Friday, February 19, 2010

KPIX Story on UC Study Airs Tonite;
Gay Artist Demands Apology


Be sure to tune in to the 5 pm and 6 pm broadcasts of the news on KPIX today. One of their most thorough reporters for local gay and AIDS stories, Joe Vazquez, will be reporting on the controversial UCLA study that alleges mini-epidemics of AIDS drug resistance in San Francisco.

The researchers, who created a math model that may be as accurate as a crystal ball, cannot be happy that more than a month after they first used sensationalistic language in a UCLA press office news release, so many people in public health in San Francisco are questioning the research.

I can't wait to see how the researchers respond to Vazquez's and his questions. Let's hope KPIX posts the TV story to their web site.

In related news, international political artist Clinton Fein, who's also a friend, sent a letter to UCLA researchers and their press officers yesterday, asking for an apology. Most unfortunately, UCLA remains committed to stonewalling and silence, and has not replied to Clinton. Here is the text of his letter:

Dear Mr.Tate, Mr. Rivero, Ms. Blower, Mr. Kahn & Mr. Okano et al:

I am writing to express my dismay at the lack of response to both my own and Michael Petrelis’ letters, sent on Friday 12, 2010, in which we expressed dissatisfaction with the questionable conclusions relating to the NNRTI study, the ill-considered, simple, flippant, and unprofessional quotes, and the total lack of regard to the tone of the conclusions and the inaccuracies they imply.

In an email response to Michael’s letter on February 12, 2010, Dale Triber Tate, Executive Director, UCLA Health Sciences Communications and Government Relations acknowledged Michael’s “serious issues” with the January 22, 2010 press release, but deflected accountability from Enrique Rivero whose name appeared on the official UCLA press release, and placed the accountability firmly in the hands of the researchers, who remained as stunningly silent as they were loud upon the issuance of the release and it’s publication in the journal Science.

Outlining their communications procedure, Mr. Tate stated the following: “A researcher calls our office to let us know that a study is being published in a journal and he/she would like a press release drafted. After receiving a copy of the study, the assigned public information officer – in this case Enrique Rivero – drafts a press release. The press release is then sent to all of the authors of the study, and if they are at multiple institutions, those as well. Each of those authors make his/her edits and additions. Once all of the authors have agreed on a final version, it is posted. The research is done by the researchers, and it is their right to characterize it, describe it as they see it. We only step in if we discover a factual mistake. There are times when we disagree with the tone or language provided by the scientist and we convey and explain those views. But the researcher is the ultimate arbiter of what is contained in the press release that is distributed.”

While I hate the thought of these one dimensional extrapolations from this not-news study gaining any more traction than deserved in this carnation, the damage has already been done. Dr. Grant Colfax, San Francisco's HIV prevention chief, told us at a recent community event (sponsored in part by UCSF, and as a result of the MRSA mess from two years ago), that HIV drug resistance is not a public health crisis, and that this model revealed nothing new.

The alarmist conclusion in the article that appeared in the journal Science, heralding this wave of self congratulatory press communications, “Consequently, currently circulating NNRTI-resistant strains in San Francisco pose a great and immediate threat to global public health,” is dangerous, misleading and designed to do little more than perpetuate the relevance of the researchers by demonizing the very subjects they relied upon to conduct their studies. Gay men.

The notion that this would have implications for treatment anywhere in the United States, let alone third world or developing countries is absurd at best, and has the potential to inject uncertainty into critical prevention methodologies and inspire hate legislation aimed at gays and people with HIV/AIDS like we are seeing in Uganda. It is dangerous, callous and inexcusable.

Despite a letter urging a dialog from Supervisor Bevan Dufty, and direct outreach by Michael Petrelis and myself, all we have received from UCLA is a cursory explanation of an antiquated and inadequate communications structure. While Mr. Tate acknowledges only stepping in when they discover a “factual mistake,” his explanation above directly implicates everyone. The researchers responsible for their quotes, and the tone of the press release, initially drafted by Mr. Rivero using loaded language such as “waves” and a “surge” of HIV drug resistant strains that "will emerge over the next five years in San Francisco due to transmission from untreated individuals." If Mr. Rivero wrote the original draft, and published the final one with his name on it, who then is accountable?

This is not how the narrative is shaped any longer. My original recommendation has now escalated into a demand.

UCLA needs to issue an apology and a retraction. Stat.

Your move UCLA. We’re all watching.

Sincerely,
Clinton Fein

Does the FBI Have a File on Harvey Milk?

When I saw the film "Milk" at the Castro Theatre in the fall of 2008, I wondered if the FBI had a file on Harvey Milk.

I was aware that the FBI, because someone had made Freedom of Information Act request, the FBI had released its voluminous files on the activities and members of the Gay Activists Alliance and the Gay Liberation Front.

Both groups were at their most active in the 1970s, just like Milk, and there's good reason to think the feds may have monitored the gay icon before his assassination, just as they kept tabs on other gay activists back then.

Since I can't locate any proof that anyone has asked if there's an file on him, today I sent a FOIA request to the FBI for any records on Harvey Milk.

I used the Get Grandpa's FBI File site to generate two letters. The first is to the field office in San Francisco, and the other is addressed to the FBI's central repository in Virginia. That letter-generating site is simple and free to use, for anyone looking for a file on any deceased person.

All I had to do was fill in the blank lines on the form about whose file I was requesting, provide basic info on the dead person, choose one option for proof of death (I picked enclosing a Wikipedia article), then click on the bright green arrow to print. It no more than ten minutes to follow all the steps, and print out the Milk Wiki page.

I've filed a few other FOIA requests over the years for other deceased notable and private individuals, and people often ask me how to make similar requests on the FBI. Like any good open government citizen activist, I want lots of my fellow Americans to do their part to bring additional sunshine to our federal government.

Click on over to Get Grandpas FBI File and make a request today. Let the sunshine in!

Thursday, February 18, 2010

UCLA: US PWA Drug Resistance:
'Quite High . . . Clinical Problems'

(Were they separated at birth?)

The Daily Bruin paper for UCLA ran a gushing article on February 10 about supposedly brilliant campus AIDS researchers and their fabulous findings. Half of it was all about Sally Blower, whose latest sky-is-falling HIV-related math model is the straw breaking the camel's back, after more than a decade of similar gloomy models.

Part of what's of interest here is her new claim that it's not just San Francisco people with AIDS suffering drug resistance, the problem is now nationwide:

“Because the level of drug resistance is really quite high (in the U.S.), it’s causing lots of clinical problems,” Blower said. “It’s harder and more expensive to treat people.”

Um, if it's not too much trouble for Blower and the Bruin, could we all see the independently verified research and stats on the supposed clinical problems, and exactly how it's become harder and costlier to treat us PWAs?

I'm not aware of anyone else in the scientific and public health communities, or indeed anyone in the AIDS Inc and PWA communities, backing up Blower's national claims.

The Bruin stenographer omitted any voices challenging Blower, and as of the date the article ran, Dr. Grant Colfax of SF DPH had made disparaging remarks about the study and its potential impact to the Chronicle and BAR. If only the stenographer had used Google to locate a front-line, public health doctor to give an opposing view.

In keeping with the apocalyptic nature of Blower's standard operating methods, the Bruin had this say about the alleged lethality of the new resistant strains of the virus:

Though it may be too late to save the U.S. from these drug-resistant strains of HIV, Blower said the new findings can be applied to places where HIV treatment is beginning.

Oh, my gosh. America is doomed! It's too late to repent, ye sinners! If only we had listened to Blower, maybe the nation could have been spared.

The problem we're really seeing with this multi-pronged crisis for UCLA is what we saw quite a bit over the past two decades with that campus and other UC campuses, particularly UCSF. Patterns are well-established and run by themselves, impervious to the communities and real people affected by the researchers.

In 2008, we saw UCSF's gays and staph infection study, with the sensationalistic aid of the campus media office, crank up the "fags in Frisco are still fcuking and spreading diseases" machine. Scary headlines soon followed. Weeks into the controversy, UCSF's school paper, the Synapse, ran a stenographic article that ignored existing criticism of the study.

Two years later, not having faced the justifiable wrath of the San Francisco gay community, UCLA naively tried to pull off that scenario, and they've run into trouble. Unfortunately, unlike the smarter folks at UCSF who recognized the larges mistakes made, honestly came forward to deal with the gay health crisis disturbing the local community.

Even with sustained and very vocal criticism from SF DPH, people with AIDS, gay advocates, a politician, our local gay newspaper, and another study challenging UCLA's prediction, the Blower and colleagues steadfastly maintain their silence.

Silence is not an acceptable component to gay male and PWA wellness.

BAR: 'Science' Must Retract UCLA
PWA Drug-Resistance Study?


Permit me to add things up for UCLA researcher and mathematician Sally Blower (above), whose latest doomsday math model related to people with AIDS continues to generate controversy.

1) Dr. Grant Colfax, head of SF DPH's HIV prevention programs has criticized Blower's model in three very public ways. He's been quoted in the SF Chronicle and on the Bay Area Reporter blog expressing strong reservations, and he appeared at a town hall meeting on gay health last week to make more of the gay community aware of his concerns.

2) A Canadian study involving thousands of actual living PWAs, carried out over more than a decade, contradicts Blower's research and found "drastic declines" in drug resistance, and was reported by Liz Highleyman of the HIVandHepatitis site earlier this month.

3) SF Supervisor Bevan Dufty yesterday sent letter to Blower requesting a frank discussion with her about the study, UCLA sensationalistic press release and the impact both are having on the local community.

4) POZ magazine's web site, in the "Web Watch" section, links to Dufty letter, making more PWAs aware of the Blower study and the controversy surrounding it.

5) This blog has publicly held Blower to account, here and here, while also communicating to her and the UCLA press department that they need to address the various concerns coming from many quarters.

On top of all that, the BAR today editorializes on the Blower study, showing that the controversy is not going away and indeed is growing. From the BAR:

Now, the prestigious journal Science has published a paper by researchers at UCSF and UCLA, including James Kahn and Sally Blower, that predicts a "wave" of HIV drug resistant strains "will emerge over the next five years in San Francisco due to transmission from untreated individuals." [...]

It was not a study examining the actual levels of drug resistant HIV and rates of its transmission in San Francisco. Other studies that have been done looked at actual levels of transmission of drug resistant strains of HIV and found rates declining, not rising. [...]

Once again, gay men in San Francisco are being stigmatized using code words.

Thank you, Cynthia Laird, BAR editor, for pointing out this reality, which doesn't seem to intrude upon Blower's thinking. The BAR also says:

If the Blower and Kahn paper is correct, why aren't we seeing any real-time red flag problems in treating people? We're not seeing that here in San Francisco, or Los Angeles, or New York City, or in any city where these medications have been prescribed widely for at least 10 years and where there has been ample opportunity to transmit resistant virus and then face the problems associated with treating patients infected with the resistant virus. [...]

If Blower were not locked up her UCLA ivory tower, she might deign to address the concerns above, and all the other questions being raised from San Francisco. Finally, the BAR wants several steps taken to undo the damage from Blower and her math model:

Science should re-review the paper and consider retracting it. The authors at UCSF and UCLA should apologize for this shoddy research that can inflame homophobia andAIDSphobia.

If Blower could put aside her ego, recognize the mistakes she's made, acknowledge the anger of San Francisco health leaders, apologize for those mistakes, and finally begin a constructive dialogue, we could move on from the controversy.

What will it take for Blower to leave her ivory tower and engage in communication with us?

Wednesday, February 17, 2010


HRC Reveals Road Map to . . . Drag Bingo!

Oh, the absurdities of the American gays and their leading political advocacy org, the Human Rights Campaign. They just keep piling up. Consider the following absurd schedule of HRC events at the grassroots level, the last weekend of the month.

Yes, Joe Solmonese made the following boast in August 2009, "I also have a very clear road map and a plan" to achieve repealing Don't Ask/Don't Tell and passing the Employment Non Discrimination Act, and hasn't shown the community his road map, but the HRC money-making machine marches on.

The 2010 edition of HRC's Carolinas Gala is one damn party-filled weekend, with nary a political action to be seen on the schedule. This gala is another in a decades-long string of examples of the real HRC agenda: Keep the money flowing. Genuine political organizing, that is effective and achieves federal results, is at the bottom of HRC's gay agenda.

Among the events scheduled over the weekend is this fun-filled activity. Please note that a map is linked to:
Friday, February 26: 7-9 p.m. Drag Bingo (HRC Style)
It’s just a silly game. It’s outrageous. It’s funny. It’s DRAG BINGO! And this weekend, it’s coming to Raleigh. Featuring the always hilarious Mary K-mart and John Paul Womble, this is a can’t miss event. Tickets are $17.
For ticket information please visit www.dragbingo.com.
Raleigh Convention Center
Room 302
500 S. Salisbury Street - view map
Doors open at 7p.m., show starts at 8p.m.

The HRC is probably beyond any hope of achieving actual benefits at the federal level for gay people in this country, when, at this point in our movement, it is easier to find so many galas on their site, and comparable political mobilizations just aren't happening with HRC's membership.

I don't know how anyone can look at the HRC Carolinas Gala page and then come out and make the argument that this is a serious org pulling out all the stops to repeal DA/DT.

As if the drag bingo and gala weekend are not enough absurdity, HRC is peddling Solmonese has a "special guest." At his org's own gala, the director is a special invitee?


Here's his bio sketch:

President of the HRC since 2005, Solmonese has created successful initiatives to advance our vision for equality in both legislative and corporate arenas.

Where is the HRC road map to gay equality?
SF Supe Dufty: Talks Needed With UCLA
AIDS Drug-Resistance Modeler


In early 2008, when a UCSF study on gay men and drug-resistant staph infections in San Francisco, along with a sensationalistic press release from the UCSF media office, touched a firestorm of controversy and concern, communication with the study's authors was demanded.

To their credit, study co-author Dr. Chip Chambers and LGBT health liaison at UCSF Shane Snowden, along with several people in the public affairs offices of the university, were quite available for public dialogues. The UCSF researchers and others were at town hall meetings, or talking on the phone with concerned activists, or trading emails about the mess created by the 2008 study for gays and people with AIDS.

I say with all honesty that the UCSF folks recognized mistakes had been made, that the communities directed affected, and stigmatized, by the study and press release needed full engagement, and they delivered on promised of open dialogue.

This example of researchers and university press people addressing the deep concerns raised by their work should be emulated by Sally Blower, her research colleagues and the UCLA press officers who all had a hand in creating a troubling study on potential AIDS drug resistance among SF PWAs. Click here and also here for background.

To help bring about a much-needed transparent dialogue with Blower, Bevan Dufty, the Board of Supervisors' member from the Castro district, and his staff sent a letter to her, requesting communication. I applaud Bevan for taking the initiative to get some talks going between the PWA community here, and the folks at UCLA.

Blower should realize, like the UCSF researchers did in 2008, that the San Francisco gay and PWA communities are totally fed up with alarmist studies, and efforts to generate sensationalistic media coverage. We cannot tolerate the dumping of studies and releases on the affected communities, and no communication or accountability from the UCLA researchers.

Now is a good time for Blower to comprehend the negative reactions to her latest doomsday math model, and to respectfully engage with the communities that are the subject of her modeling.

Here is the text of Bevan's great letter:

February 17, 2010

Dr. Sally Blower
Disease Modeling Group
10940 Wilshire Blvd Suite 1450
Los Angeles, CA 90024

Dear Dr. Blower:

I am writing to you today in hopes of opening a dialogue between you and your colleagues and members of the San Francisco LGBT and HIV/AIDS communities.

As you are aware, a press release, “Study predicts HIV drug resistance will surge,” released by UCLA on January 22, 2010, has garnered a great deal of attention from San Franciscans living with HIV/AIDS.

Members of the gay community and the head of the San Francisco Department of Public Health’s HIV prevention programs have expressed dismay to me about your press release.

In San Francisco we have taken the approach of promoting wellness and including in the planning and delivery of HIV prevention and care all members of the communities impacted by HIV. These partnerships based on solid evidence; open, clear communication and shared responsibility have been effective. We in this city and our colleagues and partners in many other cities and states have abandoned strategies which were designed to alarm or frighten community members into specific behaviors.

We approach HIV prevention and care from a health promotion platform. These strategies work to reduce and eliminate stigma and discrimination. I am certain your work is designed to reduce new infections and care for those living with HIV.

I hope you will join us in using strategies which promote health rather than risk increasing fear and stigma. I welcome the opportunity to hear about your work and your approach to that work.

I am hopeful that you will consider joining a dialogue with the San Francisco LGBT and HIV/AIDS communities about these issues. I am happy to begin the discussion via phone or emails, if that makes it easier.

Please don’t hesitate to contact me or my office so that we may be able to begin a dialogue that I hope leads to a better understanding and a level of sensitivity to these issues. I look forward to engaging in a constructive conversation that allows you to better understand the issues of San Franciscans living with HIV/AIDS, while also explaining your study and its potential consequences.

I am available to set up a meeting as soon as possible and ask that you call my office (415-xxx-xxxx) or my cell (415-xxx-xxxx), so that we can begin a dialogue about these critical issues.

Sincerely,
BEVAN DUFTY

Tuesday, February 16, 2010


Jamaican Hate Singer's
USA Tour Canceled!


Capleton, the homo-hating singer from Jamaica who suffered two cancellations in CA thanks to gay activists in Humboldt and San Luis Obispo, has canceled his tour. Says so at the Renegade Productions web site, which was the presenter of his West Coast tour. Here's the short announcement:

THE CAPLETON/COCOA TEA TOUR HAS BEEN CANCELLED.

Many thanks to the activists and groups who made this cancellation possible: Humboldt Against Hate, the Gay and Lesbian Alliance of the Central Coast, and Peter Tatchell in London. Job well done, my fellow activists!

HRC's Solmonese Gave
How Much Money to Coakley?


One of the worst Democratic candidates in recently memory to run for a U.S. Senate seat is, of course, Martha Coakley of Massachusetts. She ran a classic "take the voters and their concerns for granted" campaign, and lost the race to the GOP's Scott Brown.

I was convinced Coakley received a donation from Joe Solmonese, head of the Human Rights Campaign, because he is such a lapdog of both the Democratic Party in the Bay State and the Democratic National Committee.

However, in searching for donations from "Joe Solmonese" at NewsMeat, which shows that he gave $10,350 to Democrats and their affiliates, and a search for "Joseph Solmonese" reveals $20,250 donated to the Democrats, for a total of $30,600 from HRC's executive director, but nothing turned up regarding a donation from him to Coakley.

Thinking that Solmonese's FEC files might not be current at the NewsMeat site, I checked the CQ MoneyLine site for "Human Rights Campaign" for the 2009/2010 election cycle, and sure enough, there was a listing for a $500 donation from "Joseph Solomonese."

Yes, the Coakley campaign's filing with the FEC misspelled his name, just one more mistake from that losing campaign effort. Sure enough, back at NewsMeat, the $500 contribution from HRC's leader is posted under the incorrect spelling.

If Solmonese and HRC were an effective, productive, transparent and accountable org for the gay community, with some genuine accomplishments that directly benefit the vast numbers of our community who need federal protections in employment, housing, healthcare, military service, etc, I wouldn't give a damn about Solmonese's lapdog status for the Democrats.

But Solmonese and other HRC leaders have no urgency or public plan of action to pressure the White House and Congress on our behalf, either this spring or before the year is out.

As Chris Crain notes at his blog today, an activist effort organized by gay bloggers targeting HRC to receive phone calls and emails from gay people, is happening today, pushing HRC to better represent and aggressively lobby for our community in Washington. We need all the pressure possible from gays to force HRC to deliver on its promises of being our supposed top-notch org in the capitol.

HRC itself has not responded yet to the activist pressure, and as reported over at Queerty this morning, a member of the org's board of directors is dismissing the pressure on his blog.

Sure, it's great to see an organized campaign targeting HRC for better leadership, but I fear with DNC operative Solmonese at the helm, nothing much is going to change. I hope I am proved wrong.

Monday, February 15, 2010

Milk's Castro Camera Store May
Finally Get the Plaque It Deserves


(The current guppy-sized plaque for Harvey Milk on Castro Street. Photo credit: MPetrelis.)

When I moved back to San Francisco in February of 1985, I had lived here in the late 1970s, my friend Brett Thomas and I were walking around the Castro highly medicated.

At the front of what had been gay icon Harvey Milk's camera store, and de facto community center, I asked a simple question: "Where the plaque to commemorate the historical significance of Harvey's shop?"

Brett broke laughing when he heard my words. "We're standing on it," he said.

Damn, with all the size queens in this town, I would have thought Harvey would have easily merited a large historical sign at the camera shop. But whatever the process was that created the pitifully small bronze marker in the sidewalk that hardly anyone notices, it didn't get the job done.

That should soon well change, and I've done my part to complain (like one should ever think I can't complain!), about the injustice of the current puny plaque.

The Bay Area Reporter's blog on Friday ran a piece by Matthew Bajko, detailing plans on the part of the Castro's gay Supervisor. From the BAR:

Last July local gay blogger Michael Petrelis did a walking tour of the Castro and photographed various LGBT historical markers in the city’s gayborhood. Among his collection that he posted to his blog was the the bronze marker the city placed in front of the building where slain gay rights leader Supervisor Harvey Milk had his camera shop and campaign headquarters on Castro Street.

The plaque (seen in above photo) is “almost-impossible to read,” wrote Petrelis. “One has to really be looking to notice it.”

That could soon change if out Supervisor Bevan Dufty, who holds the seat Milk once served in at City Hall, achieves his goal of laying in the ground a far larger – and more noticeable to passersby – historical marker this spring.

As part of the city’s celebrations of the state’s first official Harvey Milk Day on May 22 – timed to coincide with Milk’s birthday – Dufty would like to unveil a new sidewalk plaque in front of the store at 575 Castro Street, now home to gift shop Given.

“Since the film so many people come looking for Harvey’s camera store. The current sidewalk plaque is the size of a piece of paper,” said Dufty [...] “A lot of people miss it. I thought what a great opportunity to make the plaque more visible and to use the plaque to draw attention to the mural on the second floor.” [...]

And here is my photo of the mural of Harvey that beautifies the street from its perch above the entrance to the store:


Let's hope we are all standing around the old Milk camera store on Castro Street this May for the unveiling of a new, bigger plaque in the sidewalk.
BC Study Belies UCLA's 'Chicken Little'
HIV Drug-Resistance Model


Thanks to the reporting by longtime science and medical reporter Liz Highleyman, writing at the HIVandHepatitis site recently, I've been made aware of a study from Canada that seriously contradicts the latest alarmist math model created by Sally Blower of UCLA. Highleyman reports:

SUMMARY: Is HIV drug resistance becoming more common? Two recent studies suggest opposite answers. A mathematical model by University of California at Los Angeles (UCLA) researchers found that resistant HIV strains are common in San Francisco, and 60% of them could potentially cause self-sustaining epidemics. [...] And a study looking at actual trends in drug resistance among participants in the British Columbia Drug Treatment Program found that the incidence of new resistance fell more than 12-fold between 1997 and 2008.

It's complicated, but in a nutshell the stigmatizing UCLA math model created by Blower is at serious odds with the reality-based findings from Canada.

According the British Columbia study published in the Clinical Infectious Diseases journal in early January, the researchers methods involved thousands of persons with AIDS on drug cocktails, over a period of more than a decade:

Longitudinal plasma viral load and genotypic resistance data were obtained from patients receiving antiretroviral therapy from the British Columbia Drug Treatment Program from July 1996 through December 2008. A total of 24,652 resistance tests were available from 5422 individuals. The incidence of successful plasma viral load suppression and of resistance to each of 3 antiretroviral categories [...] was calculated for the population receiving therapy.

So what were the reality-based results uncovered by the Canadians, and what conclusions did they draw? Quite surprising, really, emphases mine:

There has been a drastic decrease in the incidence of new cases of HIV‐1 drug resistance in individuals followed during 1996–2008. [...] Our results suggest an increasing effectiveness of highly active antiretroviral therapy at the populational level.

Now does that sound like the sky is falling to you? It sure doesn't to me. And bear in mind that the area where the study was conducted, British Columbia, includes the city of Vancouver.

That city, unlike San Francisco, has bathhouses and even with such gay sex establishments, it doesn't appear as though the Vancouver baths led to the drug-resistance Sally 'Chicken Little' Blower was so sure would happen here, if the baths reopened.

IMHO, the study from Canada calls into serious question the math models developed by Blower, her continual and cavalier stigmatizing words heaped upon PWAs in San Francisco. We must also ask if her models have any bearing on treating PWAs.

Blower and her colleagues at UCLA owe the entire PWA community here, along with officials at SF DPH and front-line physicians caring for us, an open discussion about her research and how it may have absolutely no bearing on the real live and concerns of individuals living with AIDS.

For too many years, Blower has dumped her models on the PWA community, resisted calls for communication, and the media departments at the University of California have dismissed serious criticism with pass-the-buck one-sentence replies. She should no longer be allowed to present her models without comprehensive scrutiny and better engagement with the PWAs she stigmatizes.