistic and VICE could not confirm it with pharmaceutical experts. “If any patients have a situation where they have concerns about their shipment and about temperatures or extremely hot weather, then we encourage them to reach out to the Planned Parenthood Direct support via the app and have that conversation” about replacement pills, she added.

Dudley speculated that the 104-degree figure may have come from the U.S. Pharmacopeia National Formulary (USP-NF), which establishes the official standards for drug products recognized by the U.S. Food and Drug Administration. The USP-NF states that brief exposure to temperatures up to 40 degrees Celsius (104 Fahrenheit) may be tolerated, as long as a measure known as mean kinetic temperature—or the total thermal stress that a product experiences during storage and shipping—does not exceed 25 Celsius (77 Fahrenheit). But it doesn't say how brief is "brief," Dudley said. "The other issue is that if no one is monitoring the temperature at all times, so there is no way to know what the mean kinetic temperature is and if it's exceeded the threshold."

Eckel was concerned about the potential risks from birth control pills exposed to such temperatures. “Birth control pills have quite a few different ingredients associated with them,” Eckel said. “We need to better understand the impact of temperature fluctuations and shipping on medication.”

Healthcare companies are increasingly requiring that we get our meds by mail, AC or not

Eckel also mentioned the recent experience of Loretta Boesing, a Missouri woman who claims her son’s anti-rejection medicine following a liver transplant was compromised by heat while in transit. Boesing was not allowed to pick her medication up at her local pharmacy because of the policy of her Pharmacy Benefit Manager (PBM). “PBMs were originally put in to help manage costs within healthcare settings,” Eckel explained, with one of the strategies being to mail up to three months' worth of medication for a similar co-pay as you'd pay in person. But, he said, as the healthcare industry consolidates and drug stores partner with or own both a PBM and/or an insurance company, that vertical alignment to reduce costs also reduces patients’ choice. "If one wants to go and utilize their pharmacist, they may or may not be able to do that based upon the way their insurance requests out for medications," he said.

Eckel acknowledged how mail-order prescriptions expand healthcare access but lamented what could be missed. “To me, one of the biggest concerns with mail-order is a loss of interaction with a pharmacist,” he said. “You can walk into your pharmacy at any point in time and get your questions answered. Regardless of whether there's heat concerns or heat effects there, you lose the ability to have that individual that's caring for you.”

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Monday, September 30, 2019

The UK Insists: If You Give Birth You're a Mother, Even If You're a Man

A U.K. court ruled last week that Freddy McConnell must be legally registered as the mother of his child, despite being a man. Like the stories of other trans men who have given birth, McConnell having a child while in transition became a media spectacle against his will. McConnell has stopped giving interviews, and is planning to appeal the ruling.

McConnell began his battle with the U.K. government earlier this year, after the hospital in which he gave birth refused to identify him as his child’s father. McConnell requested a judicial review of the decision, making him the first trans man to seek to be named his child’s father through legal means. His case was reported on as a landmark for trans rights—if successful, his child would become the first person born with “no legal mother,” but, instead, two legal fathers.

McConnell’s identity was initially protected by an anonymity order, but as news broke of his private lawsuit, several tabloids insisted his story was of public interest, and so the subjects’ identity should be released for publication. McConnell warned “that he and his child could be victimised and bullied as a result,” but the court agreed with the tabloids, disregarded McConnell’s concerns, and outed him to the world.

Legal struggles to obtain basic rights for transgender people in the 21st century virtually all stem from individuals, social institutions, and governing bodies that fundamentally oppose the notion that trans men are men, trans women are women, and non-binary people are neither. Profound legal efforts are underway to ban trans people from restrooms, homeless shelters, and competitive sports—and all of these institutional attacks argue that biological sex supersedes the medical reality of transgender identity, discarding trans people’s right to free will and autonomy over their bodies and lives. To the U.K. government, McConnell is “female,” and therefore cannot legally be a father.

Odd, since McConnell is also legally identified as male in the U.K. As in the U.S., there is a standardized process by which trans people can alter their legal gender in transition. As reported by the Guardian, the media organization for which McConnell works, his court case marks “the first legal definition of a mother in English common law.” The State’s high court ruling says that “motherhood [is] about being pregnant and giving birth regardless of whether the person who does so was considered a man or a woman in law.” That is an outrageous opinion that both negates the State’s own existing legal recognition of McConnell’s male identity and terrifyingly imposes one judge’s arbitrary and irrational opinion about what constitutes parenthood on a citizen. The power of the government to make determinations like this have implications for anyone who doesn’t appear identical to this narrow imagining of what it means to have a child. If we take away a trans person’s parental rights, what about adoptive parents, or in vitro pregnancies?

The ruling is unjustifiable. There is simply no reason that a man should be legally classified as a mother by the State due to a perspective on the meaning of biological sex. Well, maybe there is a reason: contempt and fear for the potential loss of power that would be brought through a shifting of classical social norms. Such a shift would displace male dominance by disintegrating archaic ideas about what makes someone a man or a woman. Those ideas aren’t necessary to spell out—we all grew up within them.

In addition to revoking McConnell’s liberty, this case is abhorrent because it insists that there is an authority over you that lies somewhere within your body. Anti-transgender players, whether they’re activists or judges, are masters of magical thinking. Whatever you think about biological sex, there is no evidence to support the idea that the body has meaning apart from the meaning we apply to it. Human beings decided what sex means once; now we're ready to do it again.

By forcing McConnell to be identified as his child’s mother, the government continues to enforce a false belief of gender dependent upon sexist social structures that have long played a primary role in implementing violent and oppressive social structures such as male superiority. At its end, this act against McConnell is a defensive assault to maintain patriarchal power and the privileging of cisgender men at the expense of all others, at all costs.

How unsurprising. Of course the State does not want to declare that McConnell could possibly be a father. If that concession were made, then the government would have to admit that biological sex does not, in itself, mean anything—that instead, the will of the individual is the only credible source to turn to.

We should all be in protest at this breach of governmental authority. By setting this precedent, the high court judge who decided this man must be a mother did exactly what men have been doing to those they perceive to be women throughout history: putting them in their place.

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Tarantino's Next Big Project Is... a Book About a Guy Who Loves Movies

Quentin Tarantino may follow through with his plan to stop making movies after his Star Trek one or his horror movie one or Kill Bill 3, but that doesn't mean he'll stop making other things. The filmmaker will probably shift over to directing plays or extremely long movies that Netflix will awkwardly chop up and pretend are miniseries, or maybe, he'll just reinvent himself as a novelist—since the guy has already started on a book, apparently.

During a conversation with Martin Scorsese for the Directors Guild of America's DGA Quarterly fall issue, Tarantino revealed that he's hard at work on a novel—and it's about a WWII veteran who loves film, or something.

Per DGA Quarterly:

QT: Right now, I'm working on a book. And I've got this character who had been in World War II and he saw a lot of bloodshed there. And now he's back home, and it's like the '50s, and he doesn't respond to movies anymore. He finds them juvenile after everything that he's been through. As far as he's concerned, Hollywood movies are movies. And so then, all of a sudden, he starts hearing about these foreign movies by Kurosawa and Fellini…

MS: Yeah, yeah, yeah.

QT: And so he's like, "Well, maybe they might have something more than this phony Hollywood stuff."

MS: Right.

QT: So he finds himself drawn to these things and some of them he likes and some of them he doesn't like and some of them he doesn't understand, but he knows he's seeing something.

A novel that sounds like Mad Men if Don Draper really loved La Strada isn't exactly the kind of book you'd expect from Tarantino, but hopefully he's got his own version of a Louis L'Amour Western in the works somewhere, too. He doesn't give us much information about where in the writing process he is or when the book will be done, though from the way he talks about the premise, it sounds like it's still in very early stages.

Tarantino's screenplays have been increasingly filled with extended prose passages, and he spent five years developing Once Upon a Time in Hollywood as a book before it made the jump to the big screen, so it's probably just a matter of time before the age of Great American Novelist Tarantino is upon us. Apologies in advance to whatever editor has to try and pare those manuscripts down.

Give the entire conversation between Tarantino and Scorsese a read over at the DGA site.



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