The Other Side of Reproductive Justice: How Sterilization and Other Forms of Coercion Are Used Against "Unworthy" Parents

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Earlier this fall, a committee of the Parliamentary Assembly for the Council of Europe held a hearing entitled “Putting an end to coercive sterilizations and castrations.” This debate continues today, November 21, 2011. What is remarkable about this is not the outcome or the discussion, but rather that it was necessary at all. After all, most parliamentary debates about contraception and childbearing these days seem to be about how to make women have more children than they want, not less.

However, if we scratch the surface a bit, it becomes clear that two seemingly contradictory political discourses happily coexist. On the one hand, policy-makers push for limits to contraceptive access for women, generally speaking. And on the other, they enforce policies that criminalize, condemn, or render impossible the reproduction of specific subgroups of women (and men), who for various reasons are seen as undesirable parents: Roma women, lesbians and gay men, transgender people, indigenous women,injection drug users, women living with HIV—the list goes on.

In this connection, coercive sterilizations and castration are at the extreme end of a spectrum that also includes criminal sanctions for drug use during pregnancy and barring LBGT individuals from in-vitro fertilization services and adoption, as well as a host of other policies geared at making pregnancy and parenting difficult for those deemed unworthy. In fact, the more “unworthy” the individual or group is considered by the general public, the more explicitly coercive the measure to limit their possibility for parenting. So much so that by considering the lengths to which a government will go to prevent certain individuals from procreating, we can gauge the extent of the stigma they face.

For example, it would probably no longer be politically viable to implement quotas for the sterilization of indigenous women, as the Peruvian government did in the 1990s, yet Roma women and even just poor women are still routinely sterilized without their consent in several countries. Lesbian women are rarely forcefully sterilized, yet they are often excluded from becoming adoptive parents or from benefiting from in-vitro fertilization processes. Many countries require transgender individuals to be sterilized before they can legally change their names or papers to reflect their preferred gender, and intersex individuals are often assigned a sex—and in the process rendered infertile—as infants and certainly before they can give meaningful consent. The most restrictive and invasive intervention, forced castration, is reserved for convicted sex offenders who, in turn, arguably are seen as the most unworthy and reviled of all.

As a human rights issue, coerced sterilization and castration are in many ways no different from other limitations on individual reproductive choice: they violate a number of fundamental rights, including the rights to health, privacy, and physical integrity. Additionally, they make discrimination and public contempt visible and as such can help target policy interventions to alleviate abuse.

But a more interesting aspect of the practice of coerced sterilization is that it crystallizes the hypocrisy of the limitations to reproductive rights. When I did research on access to abortion in Mexico in 2005, for example, I found that rape victims routinely were denied services they, by law, were entitled to, whereas sex workers and women living with HIV who were applying to the same hospitals for the same services were offered abortions they did not need and that would technically have been illegal.

When Parliamentary Assembly for the Council of Europe continues its debate on forced sterilizations on Monday, it would do well to think through in what other ways it can support individual choices on when, if, and with whom to become a parent. Only just a year ago, the Assembly refused to recommend adequate regulation of conscientious objection in the medical profession, a move that probably already has contributed to the denial of care to many women across the continent.

These are not separate issues. The Roma woman who is forcefully sterilized suffers as much as the one who is denied an abortion or other needed care. Everyone must be allowed to make individual and responsible decisions about parenting and procreation.

Sexual Harassment: Not Really About Sex At All

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This week, a national study found that sexual harassment affects about half of the students in grades seven to 12. Some might see this as an indication that there is too much talk about sex in our schools. They would be wrong. Others have chalked it up to teenage hormones and suggested that we leave well enough alone. They would be equally wrong.

Sexual harassment is nothing new. In 2008, a study found that just over a third of middle and high school students had been sexually harassed. The National Coalition for Women’s and Girls Education put the percentage at almost 90 in 1997. And, indeed, discrimination based on gender has been an actionable offence under Title IX of the Education Amendments since 1972, and since then the courts have applied Title IX to various types of sexual harassment.

But the motivation for sexual harassment seems to be shifting. Bill Bond, a school safety expert for the National Association of Secondary School Principals, notes that attempts to exploit fellow students sexually have become less common, and that now students seem to use sexual remarks to degrade or insult someone else.

This sense, that sexual harassment nowadays is more about hostility than about sex, was validated by the study published this week as well as by the study published in 2008. Both concluded that most sexual harassment in middle and high schools in the United States is directed at girls and at children suspected of being gay or lesbian.

Where straight girls are targeted, the harassment is generally about their level of sexual activity, which is either deemed too much (they are “sluts”) or too little (they are “prudes”). In the case of youth who are thought to be gay, it is the mere fact that they might even want to have sex that is “wrong.”

In other words, the more frequent type of harassment suffered by children today—and the one they report as affecting them the most negatively—is expressing hostility at children who do not fit into some preconceived notion of what “normal” sexuality is. Normality in this connection apparently means that girls must display a level of sexual activity that can go unperceived (neither too much nor too little), and that everyone should be straight.

Or to be a bit more blunt about it: sexual harassment in middle and high schools today is motivated by either misogyny or homophobia. Neither has to do with sex. And neither would be helped by treating sexual harassment between children as a result of overactive hormones to be dismissed.

In fact, the solution is just the opposite: active and broad engagement about sexuality and sex roles. Because misogyny and homophobia are fuelled by ignorance and fear. And ignorance and fear can be fought with knowledge.

Unfortunately, broad knowledge-building is not generally the objective of sex education in US middle and high schools. At best, sex education deals with sexuality as a matter of biology: how do male and female bodies engage in (heterosexual and procreative) sex. At worst, the message is that all sex is bad unless you are married and want to procreate. These types of sex education do not transfer much needed tools to our children as they grapple with their evolving sexuality. Indeed, by ignoring (or vilifying) sexuality altogether, limited sex education may instead feed the fear that expresses itself as sexual harassment.

Comprehensive sex education, on the other hand, provides the broader knowledge our children need and want. At its best, comprehensives sex education engages children on their own level of comprehension in a conversation about what sexuality means, how to relate to ourselves and each other with respect, and how to make responsible and informed choices about our sexual and reproductive lives. Comprehensive sex education not only combats the fear and stereotypes that fuel sexual harassment, it also works in terms of delaying the age of sexual initiation and lowering the number of teenage pregnancies.

All children have a right to comprehensive sex education. Giving them the information they need and are entitled to has obvious benefits for their reproductive and sexual health. It is also a way to reduce the chances that they will subject their peers to sexual harassment.

Sacrificing Women's Rights For "Popular Rule:" Why Equality is Essential

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Over the past week Libya’s interim prime minister Abdel Rahim al-Keib has made numerous statements about human rights, at times announcing high priority to the protection of rights in his administration, at others hinting that some Libyan citizens (notably women) shouldn’t expect too much.

Judging from experiences in other countries women may not fare better after a dictatorship or autocratic rule than before it.  In 2009, Afghan President Hamid Karzai signed a bill that made women subordinate to men, allegedly in an attempt to win votes. And earlier this year, peaceful female demonstrators in Egypt were submitted to forced virginity tests and brought before a military court a full month after Hosni Mubarak had resigned.

Setting aside for a moment the question of whether the current political set-ups in Egypt, Libya, or Afghanistan are more democratic than what came before, it is valid to ask whether women’s rights often are sacrificed for the sake of popular rule.  In last month’s Tunisian election, the Islamist party Ennahda won approximately 40 percent of the votes, making many worry that this country, with arguably the most advanced legal protections for women rights in the region, might slide backwards. Others countered that Islamism and feminism aren’t necessarily opposites but can, in fact, be linked.

The truth of the matter is, however, that without certain potentially unpopular back-stops to protect the rights of the disempowered, majority rule (or ruling party rule) does not always protect equal rights for all.  Indeed in the most extreme cases, state officials accused of wanting to annihilate entire groups of people within their own country can be democratically elected.

It is noteworthy that governments seeking to limit the human rights of a particular group often use the same justifications, regardless of geography or political set up.  The two most popular excuses are these: 1) our culture does not support that kind of thing; or 2) we just have a different way of doing it. 

When the first type of justification is used—such as for example in the case of rampant and very violent homophobia in Uganda and Nigeria—any criticism is highlighted as external interference with “our way of life” and ascribed to neo-colonialism or worse. This happens whether the criticism comes from in- or outside the country itself.

When the second type of justification is used—such as for example when Princess Loulwa Al-Faisal of Saudi Arabia said that women in her country are better off than in the west because “men have a duty to look after them”—those who push for more inclusive policies are simply seen as misguided: they just don’t understand.

To be sure, notions of equality, including gender equality, as a social good have not been static throughout history and the expression of what equality looks like varies a lot even within countries.  While I believe that equality is absolutely essential to human dignity, I therefore accept that this belief has not always been as broadly accepted as it is now.  

But perhaps the more interesting question in the juxtaposition of women’s rights (or gay rights, or ethnic minority rights) and democracy is not whether some people’s rights are sacrificed for popular rule (they are), but rather whether they should be as a matter of principle (I think not).

For me this is more than just a question of conviction.  Equality has proven to be intrinsically linked to happiness, health, and peaceful societies.  In comparative studies, those societies with more equitable distributions of wealth do better than more unequal neighbors on a number of social parameters such as infant mortality, crime rates, and individual contentment.  Moreover, we already know that where violence against women surges, general violence is likely to grow too.

So next time someone questions the support for the rights of a specific group of people, you might want to ask them if they support those same rights for themselves.  Not to show them up by highlighting their hypocrisy—though that might be an added benefit—but rather to make the point that we are all interdependent. Libya’s prime minister would do well to remember that too.



Violence Against Women: Not Going Away Until You Do Something About It

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This article contains absolutely nothing new about violence against women. That’s because we already know everything we need to know about it. Everyone knows it exists. Most people would say it’s a pretty bad idea. And yet it doesn’t go away. To say it’s annoying would be a serious understatement.

In the many years I have worked on women’s rights, violence against women has been a constant. Violence as an obstacle to health care. Violence as a barrier to education. Violence as an inevitable fact of life.

I am tired of it: violence against women may be a current fact—every 3 minutes a woman is beaten up -- but it is not inevitable. So here are my top three key recommendations for how you (yes: you) can make it stop before it even starts:

1. Value women’s work

Women earn 20 percent less than men in the United States. This pay inequality contributes to make women financially dependent on men and therefore stay in violent relationships. The United States needs federal legislation to guarantee women equal pay for equal work.

Basic labor protections in the United States exclude some professions that are dominated by women, such as domestic work. Part time workers in any profession are entitled to less labor market protections than those working full time, prompting some to leave the work pace all together when they have kids. This does not make them less vulnerable to abuse. In fact, rather the opposite. So, until women are valued at work it’s unlikely they’ll be properly valued at home.

2. Stop stereotyping women.

We all do it: stereotyping. We stereotype children (erratic), grandparents (indulging), and fathers (aloof). We also stereotype women, and politicians base policies and laws on these stereotypes. For example, when states obligate a woman to wait 24 hours before she can have the abortion she already decided she needs, it is based on a stereotype of women as irrational and changeable.

Some stereotypes contribute to justifying domestic violence, because they set out expectations for female behavior that, if breached, serve as an excuse for abuse. “My man doesn’t beat me,” one young woman told me proudly on the playground the other day when I disclosed I work on women’s rights. “Because I don’t give him reason to: I have dinner ready when he comes home.”

Maybe this example is extreme, but the next time you make assumptions about what men and women “should” do, ask yourself where the notions come from and if they could be used to justify abuse.

3. Make some noise.

It’s been said before: in countries where the elimination of domestic violence is seen as a political priority, supported by policies, discourse, and money, the prevalence of violence does go down over time. And at the local level, we see time after time that in those societies or communities where intimate violence is stigmatized and reviled, it abates. Making noise works.

But at an even more local level, you should start making noise among your friends. If a woman is beaten up every 3 minutes, chances are someone you know has either faced violence or meted out abuse. They need to know where you stand: talk about violence as unacceptable and question policies that stereotype women.

They might find you annoying. But not as annoying as another decade of domestic violence and abuse.

UN Special Rapporteur: Abortion Restrictions Don't Work

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Restrictions on abortions just don’t work in that they don’t result in the desired outcome.  This is the predictable, yet bold, conclusion of a report to be presented at the United Nations on Monday, October 24th by Anand Grover, a UN-appointed independent expert on health.  The report, which is part of an annual report-back from various human rights experts to the United Nations’ General Assembly, consolidates years of legal analysis and empirical evidence from other experts and concludes that abortion restrictions are unworkable and damaging to women’s health. Instead, the report advocates access to full, accurate, and complete sex education and information about contraception, as well as to all forms of modern contraception, because these services and state support for women’s equality actually do work to reduce the need for abortions.

Abortion restrictions are generally justified by reference to a desire to lower the number of terminations, be it by limiting access to abortion for all women, as in Chile, El Salvador, and Nicaragua, or just for the “undeserving,” as in most of the rest of the Americas including the United States. Some explicitly prefer pregnant women to die rather than having access to a life-saving abortion, but most refer to some sort of makeshift hierarchy of morals. 

“Most people, of course, should have access free of charge,” a high school friend from Denmark told me the other day. “But women who just keep having abortions: there really should be some sort of punishment for them.”

I have heard this sentiment echoed so many times.  “Seriously, I believe in access to abortion,” a young Mexican friend told me. “But really women need to show a minimum of responsibility.” This friend had, in the course of the same conversation, told me he recently had a condom break during intercourse.  When asked if he believed the woman in that case, if she were to become pregnant, had shown the requisite minimum of responsibility he was confused and horrified.  Of course she should have access to an abortion.  At least they had tried. 

These considerations about who, if anyone, deserves access to abortion are often at the core of public debate on the issue.  All but the most radical anti-choice activists would say that pregnant rape victims should have access, as well as those whose lives or health are threatened by the pregnancy.  This distinction between the vulnerable madonnas and the physically healthy sluts is, in fact, the bright line in determining public funding for abortion services in the United States today.

The truth of the matter is that abortion restrictions in law and policy have little if anything to do with how women and girls deal with their pregnancies.  Of the hundreds of women I have spoken to about their abortions, none mentioned the law as a deciding factor in whether or not to continue an unwanted or unhealthy pregnancy. Sure, the criminalization of abortion might be an impediment to getting a safe and timely abortion, but never a real barrier to getting one at all.

In fact, the only two questions policy-makers can helpfully ask themselves about their approach to abortion are 1) is it workable; and 2) does it actually work.

Most policies that allow only partial access to abortion for the “deserving” women are not all that workable. You need a process for determining the validity of rape claims, for example, and a solid definition of just how unhealthy a pregnancy needs to be to be unhealthy enough for the woman to be entitled to care.  In Ireland, where abortion is only theoretically legal for women who will die as a result of their pregnancy, a doctor asked me in visible distress: “How terminal does she have to be?  Can I help her if she has a 51 percent chance of dying, or does it have to be more?”

The notion proposed by my Danish friend—that irresponsible women who just have one abortion after another need to be punished—is equally unworkable.  How do you determine responsibility? And how many abortions are too many?  And what would be an appropriate punishment?  Carrying the pregnancy to term?  For many, the key moral question in the abortion debate is whether women who want their pregnancies terminated actually care.  But any policy based on a value-judgement on that count raises more ethical questions than it solves.  It is not workable.

Spread the word: abortion restrictions just don’t work.