Lynn Harris

In 2000, Dr. Matt Wise launched the Web site Getthepill.com — which provides prescriptions for emergency contraception — as a short-term end run around the obstacles women face who are trying to get the drug. “We thought emergency contraception would be over-the-counter literally within months,” he says. He assumed, therefore, that demand for the site’s services would be short-lived. Five years later, however, Dr. Wise, 35, a practicing gynecologist by day, still may not be quitting his night job anytime soon.

“I would happily walk away from this project — I mean, I’m hanging on by a thread here,” says Wise, who hasn’t taken an e-mail- and cellphone-free vacation since launching the site. “I’ve had state medical boards not happy with me, I’ve had pharmacists read me the riot act about how what I’m prescribing is wrong,” he says. “The only thing keeping me in here is realizing that we’re really making a difference — at this point we’ve helped thousands of women. And it’s part of a much bigger battle to get this stuff over-the-counter. We’re not going to go anywhere until this medicine is widely available for patients.”

Emergency contraception has been prescribed fairly commonly to women at risk of unintended pregnancy at least since the mid- to late 1990s. The medication typically consists of two pills, each containing a high dose of a hormone found in birth control pills, to be taken in sequence starting within 72 hours of unprotected sex. Not to be confused with mifepristone (the “abortion pill” formerly known as RU-486), E.C. is designed to avert pregnancy by preventing fertilization or implantation. It will not terminate an existing pregnancy.

Given that the drug’s contraindications are few and that, when it’s needed, time is of the essence, a prescription for emergency contraception does not require a face-to-face doctor’s visit. In fact, the medical establishment and a majority of doctors take the position that the drug should require no prescription at all; it is already available over-the-counter in seven states, with Massachusetts soon to follow.

Despite the fact that E.C. is known to prevent, rather than induce, abortion, political opposition to emergency contraception remains powerful. The FDA’s Aug. 26 postponement has been decried by many — including two FDA experts who resigned in protest — as “political.” According to congressional staffers who saw an early draft of a Government Accountability Office report in response to the FDA’s initial delay in May 2004, it suggests that the decision was actually made months before it was announced and involved an unusual number of top-level officials. The implication is that the process was guided more by internal machinations than by medical realities.

Back in 2000, when Wise was a medical resident at the University of North Carolina Hospital in Chapel Hill, one of his jobs was to answer the phone. “I was surprised by the number of calls from women with questions about emergency contraception,” he says. “Since we were receiving that many phone calls in our small community from women with no doctor or insurance or who had encountered some sort of ‘moral objection’ to emergency contraception from doctors and pharmacists, I just thought, ‘Gosh, on a nationwide basis there’s got to be an enormous need.’”

Wise was inspired to try to help meet that need by one of his mentors, contraceptive expert Dr. David Grimes. Grimes, he says, had always told him, “Hey, if there’s something out there you can do to help women that is morally and medically appropriate, you ought to be doing it.”

Hence the Web site. Wise launched Getthepill.com with the help of his brother — conveniently, a Web designer — who created the site’s architecture and its system for maintaining medical records. Three other people — all family or close friends — help answer phones and do other clerical work. The $24.95 prescription fee (separate from a pharmacy’s price for the medicine) covers their salaries and all other operating costs; Wise derives his income only from his in-person gynecology practice. “When we started the site I had zero money — I was in debt from med school! So we wouldn’t have put this operation together if we couldn’t have done it in a way that was very efficient,” says Wise, who has actually declined offers of cash donations.

Getthepill.com logs 30 to 50 prescription requests or inquiries per day, most from women who have found the site via a search engine or a public health Web site; some college health services also recommend the site for use on weekends, when they’re closed. Women seeking a prescription are asked to fill out a questionnaire designed, in part, to confirm that they are at risk of pregnancy — but not already pregnant. (Plan B will not harm an existing pregnancy, says Wise, but it is a waste of time for a pregnant patient to use the drug.) “If patients get confused about when their last period was, I’ll get on the phone with them and pull out my calendar and we’ll try to do the best math we can to figure it out,” says Wise. When a patient’s need is confirmed, a prescription is called or sent in to the pharmacy of her choice. If a pharmacy or pharmacist turns out to be hostile to dispensing emergency contraception — which happens once every other day or so, Wise says — his staff goes back through their extensive database, which lists pharmacies across the country that they have used successfully, until they find a friendlier one.

While Wise has gone through the cumbersome process of getting licensed to practice medicine in about 20 states — far more than your average M.D. — 26 remain in which he cannot write prescriptions. (The numbers don’t add up to 50 because of the states with OTC status and those with more flexible laws about prescriptions.) He has also decided that Getthepill.com will provide prescriptions only to patients 18 and older, even though many argue — counter to the FDA’s stated concerns — that teenagers need easy access to E.C. as much, if not more, than adults do. “From a moral standpoint, I have no problem at all prescribing to younger patients,” he says, noting that he does so — along with plenty of counseling — in his own practice. “But I realize that what we’re doing already places us under increased scrutiny from medical boards, citizens and so forth, and we want to be cautious. So we made a difficult decision — one not based on law, but just to make sure that we are able to continue the services that we provide — that we’re going to provide medical consults and prescribe EC only for legal adults.” For minors and those in the 26 off-the-list states, Wise or his staff will at least try to guide them to a Planned Parenthood or other available resource.

Squeezing online clients in between and after his work commitments, Wise also takes follow-up calls or e-mails, talking patients through pregnancy scares or bouts of nausea (one of the drug’s few side effects). “If I ever have a patient who comes back a second time needing emergency contraception, she always gets a phone call from me,” he adds. “I’m not trying to make her feel guilty, obviously; I’m trying to make sure she does all she can to sort of replan her sexual activities so that she doesn’t find herself in that situation again.”

Wise makes himself available for such calls 24/362. The site is “closed” on Christmas and Thanksgiving, and from about 3 p.m. New Year’s Eve to 3 p.m. New Year’s Day — but only because that’s when pharmacies are closed. In the five years since the site’s launched, he’s taken one vacation — sort of. “I had to get a hotel room right in the Grand Canyon, go out for a couple hours for a hike, come back up to check my e-mail, cellphone and pager,” he says.

Who are all the women keeping him so busy? Why aren’t they calling their own doctors? “First of all, it’s actually surprising how many actually don’t have a women’s healthcare provider at all,” says Wise. Some have changed jobs or insurance; some just don’t have one. Other women simply find themselves unable to contact their provider (or college health service) over a weekend or holiday. Still others feel much more comfortable talking to Dr. Internet than to Dr. Disapproval. Remarkably, says Wise, there are doctors out there who still confuse emergency contraception with mifepristone, and refuse to dispense it. Then there are those, he says, who “give their patients an enormous guilt trip before prescribing the medication.”

Wise cites one recent patient, a nurse at a small hospital who knew every doctor in town and felt uncomfortable approaching them “for fear she’d be judged in some way,” he says — for having unprotected sex, for having sex at all, for dodging the “consequences” when she does. “This is clearly a woman who has a provider, who has major access, who has good health insurance — but because of the stigma that’s out there, she chose to get the medication through us.”

Dr. Joe DeCook is one doctor who does not prescribe emergency contraception, and who hopes Wise is careful when he does. “If he’s going to give people this medication, he better give them informed consent, because [E.C.] doesn’t hardly work,” says DeCook, who is vice president of the American Association of Pro-Life Obstetricians and Gynecologists. DeCook cites several studies that appear to call the effectiveness of E.C. into question, and bemoans what he sees as a dearth of information on side effects on women and on pregnancies undetected before E.C. is taken. “It probably does prevent some pregnancies some of the time, but women are fertile for only about 36 hours a month,” so it’s unclear, he says, when the pill is actually doing its job — and what it’s doing to women’s bodies when it’s not.

Of course, given that emergency contraception (also often used: Lo/Ovral) is on the market in the first place, the FDA has already deemed it safe and effective. By and large, studies that question the drug’s effectiveness find fault not with its medical properties but with the way the drug is presented and described to women — and, indeed, with the stigmas that prevent them from asking for it when they need it.

Some physicians unfamiliar with Getthepill.com declined to comment on the Web site directly. But by reiterating the organization’s support of over-the-counter status for Plan B, a spokesperson for the American College of Obstetricians and Gynecologists implied that if the drug should be available with no prescription at all, then a prescription from an online doctor would be more than sufficient.

Dr. Beth Jordan is willing to go further. “The fact that this site exists tells you something about the great need for it,” says Jordan, medical director of the pro-abortion rights Association of Reproductive Health Professionals. “Any mechanism that makes emergency contraception more available is a good thing, so that women have timely access to a very time-sensitive reproductive technology.” Jordan’s only concern? “What about women who don’t have the computer technology? We need over-the-counter access for them.”

Having been the Web site’s only doctor for five years, Wise is now considering the possibility of incorporating others who can prescribe in states where he’s not licensed; doctors in Idaho and Kentucky have already offered their help. Expansion of the site’s services in this way would reflect Dr. Wise’s own transformation as its founder. “When I started this project I was doing it as a doctor. I viewed it as a huge unmet need, and I found a creative way to solve that problem,” he says. “But as time has gone on and I’ve realized the politics involved in getting Plan B over-the-counter, frankly, I’ve become more of an activist.”

Thankfully, Carrillo was eventually cured: of both her cancer and her self-blame. She ultimately divorced her husband, found support online and learned, as she says, that she has “nothing to be ashamed about.” But even with its happy ending, her story reveals a troubling reality: While STIs have reached pandemic proportions, the stigma surrounding them remains ugly — perhaps especially for women.

“You cannot get through a season of ‘Jersey Shore’ or ‘The Real World’ without an STI ‘joke’ implying that the person accused of having one is skanky and slutty, and saying ‘Ooh, watch out, you might catch something,’” says Adina Nack, Ph.D., a medical sociologist specializing in sexual health and author of “Damaged Goods? Women Living with Incurable Sexually Transmitted Diseases.” “And that person they’re talking about is almost always a woman. There’s a serious misconception that you have to be ‘promiscuous’ in order to contract an STI, and while men in our culture are rewarded for being sexually active, women are judged.” (Nack cites one woman in her practice who’d never even had sex, but who contracted an STI while — successfully — fighting off a rapist. Even she said, “I feel like a slut.”)

To be sure, STIs and their attendant stigmas are (as I’ve written before) no picnic for men, either. But their impact appears to be different, in certain ways, for women. Among the hundreds of people with STIs Nack has interviewed, she says, men tend to be more concerned about medical realities — the best treatment, the best protection for partners — while women focus on much broader, and harsher, implications that strike at the very core of their sexual selves: “Will I be rejected as ‘damaged goods’?” “Are my dreams for sex, love and happiness over?”

All that when, ironically, STIs are now so strikingly common that, as Nack says, “you should go out into the dating world assuming that the person you’re with has already contracted something, even though they may not know it. Even if someone says, ‘I’m ‘clean’ — I’ve been tested for everything,’ they’re either ignorant or lying, because we don’t even have definitive tests for everything.” (STIs are often asymptomatic and frequently go undiagnosed.) The CDC estimates that nearly 19 million new infections occur each year. At least half of the sexually active population will contract HPV at some point; 45 percent of women 20-24 have it already. It’s so prevalent, in fact, that the medical community considers HPV infection a virtual “marker” for having had sex at all. One in 5 adults, whether they know it or not, has herpes right now. In other words, statistically, your date is more likely to carry a sexually transmitted infection than to share your astrological sign.

Though many STIs are easily and effectively treatable, those who have them still live with threats: of painful outbreaks, other medical complications and (in the case of certain HPV strains) cervical cancer; of straight-up slut-shaming and outright rejection. Given how common STIs are — and despite efforts by, for example, writers at Jezebel to chip away at the stigma by indirectly or directly outing themselves — it’s pretty amazing how much dated stereotype and outright ignorance remains (which in turn can deter people from getting tested). People that both Nack and I interviewed tell tales of women with herpes who, when actually outed, were told by officemates to use separate work equipment, and by family members to use separate toilets.

And if people you’re probably not going to sleep with react badly, imagine having to tell someone you like-like. For single women (and of course men) with STIs, the fizzy fun of a promising new date is often flattened, they say, by fear of the looming, dreaded Talk. Michele Bouffidis, 43, of New Jersey, contracted herpes — her “rowdy tenant,” she calls it, though she experiences only rare outbreaks — from an old long-term boyfriend who didn’t tell her he had it until it was too late. Over the next five years, she dared disclose to three men; none stuck around. One, at least, took the time to consider, eventually telling her — gently and thoughtfully — that he didn’t want to take the risk. She totally understood, she says, but it still smarted. Another said, “You seem like a very classy girl — I would never have imagined you having that.” (Translation: “You slut.”) By the time No. 3 rolled around, Bouffidis was dispirited enough that she presented her diagnosis in a negative, “You’re not going to want to deal with this,” light, almost deliberately pushing him away. For three years, she didn’t date at all. “It was because I have herpes,” she confirms. “I didn’t want to deal with ‘The Talk’ any more.”

Kalani Tom, 40, of New York, usually uses e-mail to inform potential partners about her genital herpes (which she controls successfully with medication) to give them a chance to process the information on their own. Sometimes, it goes fine. “One guy said, ‘It’s gonna take a lot more than that to scare me off,’” she recalls. But the more she likes a guy, the scarier it is — and once, when the stakes were high, she choked. “He asked me if I had anything, and I said ‘no,’ ” she admits. “I was a coward. I didn’t want to be judged.” When she finally told him the truth, he was devastated — not just by her diagnosis, but by her dishonesty. (Fortunately, he tested negative.) Another recent prospect just bailed, too, upon hearing the news. But Tom — though quite contrite about her lie — remains hopeful, even defiant. “People may judge, but I know I’m not some repulsive horrible person,” she says.

Plenty of “seropositive” men and women — Nack herself included (and Michele, above) – are in happy, healthy relationships with STI-free partners willing to take on the medical logistics of avoiding transmission. “Not all potential partners are going to reject you,” she says. And many women and men with STIs have found support, community, friends (and more than friends) in online communities specifically for them. There’s an interesting, and ongoing, debate about whether dating sites for people with STIs are godsends or ghettos, but experts say they are — at least — great places for the newly diagnosed to get their groove back.

Kristin Andrews, 30, of Michigan, contracted herpes from an unfaithful boyfriend who, when he heard her diagnosis, called her “a slut and a whore and complained that now it’s gonna be hard for him to date,” she recalls. “For that first few weeks it was awful. I felt like I was one of the worst people in the world, disgusting and degraded and gross.” Then she found MPwH.net (short for Meet People with Herpes), where she got her “newbie” questions answered straightforwardly and reassuringly. Eventually, she arrived at the distinction that our society clearly — and dangerously — still refuses to accept. “I have herpes,” she says. “But it’s not who I am.”

If there’s been any elephant in any room, it’s been on MTV, since the launch of the network’s smash-success pair of reality series about teen pregnancy and motherhood. “For two seasons of ’16 and Pregnant’ and two seasons of ‘Teen Mom,’ we have never seen any pregnant teen seriously consider abortion,” media critic Jennifer L. Pozner, author of “Reality Bites Back,” has observed. While 27 percent of pregnant teens choose abortion, Pozner notes, “in MTV’s version of ‘reality,’ 100 percent of pregnant teens give birth.”

Late last night, that changed. MTV aired a 30-plus-minute interview special called “No Easy Decision,” in which three young women — including Markai Durham, who was featured last month on “16 and Pregnant” carrying her first pregnancy to term — spoke candidly about their decisions, as teenagers, to have abortions. Though MTV had not planned to promote the show, which appeared at the way-past-prime-time hour of 11:30 p.m., a leak by EW.com last week did just that — and had everyone prepared for the worst. Circling the wagons against nasty backlash, nonpartisan post-abortion support talkline Exhale, who partnered with MTV on the show, had already planned an online campaign called “16 and Loved” to act as sort of virtual clinic escorts for the young women outing themselves. Abortion-rights opponents smelled pro-choice conspiracy; abortion-rights supporters feared that the network — and especially “Dr. Drew” Pinsky — would tackle the subject with all the nuance and sensitivity of a Snooki Polizzi sucker punch.

But this member of the latter camp is relieved, delighted — and still amazed — to report that MTV got it right. Seriously, they nailed it. And by “nailed it,” I don’t mean they just did a great PSA for abortion. I mean they told the many-sided truth: that abortion is safe and common, that abortion has been made difficult to get, and, most importantly, that abortion is a complex decision made by complex human beings. (That thump you heard around 11:35 p.m. EST was the sound of 100 feminist media critics falling off our collective couches.)

Here’s Dr. Drew opening the show — and racking up stunned “FTW!”s (For The Win!) on Twitter right out of the gate: “About 750,000 girls in the U.S. get pregnant every year. And although nearly a third of these teen pregnancies result in abortion, we’ve never shown this choice on ’16 and Pregnant’ up until now. It can be a polarizing topic, and there’s quite frankly no way to talk about this and please everyone. Although controversial to some, abortion is one of the three viable options, and it’s among the safest, most common medical procedures in the U.S., so we thought it was important for us to discuss.”

In a wrenching produced segment, we then meet Markai and her partner, James, as they wrestle with their options for her unplanned second pregnancy, the result of a missed appointment for her shot of Depo-Provera. As a mother, Markai is tormented both by the prospect of terminating a pregnancy (or relinquishing a baby) and by the prospect of raising a child whose needs will splinter their already slim resources. Referring to her daughter, Zakaria — and reflecting the fact that 61 percent of women who have abortions already have children — she says, “I don’t want her to struggle because of my mistake.”

Through the rest of her segment, and in Dr. Drew’s follow-up interview with her and two other young women (Katie and Natalia), the show manages to include: medically accurate information about abortion procedures, the challenge of finding the birth control method that works for you, the positive presence of supportive family and friends, the compassionate voice of a clinic counselor (vs., for one, the cold depiction in “Juno”), the complex emotions of male partners, the cost of abortion ($750, in the case of Natalia, who sold her prom ticket back to school to help put together the funds), the cruelty of parental notification requirements (Natalie called the experience of securing an alternative judicial bypass “begging for permission to make your own decision”), the positive presence of supportive family and friends (in this case, African-American, a sadly rare portrayal), the normality of mixed feelings after the procedure (Markai says, insightfully, that she feels sadness but not regret), and the characterization of abortion as — in Katie’s words — “a parenting decision.” (In an extended interview available online, Natalia also describes the cruelty of being legally forced to view the pre-procedure ultrasound.)

All that in just over 30 minutes, all without scoldy shaming or down-our-noses voyeurism. Instead, this whoop-worthy kicker from Dr. Drew — “Hopefully this inspires us to be more compassionate when we think about abortions” — and, simply, three brave and articulate women who may have begun to raise the level of public, pop-culture conversation about abortion. Maybe it’s “just” MTV, but it matters (and God knows no one else is doing it).

“This isn’t just a television show. Media portrayals, real or fictional, don’t merely inform us — they form us,” as Gloria Feldt wrote in the Washington Post about “Friday Night Lights.” “And they miss the profound truth of women’s lives when they reduce broad issues such as sexual and childbearing choices to one word — abortion — and reduce abortion to a polarized, black-and-white debate.”

And as Dr. Drew himself said last night: “Having an abortion is not uncommon. But talking about it publicly is.” At this time, there are evidently no plans to repeat or extend the special, which was buried to begin with. So here’s a high-five to MTV for — finally, and so finely — getting this thing going.

But next time, how about prime time?

On the one hand, there’s the Gawker conclusion (shared by many), based on “in depth Internet research” revealing Cahoon on Facebook and her book on Amazon: She is “the world’s craziest dating expert” and the videos are “thrillingly real” (“please watch in splendid amazement”). On the other hand, there are those who say the videos — the costume changes! the cheesy soundtrack! the men! — are too thrilling, too splendid, too crazy to be real. Our appetite for irony is so voracious, our radar for hoaxes so sensitive, and (in some cases) satire has become so sophisticated, that indeed: These days, one could imagine Cahoon (or “Cahoon”) pulling off a head-spinningly elaborate pop-culture fake-persona long con: Joaquin Phoenix meets Stephen Colbert meets Tina Fey/Amy Poehler meets Carrie Bradshaw. (This was my take, initially. At least that’s what I was rooting for.) But the debate in the first place is a sign of our post-Blair Witch, post-reality TV, “I’m Still Here”/”Catfish“/”Jersey Shore”/YouTube times: We’ve become so jaded that it’s near impossible to distinguish between real life and a hoax — or a marketing strategy — and we’re always on the defensive for being duped. The argument over what’s real and what’s not has become, more than ever before, a major part of our reaction to art; the membrane between reality and imagination is getting more porous by the day. That mashup is what makes the Cahoon conundrum so captivating. She embodies an irresistible pop-culture zeitgeist two-fer: We thrill to a clueless train wreck; we smell a clever, clever rat.

But in all this investigation and vigorous discussion, one voice was missing: Katherine Chloé Cahoon’s. And so, I decided to call her up. Is Cahoon real or fake? The answer, at once disappointing and exhilarating: She is both.

“We meant to make the videos over the top,” she said from her home in Seattle. “I wanted to be like the travel hostess who says, ‘Come to Europe and all your dreams will come true!”" she says, still amazed that people seem to have thought otherwise. “The guys in the video called me and said, ‘They have to know we’re joking! I don’t really whip off my shirt in the gym and pose on the equipment!’” (On her website, Cahoon responded to the controversy by writing: “Of course they are parodies!”) But the videos — and the book — are also meant to be useful. These were tips the Vanderbilt grad gave to her friends upon returning to campus each fall with fabulous tales of being “manopolized” by suitors in Europe’s most “mantastic” hot spots. She explained one video tip to me about the festival of San Fermin: “If a woman wears red and white at the running of the bulls, it means you’re respecting Spanish culture, and men will want to meet you for that. And I really did have a friend who turned her sarong into a towel after spending the night on the beach!”

To some wiseass doubters, Cahoon’s claim that she meant to be funny would simply make her the Tommy Wiseau of dating advice. (Wiseau famously insisted — after his 2003 film, “The Room,” was cited as one of the worst films ever made — that it was, uh, supposed to be comedy.) But once you spend a little time with Cahoon and her Internet paper trail, it’s hard to do anything but take her at her honest, earnest word. Her ingenuousness, it turns out, is almost impossibly genuine. And that’s where she is totally for real.

The real vs. fake confusion, I think, arises from exactly what’s so beguiling about Cahoon: She actually has no idea how how funny she is. Because, really, her videos are reality magnified only about 1.3 times. In real life, she remains almost as guileless and dreams-come-true, unicorns-and-rainbows sincere as she is on-screen: Elle Woods, or Tracy Flick in a spun-sugar tutu, the über-achiever who, underneath all her cheerfulness, is actually cheerful.

Her videos look and feel awkward in part because it’s actually her dad (a photographer with no video experience) behind the camera. (For her own part, Cahoon says, she drew on what she learned at Vanderbilt in one semester of Intro to Filmmaking.) Also at Vanderbilt, Cahoon sparkled up the gridiron as a member of Danceline, the school’s official dance team. (Amazing Flickr proof lives here.) As a child, though banished from her beloved trampoline by a back injury, Cahoon took ballet six days a week and became an avid — in fact, prizewinning — gardener by age 12. The elaborate garden she created at her parents’ home in Seattle was inspired by a childhood poem she wrote called “Rainbow Ranch,” about stuffed animals who come alive and gather for tea. (In between meetings with Hollywood producers about the in-the-works film based on her book, she still maintains the garden, having spruced it up just recently for some children to come over and act out her poem.) “I love gardening,” she told me. “It’s kind of like writing in a way. You get to create something out of nothing.”

Cahoon does get stopped by people on the street, she says, who compliment her book and ask to take a photo with her. “I try to get to know my readers so I ask about them and there is always some characteristic we have in common,” she says. “One girl was in law school and loved to travel. One man worked for a major film studio. He said his entire office stopped and watched my videos. I feel fortunate to have the opportunity to meet these people.”

To someone raised on rainbows, of course, that “entire office” could have had only the best, the most laughing-with, intentions. But Cahoon is not unaware that there’s also been some laughing-at. And that, indeed, has cost her a bit of her innocence — her Internet innocence, anyway. “All the critical comments I read about me, my videos and my book were inaccurate. For example, one person claimed to have read my book, but her description of it was the opposite of what the book states. She related her own tips for meeting Euro men. These were straight out of my book even though she claimed I had omitted them. For example, she suggested learning some of the native language. Tip No. 19 in my book, entitled ‘Break Through Language Barriers,’ covers exactly this,” Cahoon says, displaying a refreshingly dated belief in the magical power of demonstrable fact. “Also, someone who made several false statements about my videos and book received comments from those who refuted every one with direct references. This did not stop her. She continued to make statements that were so false and vicious they fit the legal description of libel. After learning this, I realized that there are people on the Internet who enjoy making crude, hateful statements. Even when they know these statements are false, they do not care.” (By the way, her book’s reviews on Amazon have taken on a grand satirical life of their own. “Miss Cahoon is kind to her ignorant reader like a Swedish hostel manager might be kind to a single American girl who thinks Sweden is a rustic province of Wales and can’t for the life of her remember if she thought to tell her family she’d be abroad for a few weeks,” reads one.)

Cahoon has also learned that she’s hardly the only victim of online asshattery. “Recently, I saw a video featuring a model from one of the premier agencies. She was absolutely gorgeous. Yet there were venomous comments saying she was overweight. Some went so far as to call her fat. If this girl is fat then heaven help the rest of us!” she says. “What should she do? Quit modeling because some cruel people want to bring her down? Absolutely not! Taylor Swift, who is hugely successful and one of the sweetest girls, would not have written a song called ‘Mean’ if this were not a problem in our society.” Seriously! Europe may be looking better and better.

The Portwood saga caps an intense season on “Teen Mom,” and an intense two years for examining the nuances of domestic violence through the lens of pop culture. Of course, there’s never been any shortage of male-on-female abuse on TV, especially with ever-scummier reality shows in the mix. But lately what we’re seeing, perhaps more than ever, is female-on-male violence. Before Amber vs. Gary, we also — obviously — had Chris vs. Rihanna, along with the common and supposedly exculpatory allegation that she hit him first. We had slapsticky reports that Elin Nordegren started the whole thing by clocking Tiger Woods with a nine-iron. There was Eminem’s smash “I Love the Way You Lie” featuring, of all people, Rihanna on vocals, which whipped up debate about whether the song offered a groundbreakingly complex tale of relationship hell (with which Eminem is also familiar) or reinforced that old idea that, hey, maybe Rihanna did like the way it hurt. But one thing largely unremarked upon throughout the whole “LTWYL” micro-saga is that the violence is presented as, essentially, equal. In the song’s follow-up, “I Love the Way You Lie (Pt. II),” the woman (Rihanna singing lead this time) is not just complicit in the abuse; she is also — almost blow by blow — as violent as the man. (Eminem: “Tell me I’ll be sorry that you pushed me into the coffee table last night so I can push you off me … You hit me twice, yeah, but who’s countin’ / I may have hit you three times.”)

Inherent in the above is some suggestion of perverse 21st century gender parity: Both partners are equally to blame, both partners are equally abusive; women are strong enough to punch, women are not — or no longer — the only victims. When we hear of a woman who hits, we hear rumblings that women are “becoming more violent,” that this is the dark price we pay for female empowerment. As in, hey, feminism, thanks a lot. But are women really becoming “as violent as men”? And is that even the question we should be asking in the first place?

People who support women’s rights, and who have worked for decades to get male-on-female domestic violence taken seriously, may find this conversation not just eye-rolling, but deeply troubling. As expert Jill Murray, author, most recently, of “But He Never Hit Me,” puts it: Equating the scope, incidence and danger of male vs. female domestic violence “stands to negate everything we’ve been trying to fight for, all the work we’ve done.”

How so? Because when not just played for man-bites-dog laughs, female violence against men — especially in cases of heterosexual domestic abuse — is invoked to diminish, even deny, the reality of male violence against women.

“We can’t ignore or deny that women can be violent to their partners, whether their partners are men or women,” says Jennifer L. Pozner, author of “Reality Bites Back: The Troubling Truth About Guilty Pleasure TV” and founder of Women in Media & News. “But by hyping inaccurate studies in news reports and creating salacious narratives on crime dramas, media have for decades tried to create a false equivalence, discussing the few women who have been violent and using those women’s stories as proof that A) there’s ‘just as much’ female-to-male domestic violence as male-to-female, and B) domestic violence isn’t a problem that women have to deal with as victims anymore.” (Men’s rights activists go even further, claiming that men are [as reporter Kathryn Joyce put it] “victims of an unrecognized epidemic of violence at the hands of abusive wives.”)

Let’s see what the stats really say, and what they mean in context. The DOJ’s numbers do contain this one perhaps surprising stat among many, many others: Males and females in violent relationships are “hit, slapped, or knocked down” by partners at almost exactly the same rate. Other research accumulating since at least 2000 suggests that, in fact, females are at least as likely as males to perpetrate intimate partner violence and that abusive relationships often involve mutual violence. So if you were cherry-picking, or very-broad-stroking, you could sort of call it even.

Except it’s not. Not at all. Experts say the raw, in-a-vacuum numbers don’t even start to tell the whole story of a given relationship, or of the complex dynamics of domestic violence. Other DOJ data shows men are more likely to be attacked with a knife or hit with a thrown object; women are more likely to be grabbed, held or tripped, raped, or sexually assaulted. Perhaps more to the point, females are more likely than males to sustain severe or injurious violence and to require medical treatment. “When you take the data out of context, in some cases, women come up as violent as men,” says Meda Chesney-Lind, Ph.D., a criminologist, professor of women’s studies at the University of Hawaii, and author, most recently, of “Fighting for Girls: New Perspectives on Gender and Violence.” “But men will often use the excuse ‘she hit me first’ to justify decking her or throwing her against a wall. She slaps him, and that’s used as a pretext to beat the crap out of her. She’s the one who winds up in the hospital.”

Research also shows that male victims do not take violence by their partners as seriously as females do and, conversely, that women are more likely to be frightened by future violence. Men, perhaps most significantly, are much more likely to commit the extended, continuing violence known as “battery.”

In other words, even where select data points appear to be equal, “shared rates are not shared problems,” says Jeff R. Temple, Ph.D., an assistant professor of obstetrics and gynecology at the University of Texas Medical Branch who specializes in intimate partner violence.

Temple also notes that — likely related to changing mandatory- and dual-arrest laws in cases of domestic violence — reporting of female domestic abuse has increased; that skews the numbers as well.

Another fallacy, says Chesney-Lind: the presumption that violent women are a new post-feminist breed, hitting because being “empowered” makes them more like men. In reality, male and female domestic violence tend to emerge from different places, and with different intentions. In the context of heterosexual domestic abuse, she says, “male violence is an expression of power and control over women; men are hitting to control and get things. Women’s violence is an expression of frustration and rage and exasperation.”

And that’s where we get to the bigger picture. Bottom line, says Chesney-Lind, “we are fascinated by girls’ and women’s violence.” For those who like to see women — Angelina Jolie, even Helen Mirren — wielding serious, even heretofore forbidden, power, it’s hot. For those who fear women in that role, it’s … not. “For all the increased tolerance, even celebration, of aggressive women in pop culture, in daily life there’s still a lot of disapproval of women even speaking up at meetings or asking for a raise, let alone committing a physically aggressive act,” says Maud Lavin, author of “Push Comes to Shove: New Images of Aggressive Women.”

Adds Chesney-Lind: “To take the longest possible view, one of the things you do when you want to discourage women from seeking social justice for their gender is show that there are terrible downsides to ‘mimicking maleness.’ That has been a motif since the first wave of feminism. If you demand to go into the public sphere you’re going to be corrupted, just like men — and the most recent version of that is that you’re going to get ‘out of control,’ even hyper violent.”

None of this is to say that domestic violence by women should be accepted, excused or cheered. But when it comes to pop culture and public discourse, it needs to be discussed on its own face and in its own context, with its own set of causes and implications, not as a game of one-upmanship — and certainly not as a consequence of liberation. “Once we became concerned about them, it was very easy to find violent girls, because they’d always been there,” says Chesney-Lind. That more enlightened, accurate conversation might be — among other things — one step toward “I Love the Way You Lie (Pt. III), in which both singers say, “… and that’s why I got out.”

Mr. and Mrs. Bird-Bee are actually “Neil and Karen,” who are actually two very funny deadpan actors in giant goofy costumes. They’re the stars of a series of five webisodes at the centerpiece of a new campaign designed to raise awareness about infertility, one that nails the experience so knowingly and wittily that it’s getting big love from the infertility community — which is especially notable considering that, in fact, it’s coming from big pharma. Sponsored, subtly (no, really), by EMD Serono — Massachusetts-based maker of fertility drugs used to stimulate ovulation — the “Increase Your Chances” campaign encourages couples to visit a specialist if they hit that fertility wall, and, more broadly, aims to change the way infertility is talked, or, more to the point, whispered about, in our culture. (Part of the campaign involves sending bird- and bee-clad actors onto the streets of small cities — two weeks ago, it was Austin — to “get couples talking about fertility issues.”) The Web spots also close with key facts about infertility: One in eight couples struggles with it; it’s about equally likely that fertility issues will stem from the male as the female partner; 85 to 90 percent of fertility issues are treatable; infertility — “just relax,” my ass — has no correlation with stress. While scattered dissenters find the humor trivializing, most bloggers and commenters became big fans on sight, sending the videos to each other and also (as one poster wrote) to “close (and fertile) friends who are trying to be supportive of me but who just don’t quite understand what living with infertility is like.”

“This ad campaign takes infertility out of the darkness,” says Barbara Collura, executive director of RESOLVE: the National Infertility Association, who has partnered with Serono as a resource for patients.

What’s it doing there in the first place? Thankfully, infertility is not like it was for my childless great-aunt Bess (for whom my daughter is named), born in 1898, who went through it even before it had a name (or books, or blogs, or support groups, or treatments). But for all the resources and help available, there somehow persists the old-fashioned, possibly sexist notion that women get pregnant because that’s what they do, that conceiving is the natural, default outcome — after all, we spent so many years trying not to, goddammit — such that failing to seems to mean there’s something wrong with you. Not your plumbing, you. Result: stigma, secrecy, shame. (For the, mercifully, relatively short time I subscribed to Conceive magazine, I felt like I had to slip it inside something respectable, like Us Weekly, when I read it on the subway.) The assumption persists that every (married) woman will have a child, even those who aren’t interested. So you can imagine how that might feel for those who are. But, then, articles about infertility online, for one, often elicit ungenerous commentary that basically boils down to “boo-fucking-hoo.” Our nation’s collective pop-culture “bump watch” being on permanent orange alert (what Rebecca Traister called “pregnancy porn”) doesn’t help, either.

Speaking of culture, it’s not overflowing with positive, nuanced or compassionate images of women struggling to conceive or seeking fertility treatment. (One word: “octo-mom.”) Also, if you totally forgot that there was a dramedy about a fertility clinic on NBC called “Inconceivable,” good. In “Increase Your Chances,” Neil and Karen do drift a bit toward the tired doofy-husband/testy wife (hey, it works in “Modern Family”), but they’re still pretty winning; they still ring real, right down to the rank wheat-grass snake oil and military-timed robosex (post-coital murmur: “Don’t forget the dry cleaning”). They’re tense, they’re tender: You root for them. “They’re note-perfect, an assessment that my commenters share,” says Julie Robichaux of ALittlePregnant.com. “They’re kind of Everyinfertile, in fact, stunningly typical. For people trying to conceive, that makes it easy to relate to the couple. For those not in that situation, it advances the notion that people who do seek fertility treatments aren’t quite as egomaniacal/selfish/not-like-us as they may previously have thought — a win for the infertile community. By humanizing the couple so unerringly, the ads make us receptive to the message.”

How did Serono (and mono, the agency they worked with) get it so right? Not rocket science: They talked to people. “What you see comes directly from conversations with patients,” confirms David Stern, executive vice president of endocrinology for EMD Serono. “We wanted to come up with an awareness campaign to help create less stigma around infertility. We looked at everything being done online by IVF clinics, patient advocacy groups, and competitors, and we saw very similar themes: flowers and soft colors and other warm, fuzzy things and babies. Lots of babies. It’s all done very softly. We said, ‘OK, a lot of people are doing this and there’s still this stigma. We want to do something different that will get a conversation started, in a way that’s humorous without making fun.” He adds: “We also want to get people to physicians who know how to treat them. If they use fertility drugs, that’s great, but we really want to motivate people to go in to see specialists because that’s the best route for them to become parents.”

That’s a welcome message, too, says Robichaux. “It undoubtedly serves the drug company, but it also serves anyone who’s been trying for a while with no success. Nothing frustrates me more than to hear a friend tell me, ‘Well my gynecologist said a year’s not that long, that we should just keep trying on our own.’ Lady. You’re 41. Your doctor has done you no favors.”

The ads, she notes, also don’t pander or patronize by promising success. “That’s huge,” she says. “Not only is it a truthful acknowledgment of the limitations of medicine — imagine that — it’s also a very respectful position to take with regard to the intended audience. Infertile people know that there’s no magic bullet, or silver needle, or pregnant rainbow Pegasus crop-dusting the world with glittery baby dust.” And now they also know that there are a few more people who understand.