In this interview, Kristina Hänel talks about who her enemies and supporters are, how she has learned to deal with stress, and what advice she would give to young physicians that may find themselves in similar situations to the ones that she has encountered over her years of work as a physician-activist.
Article translated from the original German version
The esanum Global Series is a collection of articles that brings together esanum's German, Italian, English and French-language editorial teams to provide a global perspective on the contemporary issues and stories impacting physicians' lives. In our first series, "Physicians in Social Media, the digital frontline", we interview physicians whose daily work, activism, or social media presence, have sparked a full array of responses from within their own professional communities, media platforms, and beyond. Solidarity, harassment, fame and threats, and the human stories behind the controversies, are the focus of this interview series.
Kristina Hänel is one of the best-known physicians in Germany. However, her unequivocal stance on abortion and her fight against the ban on pro-choice advertising regulated in paragraph 219a, which regulates the publication of information on abortion, have brought her not only notoriety but also hostility. She was, and still is, opposed by anti-abortion activists, harassed, and even receives death threats. To not lose courage, and to remain consistant on convictions, professional work, and activism, is quite a complex set of emotional and intellectual demands that we´re keen to explore from Dr. Hänel's perspective.
Dr. Hänel, a gynecologist, got fined €6,000 in November 2017 for stating that she performed abortions in her medical praxis, and provided information about abortion on her website. Anti-abortionists and the German radical initiative "Never Again" have sued her for allegedly breaking the law, based on §219a of the German criminal code, stating that anyone who publicly "offers, announces [or] advertises" abortion services is to be punished with jail or a fine.
Dr. Hänel announced publicly that she would not pay the fine, and has stated that she would submit her case to the German Federal Constitutional Court. She left the pro-choice medical information on her website, so eventually the prosecutor filed a lawsuit. In the German context, it is quite common that prosecutors don't file a lawsuit at all, or the physician agrees to pay a small fine and take the challenged information off their website. But Dr. Hänel doubled down. "Never Again" denounces her publicly on its website babycaust.de until present, which compares the abortion procedure to the holocaust, stating that today's abortion procedures are "an escalation" of the Nazi atrocities committed during World War II.
Since she went public with her case, Dr. Hänel - often referred to in media as the “abortion physician” - is facing harassment and receiving death threats on a daily basis. A growing number of citizens are mobilizing to demand the abolishment of §219a in the German criminal code, on which the verdict against Dr. Hänel is based upon. An online petition in support of this reform of the criminal code that Dr. Hänel handed over to the German Parliament has reached more than 150,000 signatures.
§219a was introduced in 1933 and hasn’t been changed much since then. For Dr. Hänel "this law is outdated, which is why it's hardly ever applied anymore. It is only used to bully and intimidate physicians". By March 2019, as the lawsuit against Dr. Hänel continued the governing coalition in Germany agreed on reform §219a. Providing information about abortions online is no longer punishable, yet physicians are not allowed to describe the procedures and are forbidden to advertise abortions for financial gain.
By 2022, the abolition of §219a has been decided. The German Federal Minister of Justice, Marco Buschmann, emphasised that this would put an end to an "untenable state of affairs" that forbids those who are best qualified to provide information on abortion. Kristina Hänel shared with news outlets that this decision filled her with joy and satisfaction.
We are dealing with a somewhat more complex problem. Basically, an unwanted pregnancy and an abortion, is a dilemma that is characterised by ambivalence and taboo, both individually and socially. The legal situation in the German context aggravates the problem for the affected patients, and for the professionals performing the abortion by the fact that not only the abortion itself is regulated in the criminal code, but that factual information is prohibited by §219a of the code. This paragraph has been used for more than 10 years by individual anti-abortion activists who have denounced several hundred physicians in recent years. The grouping of anti-abortion activists ranges from fundamentalist religious to right-wing milieus. They operate partly through advertisements, partly through "pavement harassment" on specific people in the streets, threats, and political influence. They are internationally networked and sometimes have other goals, such as Agenda Europe, which aims to restore what they call a "natural order".
I have been familiar with the issue for over 30 years. At that time when I started dealing with reproductive issues, we started performing abortions at Pro Familia in Giessen (Germany) and received strong hostility from evangelical anti-abortion groups who, for example, chained themselves in front of our operating rooms. For example, I had my name taken out of the phone book after receiving threatening phone calls.
Since the vast majority of the emails and letters I receive are positive and supportive, this far outweighs the agitation and painful attacks. Nevertheless, the constant subliminal feeling of threat always remains. Occasionally I contact the police, but since most of the theats come from internet-based platforms, it is usually difficult to trace. I think I can bear it better because I no longer have small children, as I did 30 years ago. So I'm no longer so vulnerable.
I think that without the signature campaign at change.org, my case would not have experienced such a large reach so quickly. But then all the hostility wouldn't have come so quickly either. That runs in parallel. I also only came across Twitter and engaged in it because of the whole situation surrounding my lawsuit. It allows me to pass on information quickly.
The workload has increased significantly. Not only do more patients simply come in, many call from all over Germany because they are stuck in their area and need support and advice. Some also come to me with completely different problems than an unwanted pregnancy because they think I am a fighter and that I can solve all their problems. Of course, this is a complete exaggeration and usually leads to nowhere. In addition, a lot of trainees want to learn in my practice and we can only accommodate so many of them to a limited extent. I see this as a positive development, since abortion is usually not taught either at university or in any form of continuous medical education or training.
I have experienced a lot of solidarity. Many individual colleagues from very different specialities, also from abroad, have encouraged me and expressed their solidarity. From the beginning, the German Women's Health Working Group (Arbeitskreis Frauengesundheit) has clearly supported the colleagues who have been denounced. My professional society, the DEGAM (German College of General Practitioners and Family Physicians), gave me the opportunity to publish a specialist article in the ZFA (the German Journal for General Medicine) and always supported me. Individual representatives of the professional association of gynaecologists and the DGGG (German Society for Gynaecology and Obstetrics) have also supported me.
That I can understand them when they shy away from confrontation, when they want to protect their families, their friends and themselves. That I would support them if they dare to stand by their convictions and, where they are, want to change the world a little bit for it to become a better, fairer, and more humane one. That satisfaction in the profession depends very much on whether medicine is "human", whether teamwork is truly functioning, and there is identification with the work that is being done. Once this is clear, then there is probably not a more exciting, more satisfying profession than ours.
The fact that any organization takes the opportunity to inform about the topic is already helpful. Furthermore, it is always helpful if factual and serious information on abortion is made available. "Doctors for Choice", for example, have compiled a lot of important information on their homepage.
We hope to inform, inspire, and encourage our readers with these interviews, and we look forward to sharing more fascinating stories from physicians around the world in the next instalments of our esanum Global Series, a joint editorial effort by the teams from esanum.de, esanum.fr, esanum.it and esanum.com.