It’s too late to arm yourself with a copy of the September issue of The Blue & White. Here, Senior Editor Anna Bahr explores the history of women and gay health at Columbia.

In the fall of 1983, women graced Columbia’s undergraduate class for the first time. The same year, the HIV/AIDS crisis rose to global prominence. It marked a remarkable confluence of both triumph and tragedy, each of which was navigated by groups of ambitious individuals whose activism determined the future attitudes of the University toward marginalized groups. They endowed an institution with empathy.

Health care, as evidenced by every stump speech of this summer’s presidential campaigns, is a specifically political issue. Who gets sick and how quickly they are treated reveals their socioeconomic status, sex, and sexuality. Being the disadvantaged party in any of those categories can mean the difference between life and death. However, in contrast to the current vitriolic climate, Columbia’s historic health care reforms eluded overt controversy. Likewise, they lacked the antagonistic explosiveness of the hallowed ‘68 protests, so often held up as the standard of Columbia counterculture. Medical care that addressed the needs of women and queer men was espoused as an obvious course of action. Advocates shaped policy not because they were violently critical of existing structures, but because they were explicitly self-righteous and stood up for their beliefs without interrupting the overall pace of life.

Illustration by Lily Keane

After lagging behind peer institutions, once Columbia integrated undergraduate women into its student body, it did so unequivocally. The university threw generous support behind building a Women’s Health Center at a time when explicit discussion of reproductive health was “marginalized and not acceptable at most university settings,” says Dr. Martha Katz, the Center’s first director. Open for its first full year in 1984, the clinic introduced a new model of care that not only offered superior sexual health services—an unprecedented investment in women’s well-being—but also worked with Columbia security to manage cases of rape. Counselors would accompany victims to the hospital, and advise women dealing with sexual harassment before the term had a functional meaning; Columbia’s care providers professionalized emotional as well as physical support.

Almost contemporaneously, another remarkable development took place within the campus medical establishment. In 1985, the University became the first academic institution in the country to offer free HIV testing to its queer student and faculty community through the Gay Health Advocacy Project (GHAP)—much to the chagrin of its notoriously image-conscious administration. Racing ahead of nationwide recognition of the disease, GHAP reached out to researchers at St. Luke’s for trials with HIV-positive students and encouraged testing at Columbia before AZT (an antiretroviral used to treat the virus) had been officially approved by the FDA. Still, Columbia’s administrative leadership was concerned with the liabilities of the virus, going so far as to form an HIV Advisory Committee that sought to distance the University’s image from associations with the disease scourging New York. The committee discussed the realities of HIV as a handicap in admission to law and medical schools based on applicants’ HIV status: will they live long enough to survive graduate school?

The Women’s Health Center

Robert Pollack, then the Dean of Columbia College, described the faculty vote to admit women as the obvious step forward: “Opening the College to women was by any measure fair, generous, creative, democratic and open-minded.” Yet the decision was infamously delayed. Though the university saved face through its relationship with next-door Barnard and ever-present female graduate students, Columbia’s academic rivals were reaping the benefits of coeducation long before Columbia, and the University needed more than speeches to catch up. John Jay lacked bathroom facilities with the requisite “Women” sign on the door. Panty raids at Barnard were Friday fraternity fun. Medical care did not include gynecological services.

But Columbia readied itself for the inclusion of the fairer sex with enthusiasm, recognizing that, “If the university wanted to serve its women students, it needed to meet their needs,” says Rebecca Weiker, CC ’88, one of the first women admitted as an undergraduate. “Not just as an afterthought, but as a priority. If Columbia was really going to be coed, it had to treat women well.” With the support of both Richard Carlson, the director of Health Services, and the Dean, the Women’s Health Center did just that.

This was ten years after Roe v. Wade, when stories of back alley abortions and plane flights for overnight procedures in willing clinics were still fresh in the minds of American women. To organize health care around the unique demands of women was a phenomenon born of the pro-choice movement—an ambitious tenet of the feminist agenda. But the University, though progressive, proceeded cautiously. Still recovering from its 1960s adventures in controversial politics, throwing immediate weight behind a mission statement with a resounding feminist ring was unlikely. Candid conversation about birth control, STIs and eating disorders was still rare between mother and daughter, let alone in school-sanctioned forums. For the American public, such forthright dialogues were freely associated with bra-burning and Gloria Steinem’s rhetoric.

To reassure the administration that its goals were focused on public health, not public policy, the clinic’s visionaries had to temper the program’s radical connotations by clearly delineating between women’s care and women’s liberation. “The people who developed Our Bodies, Ourselves [an early iteration of women’s health advocacy publications, radical for its frank discussions of abortion and pregnancy] were alienated. They didn’t fit into the academic setting. Columbia trusted us because we mainstreamed the image of women’s health. It wasn’t fringe anymore,” says Dr. Katz.

Thanks to a $300,000 grant from the New York State Dormitory Authority (the project was funded independently of university investment) to build and buy equipment, a bright, modern space was renovated, complete with three examining rooms and a counseling room. The clinic abandoned the expensive care of specialists and primary physicians, instead using nurse practitioners who could spend more time with young women, helping them to assess potential risks to their health. While the renovation was aided by state funding, the clinic operated under the budgetary oversight of Columbia Health Services. This arrangement gave the University administration some distance from the program while sanctioning it.

Care surpassed the basic annual in-and-out physical. It was a safe space. Even faculty experiencing sexual harassment sought counseling at the clinic. in an era when date rape and sexual coercion were absent from collo- quial vocabulary and rarely publicly acknowledged, the clinic prioritized assault issues and took initia- tive in cases of student rape. The clinic even devel- oped some of the first crude rape kits, sterilized and pre-packaged versions of which later became standard hospital gear. dr. Katz went as far as to perform a vaginal smear for a violently assaulted undergraduate student at St. Luke’s—a hospital at which she was not formally employed. “The spirit of the women who worked at the clinic was amazing. i haven’t seen anything like it since. it was more a move- ment than a clinic. The level of commitment transmitted to the nature of the care,” she remembers.