The International Woman

Tags

Baird, birth control, Eisenstadt, Griswold, inspire change, international women's day, margaret sanger, olympics, sarah burke, Sochi, supreme court, women

Although we at the Margaret Sanger Papers Project like to believe that women are important every day of the year, it is on March 8^th that it is socially acceptable to tell this to the world with multiple exclamation points!!!  And so, we wish to say to you, in underlined, bold, capital letters, HAPPY INTERNATIONAL WOMEN’S DAY!!!

Each International Women’s Day is different.  I like to believe that it is because each of us has grown in our own special way since last March 8^th, but more literally it is because every International Women’s Day has its own theme declared by the United Nations.  While each one is empowering, the themes give women and men alike a time to reflect on ways in which to make the world around them a better place.  2012 urged Empowerment to Rural Women and ending poverty and hunger, while 2013 called for an end to violence against women.  2014’s theme, however, is especially close to our hearts in that the United Nations urges us this year to Inspire Change.

At the 2009 Winter X Games, Burke of Whistler, British Columbia, poses with her gold medal after winning the women’s skiing superpipe at Buttermilk Mountain in Aspen, Colo.

While a slightly general topic, inspiring change means something different to everyone with a dream.  Remembering the Sochi Winter Olympics, Sarah Burke comes to mind as a woman who devoted her whole life to change.  She successfully lobbied the International Olympic Committee into adding the ski halfpipe event for men and women to the 2014 winter games schedule.  Though she passed away due to an accidental fall during a practice, Burke, a four-time Winter X Games gold medalist, was considered a shoe-in for a medal at Sochi.  Although gone from our physical lives, Burke will always be remembered in her dedication to advocating her passion.

There is no question that Margaret Sanger also had that passionate devotion for her cause of inspiring change.  Sanger risked enormous fines, substantial time in jail, and the separation from her family for extensive periods of time for the chance to give women the information she knew they needed and deserved.  The amount ground Sanger covered is tremendous enough – not only did she travel throughout the United States and Canada, but she also traversed Europe and Asia to reach the most remote pockets of people she could find.  And those people responded to her with open arms and an outpouring of gratitude.

Sanger prepares to speak in front of the Senate, 1934

But Sanger would be nothing if only a world traveler.  Not only did she speak around the world, but she challenged the American government’s laws that blocked her path in the first place.  Sanger testified often before Senate committees about changing the Comstock Law, section 211 of the U.S. Penal Code, which made it so difficult for women to obtain even the smallest amount of information about contraceptives.  After a so many failed efforts to win legislative change, Sanger and her team turned to the United States Court of Appeals, Second Circuit for a judicial victory.  In U.S. v. One Package Containing 120, more or less, Rubber Pessaries to Prevent Conception (U.S. v. One Package), Sanger and Hannah Stone, one of her clinic physicians, orchestrated a package delivery of a box of pessaries, another word for diaphragms, to be sent from Japan to Hannah Stone.  Sanger and Stone informed the U.S. government about the delivery, and because at this time not even physicians were allowed to receive contraception by mail a lawsuit was created.  Through years of battles, the suit traveled all the way to the Supreme Court, where Sanger and Stone won the right for physicians to receive contraception information and devices through the mail.  Although the Supreme Court decision was not made until 1965 in Griswold v. Connecticut to grant the right to privacy to married couples and their contraceptive uses, Sanger was able to see her dream realized before her death a year later.

Sanger’s influence stayed with women long after her death.  In Eisenstadt v. Baird (1972) the Supreme Court ruled 6-1 that laws limiting contraceptive use to married couples was discriminatory, and that all people should have equal access to birth control.  From Justice Brennan’s majority ruling: “If the right of privacy means anything, it is the right of the individual, married or single, to be free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.”

This International Women’s Day challenges you to do something that inspires change.  Whether it is a small change, like drinking water rather than soda to improve health, or a bigger change, like lobbying for a new Olympic sport or a change in the federal law, each change in the direction of improvement is a change worth working toward.

For more information see:

http://www.internationalwomensday.com/default.asp#.UxDFz-NdXfU

http://sarahburkefoundation.com/

http://www.nyu.edu/projects/sanger/

What does Helen Gurley Brown’s Legacy have to do with Margaret Sanger?

Tags

Cosmo, Cosmopolitan, Helen Gurley Brown, Sex and the Single Girl, What Every Girl Should Know

Helen Gurley Brown’s Sex and the Single Girl, a landmark work that catered to the single woman of the early 1960s.

Helen Gurley Brown’s recent death prompted both fans and critics alike to debate her legacy and impact on women’s rights. Was she a feminist? An anti-feminist? Whether she helped or hindered the feminist cause can be debated, but Brown never questioned her ideals. “How could any woman not be a feminist?” she once asked aloud in an interview with Cosmo in 1985. Making a woman feel “comfortable to be themselves” was Brown’s primary goal, and one she considered to be quite feminist in itself.

Though Brown is best known as the editor-in-chief of Cosmopolitan Magazine, it was her first book, Sex and the Single Girl that brought her to the public eye and secured her position at Cosmo. The book was a celebration of a single life in which women enjoyed as much sexual freedom as men did. So, what does Sex and the Single Girl have to do with Margaret Sanger? In short, quite a lot.

Though Brown did not feature birth control in the book, she did refer to it as a “safe” and “reliable” option for women who decided to engage in sexual intercourse. Without birth control, there would be no Sex and the Single Girl, and Sex and the Single Mother, some may argue, doesn’t have quite as provocative a vibe!

Sanger and Brown had much in common. Both women experienced hardships in their early lives that propelled them to fight for what they separately defined as women’s rights. Born in Green Forest, Arkansas, an outpost of the Ozarks, to a “hillbilly” family, Brown remembered her difficult upbringing as she searched for an alternate road; one unlike that of which her parents had experienced. Offering women a different view, and celebrating a lifestyle that didn’t conform to the societal norms for women at the time, was what drove her career.

Similarly, events of Sanger’s childhood served as the impetus behind much of her resolve. The painful memories of her mother’s childbearing experiences and her premature death at age 52 left Sanger–one of eleven children– passionately focused on women’s reproductive rights. Both women wanted better than the choices their mothers had, not just for themselves, but for all women. As a result, they dedicated their life’s work to ensuring that women would have broader options.

Helen Gurley Brown’s landmark work Sex and the Single Girl was published in 1962 on the brink of the Sexual Revolution. Featuring the terms “sex” and “single girl,” the title alone was enough to incite collective gasps amongst traditionalists emerging from the sexually suffocating 1950s, a decade dedicated to celebrating the ins-and-outs of housewifery. Sex and the Single Girl offered a new path, one for women who failed to fit into the happily married mold. And although much of the advice had a “how to please your man” feel, the nature of Brown’s advice was always to encourage what she believed to be the advancement of women, whether it was economically, sexually, or personally (though the bits about striving to be an office sex symbol make that sometimes difficult to understand).

Though controversial, Sex and the Single Girl did not break any obscenity laws as Sanger’s early works did. What Every Girl Should Know, Sanger’s breakthrough newspaper column, published in the socialist The Call, and later in 1921 in a compiled format, was the first work to challenge the status quo and enlighten young women regarding their physical and emotional maturity. Sanger’s main focus was on providing young women with factual information about sex and reproduction so that they could make informed decisions about their reproductive lives.

What Every Girl Should Know was considered so controversial that the Post Office banned one of the columns since it dealt with venereal diseases. Because the words “gonorrhea” and “syphilis” were included in the article, they violated the Comstock Law of 1873, which outlawed lewd, lascivious, indecent, and obscene publications. Instead of the column, its readers turned to the The Call one Sunday morning, to see the article masthead — “What Every Girl Should Know” and then the words: “NOTHING by order of the Post Office.”

Image from the New York Call, printed in response to a temporary suppression of Sanger’s What Every Girl Should Know by the US Postal Authorities.

This was Sanger’s first brush with the Comstock Act, which we battled in one form or another until 1937 when its bans on birth control were eased. She continued publishing What Every Girl Should Know in pamphlet form, also republishing an earlier column on sex education, What Every Mother Should Know, the Woman Rebel and Family Limitation.

Sanger’s work predated Brown’s, and their messages were very different. But without Sanger’s pioneering efforts, and her indefatigable work to make contraception acceptable, safe and effective, Sex and the Single Girl would not have been possible. As Sanger wrote in 1916:

In former days the women and girls were kept within the close confines of the home. Innocence was their charm, and ignorance was a virtue. There was no need that the girl should know anything of her body, of the marriage state, or of motherhood, until she was given over by her parents into the hands of her husband for instruction and care.

Today, however, this is no longer sufficient. The girl of today begins her life at 14 years to leave the home and the cloistered care of her parents to enter into the world’s work. Never before has she worked so closely at the side of her brother, and never before has she had greater need for knowledge of her self, her physiology, her emotions and desires–in fact, a need to know herself throughout. Education is her only and principal weapon for her defense against downfall.

Thousands of young girls are being caught in the meshes of modern life because of their ignorance of themselves. Ignorance of a girl’s body is one of the strongest forces that sends her into unclean living: and all the curfew bells, the legislation and the suppression in the world will only strengthen this force instead of lessening it.

From the fourteenth to the twenty-third year every girl passes through a budding period called the adolescent period. She finds herself suddenly changed from a little girl with her hair down her back, whose interests have been dolls and toys, into a different being, with new sensations, new dreams, new awakenings–all of which she does not understand. (Sanger, “Tell Girls Things they Should Know,” 1916.)

The successful single life that Brown initially described in her work could only be achieved with the help of birth control– a message that Cosmo‘s readers were quick to grasp by the the early 1970s. Cosmo itself was a little slower to embrace birth control and regularly discuss its uses within the magazine’s pages, but it was the only leading women’s publication to do so.

Many of Brown’s statements and actions are considered controversial by today’s standards. Some today have branded her a “stiletto feminist,” and hold her responsible for the indoctrination of sex and beauty idolatry that many women hold themselves accountable for attaining. Others see her as a bold woman who fought for women’s sexual and personal freedom at a time when others were hesitant to do so– even despite the questionable direction Cosmo took later on in terms of advancing the feminist cause.

As history debates the legacy Brown will leave behind, it will be important to remember that while she was successful, powerful, and able to be in control of her life’s work, she was also in a position in which she had the freedom of choice and expression to be controversial and groundbreaking largely because of the heroic actions of many leading women who paved the way for her to be so.

__________________________

Click here for Sanger’s “What Every Girl Should Know series.

Sanger and Mike Wallace

Tags

current-events, margaret sanger papers

To commemorate the death last week of hard-hitting journalist Mike Wallace, I would like to recall his controversial 1957 interview with a frail 78-year old Margaret Sanger, as described in the Margaret Sanger Papers Project Newsletter, # 38, Winter 2004/5, in an article by our associate editor, Peter C. Engelman. The 39 year-old Wallace invited Sanger to appear on his ABC program, Mike Wallace Interview on June 3, 1957, but she was reluctant to be interviewed because she had heard “things” about the program. She finally agreed to appear, when Wallace cancelled the program, bowing to the demand of his sponsor, Philip Morris, which was being pressured by the Catholic Church. Angered by these threats and Wallace’s response, Sanger reacted by tentatively scheduling an interview with a Wallace’s old show Night Beat. Wallace responded by quickly signing Sanger to a contract for the interview.

“Good evening,” Wallace began his live program at 10pm on Saturday night, September 21, 1957, opposite the formidable Western program,Gunsmoke, “what you’re about to witness is an unrehearsed, uncensored interview on the issue of Birth Control. It will be a free discussion of an adult topic, the topic that we feel merits public examination. My name is Mike Wallace, the cigarette is Philip Morris.” On a bare, darkened set with cigarette smoke curling, sat Wallace under one spotlight, as he introduced Margaret Sanger, sitting opposite under another spotlight, as as a crusader who opened the first birth control clinic, went to jail eight times, suffered long separations from her children, a break-up of her first marriage, and “constant harrowing social abuse” for her allegiance to the cause of birth control.

Sanger looked all of her 78 years, the poor lighting and smoky haze accentuating her withered appearance. Weakened by heart problems over the past decade and a host of other ailments, Sanger also seemed uncomfortable, fidgety, unsure where to look at times. But the interview started off well. She handled Wallace’s first question, about the origins of her crusade, with relative ease. “I saw women,,” she told him, “who asked to have some means whereby they wouldn’t have to have another pregnancy too early, after the last child, the last abortion, which many of them had. Certainly there are numerous things […] that really made you feel that you had to do something.” She cited her mother’s premature death after bearing eleven children as a motivating force.

Wallace, sounding at times more like an interrogator than an interviewer, suggested that maybe Sanger was “driven emotionally toward the birth control movement because of antagonism toward the church” stemming from her troubled upbringing with a Catholic mother and atheist father.

She responded: “No I don’t think I had anything of the kind in mind–I was–I was what I would call a born humanitarian. I don’t like to see people suffer, I don’t like to see cruelty even to this day and in nursing you see a great deal of cruelty and unnecessary suffering. At that time, there was no opposition as far as the church was concerned, any church. It was mainly the law, Federal Laws and State Laws, that one had to–to think of. The church was not in my mind at all.”

On the issue of population control, however, Sanger seemed to have trouble hearing Wallace’s questions and began stumbling over her words, beginning a thought but not having a clear sense of where she was taking it. When Wallace turned again to the Catholic Church, Sanger regained some of her old vigor. Wallace asked her to comment on the official position of the Catholic Church on birth control-–that any contraception is used “unethically and unnaturally” since “the immediate purpose and primary end of marriage is the begetting of children.”

SANGER: “It’s very wrong, it’s not normal-–it’s-–it has a wrong attitude towards marriage, toward love, toward the normal relationships between men and women.”

WALLACE: “Well the natural law they say is that first of all the primary function of sex in marriage is to beget children. You don’t disagree with that?”

SANGER: “I disagree with that a hundred percent.”

When Wallace asked Sanger what she thought the Church’s motive was in forbidding birth control, Sanger refused to give an answer.

WALLACE: “Have you heard it said, that the reason that the Church is against birth control is because they want more Catholics?”

SANGER: “I’ve read it.”

WALLACE: “Do you believe it?”

SANGER: “Yes. If you read their papers at Boston, that that’s what had happened in Boston in Massachusetts. They had simply outbred the Protestants and they–they-–in Boston in Massachusetts they had control. I read that in their own papers.”

The interview then began to disintegrate as Sanger grew flustered over Wallace’s successful reduction of the topic to a personal debate between Sanger and the Church. She now looked for traps and unfounded accusations, and sounded defensive and unsure of herself. She had prepared some index cards with possible answers to some of his questions, but never referred to them.

Wallace presented the argument that birth control encouraged promiscuity, quoting from a magazine article that claimed it “tends to weaken the moral fibre of the community. Immunity from parenthood encourages promiscuity, particularly when unmarried persons can so easily avail themselves of the devices. Do you doubt that?”

SANGER: “I doubt it.”

When Wallace asked her what her feeling on the issue was, Sanger replied, “My feeling is that love and attraction between men and women, in many cases is the very finest relationship; it has nothing to do with bearing a child, it’s secondary many, many times and we know that–you see your birth rates and you can talk to people who have very happy marriages and they’re not having babies every year. Yes, I think that’s a celibate attitude […] It’s an unnatural attitude to take–how do they know? I mean after all, they’re celibates. They don’t love, they don’t know marriage, they know nothing about bringing up children nor any of the marriage problems of life, and yet they speak to people as if they were God.”

Wallace then returned to Sanger’s views on the Catholic church, and she again became frustrated and flustered. He then asked her about her own views of divinity and sin.

SANGER: “I think the greatest sin in the world is bringing children into the world–-that have disease from their parents that have no chance in the world to be a human being practically. Delinquents, prisoners, all such a thing just marked when they’re born. That to me is the greatest sin–that people can–can commit.”

But when Wallace asked her if she believed infidelity was a sin, Sanger, even more flustered, answered, “Well, I’m not going to specify what I think is a sin. I stated what I think is the worst sin.”

Wallace then asked Sanger about ways to reduce the divorce rate. When she began to discuss marriage counseling services at birth control clinics, he interrupted Her.

WALLACE: “May I–-may I ask you this could it be that women in the United States have become too independent–that they followed the lead of women like Margaret Sanger by neglecting family life for a career?” He was referring to the independent life she maintained during her second marriage to J. Noah Slee.

Sanger claimed she had enjoyed a happy marriage, though she did not discuss birth control as a tool for balancing family life and career. When Wallace implied , that in her own life she chose work over family, Sanger was shocked and could only muster a grandmotherly smile as she showed the camera snapshots of her grandchildren. She then obediently plugged the sponsor with an awkward endorsement of Phillip Morris cigarette. smoking.

In the days and weeks after the interview, Sanger’s friends and supporters uniformly attacked Wallace and his interview technique, but Sanger knew she had missed a rare opportunity to promote birth control to a wide audience. She wrote her niece, “I had a good time at those moments of his confusion! He was, of course, speaking for the R. C.’s as instructed. It was sad I did not get in anything about world wide Birth Control work.” To a friend, she noted that though Wallace “got a few replies that knocked him pale in the face. I had a good time, even though the time was wasted as far as Birth Control was concerned. The questions he asked were old stuff to me. I’d almost forgotten how I used to answer them.” (MS to Olive Byrne Richard and to Ellen Watumull, Oct. 9, 1957 Margaret Sanger Papers Microfilm Edition: Smith College Collections (MSM), Reel 52, frames 540, 950.)

In December 1957, after Wallace sent Sanger an engraved cigarette box as a Christmas gift, she replied, “It is certainly a good reminder of a most amusing evening. . . . I have had so many letters, phone calls, and personal talks about the Mike Wallace interview. Some of my admirers hope to get a chance to ‘kill’ you one day, because you caused them to spend their valuable time listening to ‘crazy’ questions about the Roman Catholic religion and not a word about the world-wide spread of birth control practice and education. I have a letter from a listener who writes she is convinced that ‘Mike Wallace is a Roman Catholic.’ So it goes.” (MS to Wallace, Dec. 19, 1957 [MSM S53:121].)

If Sanger had been younger and in better health, she would no doubt have been less flustered by Wallace’s questions, and not thrown off by his interview style. But given her age and condition, perhaps this was an early example of so-called “gothcha” journalism. More likely it was Mike Wallace being Mike Wallace. When asked about the interview in 2004, Wallace called Sanger a “genuine pioneer,” and did not recall her being flustered or nervous, but rather “sure of her ground.” It is perhaps more a testimony to Sanger’s own history and reputation that he thought her tough enough to take on!

Pink Ribbons Don’t Hold Together When It Comes to Women’s Health

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Komen Foundation, planned parenthood, women's health

Over the past few days, we have witnessed another passionate struggle in the battle that has been fought since at least 1916: the politicization of women health. In October 1916, Margaret Sanger was arrested in for opening her Brownsville birth control clinic in Brooklyn, New York. Nearly a century later, Sanger’s organization Planned Parenthood is at the epicenter of the continued struggle for women’s control over their own bodies. The controversy around the relationship between Planned Parenthood and the Susan G.Komen Foundation For the Cure unfolds on websites rather than street corners, but the stakes are the same. While we have come a long way from Brownsville, women’s rights to their bodies are still under threat.

On January 31, the Komen Foundation, the world’s leading breast-cancer advocacy group,  announced a decision to cut its funding to Planned Parenthood, an organization founded by Sanger that offers family planning services to over five million women and men worldwide. The funding from the  Komen Foundation (about $600,000 annually) permitted Planned Parenthood to offer free breast cancer screenings to its patients. The decision to stop funding Planned Parenthood ostensibly came in the wake of a new policy change that prohibited the Foundation from donating money to any organization under investigation by the Federal Government. It does not take much research, however, to see that these new policies were an excuse to de-legitimize and cut ties with Planned Parenthood. The federal investigation into Planned Parenthood was opened by anti-choice congressmen into the Federation’s abortion policies only and has not led to any charges. The new president of the Komen Foundation, Karen Handel, who oversaw the policy changes, has a legacy of anti-choice and anti-Planned Parenthood crusading.  More evidence that the policy changes were intended to specifically target Planned Parenthood? The prohibition has not stopped the Komen Foundation from funding $7.5 million worth of cancer research at Penn State, an institution which is currently the subject of a federal investigation regarding the former assistant coach Jerry Sandusky, who is indicted on multiple accounts of child sex abuse.

Women’s health has always been at the center of Margaret Sanger’s vision. In a public radio address in 1937, Sanger reiterated birth control’s importance to mothers’ health :

“Out of every three women who die from causes related to childbearing, two could have been saved. Too frequent and too many pregnancies are responsible for a large number of these preventable deaths. And abortion, that tragic substitute for reliable birth control, is the cause of 25 per cent of maternal deaths.”

As Sanger’s organization expanded, so did their services to women’s health. From the 1920s, when the first birth control clinics opened their doors, doctors at Planned Parenthood were often the first to detect ovarian and cervical cancer in female patients. Today cancer screenings, including breast exams, have become an essential part of Planned Parenthood : in 2010 the organization was able to offer 750,000 breast exams, many of which were made possible by the Komen Foundation. By refusing to continue to fund these exams, the Foundation bowed to the interests of anti-abortion advocates who criticized its relationship with Planned Parenthood. In doing so, Komen has compromised on its commitment to women’s health services. This affront especially affects low-income and uninsured women for whom Planned Parenthood is one of the only options for affordable women’s health services. The war against Planned Parenthood is, at its heart, a war against poor women’s bodies. Elite women like the Foundation’s president Karen Handel and founder Nancy Brinker will always have access private doctors for their women’s health needs. Much of Planned Parenthood’s clientele, however, does not have that same level of privilege.

The Komen Foundation’s announcement has provoked unprecedented public outrage.  Politicians, bloggers, and media outlets have denounced the politicization of women’s health. Donations to Planned Parenthood flooded in: the organization has received more than one million dollars in the past few days from supporters eager to see women’s health services continue. The Komen Foundation has also reported a 100% increase in donations in the past few days. But just a few hours ago, responding to public pressure, the Komen Foundation declared that it reversed the controversial decision to de-fund Planned Parenthood. Hopefully the temporary break in ties between these two organizations was just a lapse in judgement on the part of Komen’s leaders. Sanger’s commitment to accessible women’s health care prevails, for now. But the controversy has reminded us anew the importance of being vigilant in protecting the rights that Sanger and her successors dedicated their lives to securing.

The “Tech” of Safer Sex and Reproductive Technology

Tags

birth control methods, Saturday Night Live

This video has been making the rounds since the weekend. It depicts an advertisement for “Lil Poundcake,” whose hair smells like frosting and who comes with accessories like a cell phone and earrings that her human friends can wear too. She is also equipped to administer the three shots over a six-month period that make up the HPV vaccine.

Shockingly (or perhaps not, if you speak satire/happened to watch Saturday Night Live this week), Lil Poundcake is a parody, designed to poke fun at the “HPV wars” that have been taking place during the Republican campaign for the Presidential nomination. It’s a humorous way of drawing attention to the hysteria surrounding the HPV vaccine and proposals (or legislation, where such legislation exists) to make it mandatory for all students – sometimes just female students, sometimes female and male – of a certain age.

One of the more striking things about the video is just how much it highlights the fact that when it comes to safer sex and reproductive health technologies, the delivery methods may have advanced (lower doses of pills than in my mother’s generation, condoms that “feel as though you aren’t using one,” silicone rings administering the same synthetic hormones in birth control pills) but the basic building blocks are the same. Even though there are advances being made (the much buzzed-about “male birth control” comes to mind), when it comes to contraception there are precious few options to choose from – and I recognize that I, living comfortably and legally in a medium-sized city, in a country with accessible health care provided by the provincial government, am coming from a place of serious privilege. If Margaret Sanger were to walk through a sexual health centre, she would most likely recognize most of the devices and methods on display as current – rather than former – birth control methods.

Over at RH Reality Check, Kirsten Moore has a great post up about the differences in technological advancement between smartphones and contraceptives, arguing that if consumer demand for advancement in one mirrored that of the other, the safer sex and contraceptive product market would look quite different:

The opportunities for innovation in products and services are as varied as the women and men who need them. There is no one silver bullet (or pill, or condom) when it comes to contraception: each woman is different and has unique and changing life circumstances. As consumers, we need to talk about what we like, what we don’t like, and what we wish we had when it comes to birth control.

Keeping safer sex and reproductive health technologies out of the public discourse – except to demonize and discredit them – does nobody any favors.

Sanger worked throughout her entire life to improve the accessibility and caliber of birth control in the United States and globally, using methods as diverse as government lobbying for increased research efforts and, when necessary, smuggling. Why, then, should we assume that what we have is “good enough,” and stop asking for something better?

Without open discourse about what works, what doesn’t, and who likes to use what (and for which reasons), there is no room for innovation. There is no question that for many, many people, the barriers to accessing what is actually available are financial, physical, and social. It is, however, possible to improve access to what does exist without forgetting to keep an eye on what might be coming over the horizon.