CARLOS Tiger without Time

“The Artist,” a love letter to Hollywood, got hugs, kisses and the best-picture Oscar on Sunday at the 84th Academy Awards ceremony here. The film also took the awards for best actor and best director, in a minisweep that found the movie industry paying tribute to not just the movie but to its own roots as well.

“I want to thank Billy Wilder, I want to thank Billy Wilder and I want to thank Billy Wilder,” said Michel Hazanavicius, the film’s director, in keeping with a self-referential theme that ruled the evening.

Thomas Langmann, the producer, accepting his award for a mostly silent, black-and-white fable about an actor’s struggle with the end of silent film, said the achievement was dedicated to his father, the deceased French director Claude Berri.

Until Sunday no silent film had won the top Oscar since “Wings,” at the first Academy Awards ceremony in 1929. But nostalgia ruled the night, as “Hugo,” about another silent star, Georges Méliès, won a string of less prominent awards, and “Midnight in Paris,” a comic time trip to Paris in the 1920s, took the prize for original screenplay for Woody Allen.

Meryl Streep, a winner for her portrayal of a doddering Margaret Thatcher in “The Iron Lady,” made her victory look like a shock. But she hadn’t won since 1983, even though she reigns as the actor with the most nominations in the history of the Academy of Motion Picture Arts and Sciences, with 17 in all. Ms. Streep said she could imagine half of America gasping: “Oh no! Oh, come on! Why her? Again?” as her name was read.

When the only surprise is a victory by Ms. Streep, you know things are going by the script. Viola Davis, for her work in “The Help,” had been considered a strong candidate as the best-actress winner.

“Merci, beaucoup, I love you!” shouted Jean Dujardin, as he picked up his award as best actor for a movie that was conceived in France, but showered its adoration on the Hollywood of yore.

After a dry spell in the early evening, “The Artist” gained momentum as the major awards were presented, beginning with a prize for Mr. Hazanavicius. The winner unscrolled a long string of French-accented “thank yous” that included Uggie the dog.

Christopher Plummer, born in 1929, won his first Academy Award, as best supporting actor, for “Beginners.” “You’re only two years older than me, darling — where have you been all my life?” said Mr. Plummer, in picking up a statuette that was first given for films made in 1927 and 1928.

It was long overdue recognition for Mr. Plummer, who had appeared in dozens of films over more than 50 years, and finally won for his portrayal, in “Beginners,” of a father who in his final years acknowledges being gay.

“Congratulations to Mr. Plummer; the average age of the winners has now jumped to 67,” joked Mr. Crystal.

That was before Woody Allen, 76, won a best original screenplay Oscar for “Midnight in Paris,” bumping the average age still higher. That film was another nostalgia trip, about literary Paris in the 1920s. In keeping with a personal tradition, Mr. Allen was a no-show, and left the Academy to accept its own prize on his behalf.

Closer to present time, Alexander Payne, Nat Faxon and Jim Rash had just won an adapted-screenplay Oscar for “The Descendants.” It was welcome recognition for a movie that once appeared among the front-runners for best picture, but seemed to falter as a grueling, monthslong campaign season showered pre-Oscar prizes on “The Artist.”

There was a dollop of drama to the proceedings.

As the show passed its midpoint, “Hugo” had made the only show of force. A 3-D tale, set in Paris, it had won five Oscars, for cinematography, art direction, sound editing, sound mixing and visual effects.

Meanwhile, two hours in, “The Artist,” supposedly the night’s front-runner, had won only two awards, those for its Jazz Age costume design and musical score. If the early snubs sent a shiver through Harvey Weinstein, whose company distributed “The Artist” in the United States, he could take comfort, at least, in a win for “Undefeated.”

That film, about a black urban high school football team and its white coach, was also distributed by the Weinstein Company, and took the Oscar for best documentary feature. One of the film’s makers drew a gasp in the auditorium when he broke Oscar protocol by tossing off a strictly forbidden obscenity — something rare at the tightly controlled Academy Awards.

Chris Rock followed with a racial joke, about black men getting lousy roles even in animated films. It may have been in questionable taste, but it jarred the show closer to modern times.

“Rango” was the animation winner, from the director Gore Verbinski and Paramount Pictures. Both DreamWorks Animation, which had “Kung Fu Panda 2” in the running, and Walt Disney’s Pixar Animation, which had no nominee in the category at all, had watched their grip on the prize slip to Mr. Verbinski, who had never before made an animated film.

Elizabeth Taylor was the capper in an especially crowded memorial sequence that paid tribute to one after another among the film figures who died in the last year. The actor Ben Gazzara, the movie executive John Calley, and the Oscar show producers Gil Cates and Laura Ziskin were among them.

Finally, the show settled into its inevitable rhythm of presentation, thanks, and congratulatory applause — in a typical Oscar broadcast, only a relatively small sliver goes to production numbers and pranks by the host. But the montage moments kept coming.

As the end neared, actors like Julia Roberts and Robert Downey Jr. were on film carrying on about why they love film. “I’ve never had any of those feelings,” said Mr. Crystal.

And the demographic jokes never stopped. “Perky gets old fast with this crowd,” Ben Stiller warned Emma Stone, as she milked a bit that wound around her status as a first-time presenter.

Indeed it was a mirth-by-any-means-necessary kind of night: Will Ferrell, Tina Fey, Chris Rock, Kristen Wiig, Kermit the Frog and a parade of other comedians were among the presenters.

Mr. Crystal, his vaudeville grin firmly in place, set the tone early, opening the show with a song-and-dance montage that managed to send up the nine best-picture nominees, Tom Cruise, the movie “Bridesmaids,” and his own aging career all at once.

“This is my ninth time, my ninth time hosting the Oscars,” he quipped in an opening monologue that seemed bent on leaving no one out. “Just call me ‘War Horse.’ ” Pointing one of his barbs directly at the film industry, he added, “Nothing can take the sting out of the world’s economic problems like watching millionaires present each other with gold statues.”

The theater was gilded and draped in red, as were many of the starlets. The idea was to mimic a glamour that came with the movies of old — a time when, perhaps, they mattered a little more than they do in an age of multiplatform entertainment.

The big show-business smile that infused the ceremony was more than a ratings ploy. It was also an effort by the Academy to move past a tumultuous Oscar season that left the organization bruised if not bloodied.

Mr. Crystal came aboard as host at the last minute in November, pinch-hitting for Eddie Murphy, who dropped out when Brett Ratner, his friend and a producer of the show, resigned amid a media storm over his use of an anti-gay slur at a panel discussion in Hollywood. Simultaneously, the normally staid Academy had to deal with infighting over its new chief executive, Dawn Hudson, and the changes she was trying to implement. Ms. Hudson finally defended herself a few days ago in an interview with The Hollywood Reporter.

A generally weak box-office performance among the year’s nine best-picture contenders — only one of which, “The Help,” amassed more than $100 million in domestic ticket sales — had already caused worry about the Oscar show’s ratings potential. Then moviedom took an added blow to its confidence, watching this year’s Grammy Awards show attract about 40 million viewers as music fans rallied around the death of Whitney Houston; last year’s Oscars drew 37.9 million viewers.

Meanwhile, a demographic survey by The Los Angeles Times renewed questions about the 5,800-member Academy’s cultural relevance. Membership was found to be overwhelmingly white, male and 60ish. The results echoed conventional wisdom, but provoked new debate about whether the Oscars still mattered to an increasingly diverse America, let alone a global audience.

The television ratings may provide a clue. (At 3 hours 8 minutes, the show ranked among the shorter broadcasts in recent history.) In the meantime, the longing for past glory was perhaps most wistfully expressed by Bret McKenzie, whose composition, “Man or Muppet,” won for best original song.

Backstage, Mr. McKenzie modestly allowed that his song, for the film “The Muppets,” couldn’t hold a candle to Paul Williams and Kenneth Ascher’s “Rainbow Connection,” which has been Kermit the Frog’s theme song through the years.

That song was a classic, Mr. McKenzie said; his own, he contended, was nothing by comparison. Somewhere in that was a lesson for the night.

But specialists in adolescent medicine and mental health experts say that dark postings should not be hastily dismissed because they can serve as signs of depression and an early warning system for timely intervention. Whether therapists should engage with patients over Facebook, however, remains a matter of debate.

And parents have their own conundrum: how to distinguish a teenager’s typically melodramatic mutterings — like the “worst day of my life” rants about their “frenemies,” academics or even cafeteria food — from a true emerging crisis.

(Dr. Megan A. Moreno has studied college students’ Facebook postings for signs of depression. Some showed signs of risk.)

Last year, researchers examined Facebook profiles of 200 students at the University of Washington and the University of Wisconsin-Madison. Some 30 percent posted updates that met the American Psychiatric Association’s criteria for a symptom of depression, reporting feelings of worthlessness or hopelessness, insomnia or sleeping too much, and difficulty concentrating.

Their findings echo research that suggests depression is increasingly common among college students. Some studies have concluded that 30 to 40 percent of college students suffer a debilitating depressive episode each year. Yet scarcely 10 percent seek counseling.

“You can identify adolescents and young adults on Facebook who are showing signs of being at risk, who would benefit from a clinical visit for screening,” said Dr. Megan A. Moreno, a principal investigator in the Facebook studies and an assistant professor of pediatrics at the University of Wisconsin-Madison.

Sometimes the warnings are seen in hindsight. Before 15-year-old Amanda Cummings committed suicide by jumping in front of a bus near her Staten Island home on Dec. 27, her Facebook updates may have revealed her anguish. On Dec. 1, she wrote: “then ill go kill myself, with these pills, this knife, this life has already done half the job.”

Facebook started working with the National Suicide Prevention Lifeline in 2007. A reader who spots a disturbing post can alert Facebook and report the content as “suicidal.” After Facebook verifies the comment, it sends a link for the prevention lifeline to both the person who may need help and the person who alerted Facebook. In December, Facebook also began sending the distressed person a link to an online counselor.

While Facebook’s reporting feature has been criticized by some technology experts as unwieldy, and by some suicide prevention experts as a blunt instrument to address a volatile situation, other therapists have praised it as a positive step.

At some universities, resident advisers are using Facebook to monitor their charges. Last year, when Lilly Cao, then a junior, was a house fellow at Wisconsin-Madison, she decided to accept Facebook “friend” requests from most of the 56 freshmen on her floor.

She spotted posts about homesickness, academic despair and a menacing ex-boyfriend.

“One student clearly had an alcohol problem,” recalled Ms. Cao. “I found her unconscious in front of the dorm and had to call the ambulance. I began paying more attention to her status updates.”

Ms. Cao said she would never reply on Facebook, preferring instead to talk to students in person. The students were grateful for the conversations, she said.

“If they say something alarming on Facebook,” she added, “they know it’s public and they want someone to respond.”

While social media updates can offer clues that someone is overwrought, they also raise difficult questions: Who should intervene? When? How?

“Do you hire someone in the university clinic to look at Facebook all day?” Dr. Moreno said. “That’s not practical and borders on creepy.”

She said a student might be willing to take a concerned call from a parent, or from a professor who could be trained what to look for.

But ethically, should professors or even therapists “friend” a student or patient? (The students monitored by Dr. Moreno’s team had given their consent.)

Debra Corbett, a therapist in Charlotte, N.C., who treats adolescents and young adults, said some clients do “friend” her. But she limits their access to her Facebook profile. When clients post updates relevant to therapy, she feels chagrined. But she will not respond online, to maintain the confidentiality of the therapeutic relationship.

Instead, Ms. Corbett will address the posts in therapy sessions. One client, for example, is a college student who has low self-esteem. Her Facebook posts are virtual pleas for applause.

Ms. Corbett will say to her: “How did you feel when you posted that? We’re working on you validating yourself. When you put it out there, you have no control about what they’ll say back.”

Susan Kidd, who teaches emotionally vulnerable students at a Kentucky high school, follows their Facebook updates, which she calls a “valuable tool” for intervention with those who “may otherwise not have been forthcoming with serious issues.”

At Cornell University, psychologists do not “friend” students. At weekly meetings, however, counselors, residence advisors and the police discuss students who may be at risk. As one marker among many, they may bring up Facebook comments that have been forwarded to them.

“People do post very distressing things,” said Dr. Gregory T. Eells, director of Cornell’s counseling and psychological services. “Sometimes they’re just letting off steam, using Facebook as something between a diary and an op-ed piece. But sometimes we’ll tell the team, ‘check in on this person.’ ”

They proceed cautiously, because of “false positives,” like a report of a Facebook photo of a student posing with guns. “When you look,” said Dr. Eells, “it’s often benign.”

Dr. Moreno said she thought it made sense for house fellows at the University of Wisconsin to keep an eye on their students who “friend” them. Students’ immediate friends, she said, should not be expected to shoulder responsibility for intervention: “How well they can identify and help each other, I’m not so sure.”

Tolu Taiwo, a junior at the University of Illinois at Urbana-Champaign, agreed. “I know someone who wrote that he wanted to kill himself,” she said. “It turned out he probably just wanted attention. But what if it was real? We wouldn’t know.”

In fact, when adolescents bare their souls on Facebook, they risk derision. Replying to questions posted on Facebook by The New York Times, Daylina Miller, a recent graduate of the University of South Florida, said that when she poured out her sadness online, some readers responded only with the Facebook “like” symbol: a thumb’s up.

“You feel the same way?” said Ms. Miller, puzzled. “Or you like that I’m sad? You’re sadistic?”

Some readers, flummoxed by a friend’s misery, remain silent, which inadvertently may be taken as the most hurtful response.

In comments to The Times, parents who followed their children’s Facebook posts said they did not always know how to distinguish the drama du jour from silent screams. Often their teenagers felt angry and embarrassed when parents responded on Facebook walls or even, after reading a worrisome comment by their child’s friend, alerted the friend’s parents.

Many parents said they felt embarrassed, too. After reading a grim post, they might raise an alarm, only to be curtly told by their offspring that it was a popular song lyric, a tactic teens use to comment in code, in part to confound snooping parents.

Ms. Corbett, the Charlotte therapist, said that when she followed her sons’ Facebook pages, she used caution before responding to occasional downbeat posts. If parents react to every little bad mood, she said, children might be less open on Facebook, assuming that “my parents will freak out.”

Dr. Moreno said that parents should consider whether the posts are typical for their child or whether the child also seems depressed at home. Early intervention can be low-key — a brief text or knock on the bedroom door: “I saw you posted this on Facebook. Is everything O.K.?”

Sometimes a Facebook posting can truly be a last-resort cry for help. One recent afternoon while Jackie Wells, who lives near Dayton, Ohio, was waiting for her phone service to be fixed, she went online to check on her daughter, 18, who lives about an hour away. Just 20 minutes earlier, the girl, unable to reach her mother by phone, used her own Facebook page to post to Mrs. Wells or anyone else who might read it:

“I just did something stupid, mom. Help me.”

Mrs. Wells borrowed a cellphone from her parents and called relatives who lived closer to her daughter. The girl had overdosed on pills. They got her to the hospital in time.

“Facebook might be a pain in the neck to keep up with,” Mrs. Wells said. “But having that extra form of communication saves lives.”

Though she was, by her own account, “not a strong soldier,” she received excellent job reviews at Fort Leavenworth, Kan., where she counseled prisoners. But last year, Captain Carlson, a social worker, was deployed to Afghanistan with the Colorado National Guard and everything fell apart.

After a soldier complained that she had made sexually suggestive remarks, she was suspended from her counseling duties and sent to an Army psychiatrist for evaluation. His findings were shattering: She had, he said in a report, a personality disorder, a diagnosis that the military has used to discharge thousands of troops. She was sent home.

She disputed the diagnosis, but it was not until months later that she found what seemed powerful ammunition buried in her medical file, portions of which she provided to The New York Times. “Her command specifically asks for a diagnosis of a personality disorder,” a document signed by the psychiatrist said.

Veterans’ advocates say Captain Carlson stumbled upon evidence of something they had long suspected but had struggled to prove: that military commanders pressure clinicians to issue unwarranted psychiatric diagnoses to get rid of troops.

“Her records suggest an attempt by her commander to influence medical professionals,” said Michael J. Wishnie, a professor at Yale Law School and director of its Veterans Legal Services Clinic.

Since 2001, the military has discharged at least 31,000 service members because of personality disorder, a family of disorders broadly characterized by inflexible “maladaptive” behavior that can impair performance and relationships.

For years, veterans’ advocates have said that the Pentagon uses the diagnosis to discharge troops because it considers them troublesome or wants to avoid giving them benefits for service-connected injuries. The military considers personality disorder a pre-existing problem that emerges in youth, and as a result, troops given the diagnosis are often administratively discharged without military retirement pay. Some have even been required to repay enlistment bonuses.

By comparison, a diagnosis of post-traumatic stress disorder is usually linked to military service and leads to a medical discharge accompanied by certain benefits.

In recent weeks, questions about whether the Army manipulates psychiatric diagnoses to save money have been raised at Joint Base Lewis-McChord near Tacoma, Wash., where soldiers undergoing medical evaluations before discharge complained that psychiatrists rescinded PTSD diagnoses, leaving the soldiers with diagnoses like personality disorder that did not qualify them for medical discharges.

In a memorandum, an Army ombudsman wrote that a doctor from the base hospital, Madigan Army Medical Center, said that one diagnosis of post-traumatic stress disorder can cost $1.5 million in benefits over a soldier’s lifetime. The doctor also counseled his colleagues to be good stewards of taxpayer money by not “rubber-stamping” such diagnoses.

In the wake of those complaints, the Army has removed the head of Madigan and suspended two doctors at a special forensic psychiatric unit. It has also reviewed the cases of 14 soldiers and reinstituted PTSD diagnoses for 6 of them.

Some senior military officials have raised concerns that PTSD is overdiagnosed. Still, the Defense Department has denied that it uses psychiatric diagnoses either to weed out injured or low-performing troops, or to save money.

“Our goal is to provide the most accurate diagnosis,” said Maria Tolleson, a spokeswoman for the Army Medical Command.

On Captain Carlson’s case, the Colorado National Guard declined to comment. Officials at Womack Army Medical Center at Fort Bragg, N.C., said the psychiatrist who evaluated Captain Carlson in Afghanistan, Maj. Aniceto Navarro, was not available for an interview.

But in a statement, the hospital said: “No commander may order a credentialed clinician to make a particular diagnosis. Dr. Navarro did not feel he was being ordered by the service member’s command to make a particular diagnosis. The sentence referenced was written in terms of the commander asking to evaluate for a personality disorder, i.e. asking if one existed, not ordering to diagnose a personality disorder.”

Though it is impossible to know how many veterans are disputing their personality disorder discharges, Vietnam Veterans of America, an advocacy group, with help from the Yale veterans legal clinic, has sued the Defense Department seeking records they say will show that thousands of troops have been unfairly discharged for personality or adjustment disorder since 2001.

“We believe that many of the people who received personality disorder discharges were wrongly diagnosed and that in fact they were suffering from PTSD or traumatic brain injury,” said Thomas Berger, executive director of Vietnam Veterans of America’s health council.

Although the number of personality disorder discharges is small relative to the total number of troops who have served since 2001, Congress was concerned enough about the issue to hold hearings in 2007 after reading reports that troops with post-traumatic stress and other combat-related injuries were being discharged for personality disorder.

The Defense Department then tightened its requirements, partly to ensure that troops who had served in combat zones and had PTSD were not discharged for personality disorder. Personality disorder discharges subsequently declined, to 1,078 in 2010 from 4,264 in 2007, data obtained by Vietnam Veterans of America show.

But the Government Accountability Office said in 2010 that the Defense Department had not proved that it was in full compliance with its rules. And Captain Carlson’s case shows that the military continues to issue personality disorder diagnoses in questionable ways, according to veterans’ advocates and her lawyers, Stephen H. Carpenter Jr. and Daniel C. Russ.

Unlike the soldiers at Madigan, Captain Carlson has not been given a diagnosis of PTSD. But the personality disorder diagnosis could complicate her ability get a medical discharge for a back injury and other problems. Perhaps more significant, the diagnosis will be listed on her discharge papers, which employers typically review when they are considering veterans for a job.

“It may have a significant impact on her ability to find employment,” Mr. Carpenter said.

Captain Carlson, now 55, signed up with the Army after a co-worker at a Milwaukee trauma hospital, a surgeon in the National Guard, told her that the Army badly needed therapists and social workers. Intrigued, she got an age waiver and joined through a program that commissions officers based on their specialized training.

At Fort Leavenworth, where she served for three years, supervisors called her “highly talented,” “outstanding” and “a dedicated officer,” according to a 2008 evaluation.

After leaving active duty, Captain Carlson moved to Colorado Springs in 2010 to take a civilian job as a substance abuse counselor at Fort Carson. But she soon learned that the Colorado National Guard, which she had just joined, would deploy to Afghanistan in early 2011. She told her commander she wanted to go.

“I wanted to experience what soldiers experience,” she said in an interview.

But her problems began soon after she arrived in Afghanistan last February. She got lost outside a combat outpost and wore shorts when she should have been in combat uniform. Then a junior enlisted soldier accused her of sexual harassment, citing an off-color remark she made during a game of Scrabble with several soldiers at a combat outpost.

Captain Carlson contends the remark was innocent, but the Army sent her back to Bagram Air Base near Kabul and opened an investigation. A major general eventually gave her a memorandum of reprimand, a potentially career-ending action. But she says it was the psychological evaluation she received at Bagram that upset her the most.

In notes from that evaluation, Dr. Navarro wrote that “it is very difficult to draw absolute conclusions for a personality disorder.” But he noted that her command had asked for the diagnosis and, in his final report dated three days later, Dr. Navarro did just that.

Captain Carlson has “a very dramatic style” and “chronic difficulty in adjusting,” Dr. Navarro wrote in that report, concluding that she had “personality disorder NOS” — not otherwise specified — “with histrionic traits.” He recommended that the Army move swiftly to discharge her if she did not comply with counseling from her commander.

Experts say personality disorder is generally evident in a person’s youth, leaving a telltale pattern across failed jobs and broken relationships. For that reason, they generally recommend that diagnoses include reviews of patients’ medical records and interviews with people who have known them for years. Dr. Navarro says in his notes that he did not have access to her records.

Dr. Andrew E. Skodol, research professor of psychiatry at the University of Arizona and an expert on personality disorder who was not familiar with Captain Carlson’s case, said it would not be surprising for a person who entered the Army in middle age to have trouble adapting to the stresses of military life and deployment. But that would not necessarily qualify as a personality disorder, Dr. Skodol said.

After leaving Afghanistan last year, Captain Carlson went to Joint Base Lewis-McChord, where a psychiatrist gave her a diagnosis of adjustment disorder, her lawyers said. That psychiatrist has since been suspended as part of the Army’s investigation into Madigan.

It will be up to the Colorado National Guard to decide how Captain Carlson will be discharged, a process that could take months. At the least, Captain Carlson wants the personality disorder diagnosis removed from her record.

“It’s a bad label,” she said. “I’m a broken soldier. I’m old. And they just want to get rid of me.”

By JAMES DAO, NYT, February 24, 2012

Even the most pro-choice politicians, for instance, usually emphasize that they want to reduce the need for abortion, and make the practice rare as well as safe and legal. Even the fiercest conservative critics of the White House’s contraception mandate — yes, Rick Santorum included — agree that artificial birth control should be legal and available. And both Democrats and Republicans generally agree that the country would be better off with fewer pregnant teenagers, fewer unwanted children, fewer absent fathers, fewer out-of-wedlock births.

Where cultural liberals and social conservatives differ is on the means that will achieve these ends. The liberal vision tends to emphasize access to contraception as the surest path to stable families, wanted children and low abortion rates. The more direct control that women have over when and whether sex makes babies, liberals argue, the less likely they’ll be to get pregnant at the wrong time and with the wrong partner — and the less likely they’ll be to even consider having an abortion. (Slate’s Will Saletan has memorably termed this “the pro-life case for Planned Parenthood.”)

The conservative narrative, by contrast, argues that it’s more important to promote chastity, monogamy and fidelity than to worry about whether there’s a prophylactic in every bedroom drawer or bathroom cabinet. To the extent that contraceptive use has a significant role in the conservative vision (and obviously there’s some Catholic-Protestant disagreement), it’s in the context of already stable, already committed relationships. Monogamy, not chemicals or latex, is the main line of defense against unwanted pregnancies.

The problem with the conservative story is that it doesn’t map particularly well onto contemporary mores and life patterns. A successful chastity-centric culture seems to depend on a level of social cohesion, religious intensity and shared values that exists only in small pockets of the country. Mormon Utah, for instance, largely lives up to the conservative ideal, with some of America’s lowest rates of teenage pregnancies, out-of-wedlock births and abortions. But many other socially conservative regions (particularly in the South) feature higher rates of unwed and teenage parenthood than in the country as a whole.

Liberals love to cite these numbers as proof that social conservatism is a flop. But the liberal narrative has glaring problems as well. To begin with, a lack of contraceptive access simply doesn’t seem to be a significant factor in unplanned pregnancy in the United States. When the Alan Guttmacher Institute surveyed more than 10,000 women who had procured abortions in 2000 and 2001, it found that only 12 percent cited problems obtaining birth control as a reason for their pregnancies. A recent Centers for Disease Control and Prevention study of teenage mothers found similar results: Only 13 percent of the teens reported having had trouble getting contraception.

At the same time, if liberal social policies really led inexorably to fewer unplanned pregnancies and thus fewer abortions, you would expect “blue” regions of the country to have lower teen pregnancy rates and fewer abortions per capita than demographically similar “red” regions.

But that isn’t what the data show. Instead, abortion rates are frequently higher in more liberal states, where access is often largely unrestricted, than in more conservative states, which are more likely to have parental consent laws, waiting periods, and so on. “Safe, legal and rare” is a nice slogan, but liberal policies don’t always seem to deliver the “rare” part.

What’s more, another Guttmacher Institute study suggests that liberal states don’t necessarily do better than conservative ones at preventing teenagers from getting pregnant in the first place. Instead, the lower teenage birth rates in many blue states are mostly just a consequence of (again) their higher abortion rates. Liberal California, for instance, has a higher teen pregnancy rate than socially conservative Alabama; the Californian teenage birth rate is only lower because the Californian abortion rate is more than twice as high.

These are realities liberals should keep in mind when tempted to rail against conservatives for rejecting the intuitive-seeming promise of “more condoms, fewer abortions.” What’s intuitive isn’t always true, and if social conservatives haven’t figured out how to make all good things go together in post-sexual-revolution America, neither have social liberals.

At the very least, American conservatives are hardly crazy to reject a model for sex, marriage and family that seems to depend heavily on higher-than-average abortion rates. They’ve seen that future in places like liberal, cosmopolitan New York, where two in five pregnancies end in abortion. And it isn’t a pretty sight.

By ROSS DOUTHAT, nyt, February 18, 2012

Bill Gates is co-chairman of the Bill and Melinda Gates Foundation. NYT: Published: February 22, 2012

It has often been said throughout time that a picture is worth a thousand words. Any picture may be worth a thousand words, but only a few rare photos tell more than a thousand words. They tell a powerful story, a story poignant enough to change the world and galvanize each of us. Over and over again…