Sexuality in Color: Reproductive Justice and the State

When I was in undergrad at a small liberal arts college, I was required to read a lot of texts by
20th century post-structuralist French philosopher Michel Foucault. I found these assignments incredibly frustrating not only because it's so difficult to spell Foucoult Foucault, but also because the texts were comprised of a lot of inaccessible academic theory. I liked a lot of his ideas that we talked about in class, like the social construction of identity and sexuality, but I found it hard to relate to my own lived experiences as I frantically flipped back and forth between my readings and the dictionary. The words were too big and the concepts were too abstract and complex for me to wrap my head around.

The only one of Foucault's ideas that really stuck with me was that of biopower, a phenomenon he described in which governments develop systems of controlling the bodies and reproductive abilities of their citizens in order to control the population as a whole. These systems and institutions (like schools, governments, the healthcare system, etc) fit together in a way that dictated the daily lived experiences of individuals. That was a concept that helped to frame my own world, although I had trouble really holding onto it for more than one class session or discussion.

Years later, thanks to the work of many activists and scholars since, I have a much more accessible framework for understanding these concepts and applying them to my daily life — reproductive justice. This is different from reproductive health, which refers to the access and delivery of healthcare services that concern reproductive and sexual aspects of our bodies' systems; and different from reproductive rights, which refers to the legal protection of each individual's right to access and make informed decisions about contraception, emergency contraception and abortion, etc. Reproductive justice is a framework that encompasses all of these aspects of sexuality and reproduction with the added lens of historical systematic oppression.

Another way of putting it? Reproductive justice advocates don't just want everyone to have access to birth control or quality sexual healthcare: They also aim to acknowledge and combat the institutional and social oppressions that inhibit the health and wellbeing of people in marginalized communities. We don't just want to put birth control pills into the hands of the people and call it a day — we want to examine all the different ways that identity and the dual forces of social norms and political structure (sociopolitics) influence how someone views their own reproductive health and sexuality, and address the factors in someone's life (like income level, education level, immigration status, minority race/ethnicity, disability, cultural upbringing, gender roles) that might prevent them from having ideal sexual and reproductive experiences.

Black women, for example, are less likely to receive on-time prenatal care, which has a direct correlation with higher rates of infant mortality and birth-related complications. When pregnant women don't regularly see a doctor (whether due to lack of insurance, lack of transportation or time off, etc), there is less opportunity for STI testing and treatment, resulting in things like higher rates of HIV transmission from mother to child in POC communities. These are the types of disparities that reproductive justice advocates are trying to address — the intersections of social justice issues (protective labor laws, fair wages, healthcare access, cultural stigma, interpersonal violence) with reproductive and sexual health outcomes.

The term was coined in June 1994 at the Illinois Pro-Choice Conference in Chicago by a group of black female activists in an effort to expand the then-dominant narrative beyond a woman's right to an abortion. While this was an important topic (especially given the continuing fallout after the Roe v. Wade decision of 1973), focusing on it alone left out the experiences of a lot of women and gender nonconforming people who had other issues impacting their reproductive health and wellness. While abortion is an important fundamental right, there are all sorts of injustices and disparities that need to be addressed. This concept provides a platform for advocacy organizations like SisterSong, Forward Together, and Trust Black Women in their missions to improve the mental, physical, and sexual health of Native people, immigrants, and queer and trans people of color worldwide.

It's not hard to find real-life examples of how intersecting systems of oppression affect the reproductive and sexual health of marginalized communities — just look to our current executive administration. Less than six months ago, President Trump put an end to President Obama's Deferred Action for Childhood Arrivals (DACA) program, which granted temporary deferral of deportation for those who were minors when they entered the country undocumented. The goal of Obama's executive order was to help provide a better quality of life and more stability for those whose parents had immigrated to the U.S. In certain states, additional rights were granted for DACA-approved individuals like driver's licenses and the ability to access state-sponsored health services.

This change came after Trump so famously made the comment on his campaign trail that people who immigrate from Mexico are "drug dealers, thieves, robbers, criminals, and killers," adding that these "predators and criminal aliens [...] poison our communities." He's also famously used the term "anchor baby," a pejorative term that refers to children who have earned U.S. citizenship as a result of being born on U.S. soil. These comments directly contribute to the xenophobia and racism that makes the lives of immigrants and non-immigrants of color that much harder, and adds to stigma that paints people of color as stereotypical "dangerous foreigners."

This amounts to more harmful effects than just thinly veiled racism; the proof is in the health disparities that can be observed in these communities. Although immigrant Latinx women make up at least 10 percent of women living in the U.S., they face significant obstacles to accessing healthcare. In most states, people of undocumented status are not able to obtain health insurance or coverage, but in states where they can access state-sponsored healthcare, like California, they have to wait for a minimum of five years after registering as undocumented.

For families making little income, five years without health insurance puts a lot of undue stress on their physical and mental health. For these families, serious injuries, illnesses, or even a pregnancy could force a decision between basic needs like food and shelter, and medical care, which no one should have to make. For folks living in particularly rural and/or conservative areas, there may not even be reproductive/sexual healthcare services to access (see Alaska, the largest U.S. state, which only has eight dedicated family planning clinics that are guaranteed to provide contraceptive counseling, STI testing/treatment, and abortion services). Even for those who aren't undocumented, there are many other barriers to accessing reproductive healthcare, including lack of affordable insurance options, poverty, lack of culturally and linguistically appropriate care, fear of apprehension by immigration enforcement, and bans on abortion access for women being held in immigration detention.

Not to mention, the Western medical system is built on centuries of exploitative and unethical experimentation of people of color (read more over at Sexuality in Color: The Foundations of Gynecology), which understandably creates deep-rooted mistrust for the medical establishment. All of these are a direct result of hundreds of years of institutionalized racism and colonialism combined with legislation intended to directly impact the access and knowledge that Native folks, immigrants, and people of color have to their own bodies.

When federal, state, and local legislation dictates whether and how people can afford (and healthcare systems can provide) treatments and services related to sexual and reproductive health, they are directly implicated in the resulting health effects. Our current administration is aiming to roll back protection of these rights and access, and this in turn contributes to the interconnecting web of social institutions that manage our collective biopower. And it's our responsibility, as advocates for reproductive justice, to consciously resist that force in order to protect access and positive health outcomes for all.

If you're saying to yourself: I'm just one person — what could I possibly do to affect these issues on a national level? I have good news for you — there are a million and one ways to be involved in the revolution. Contact your local representative. Volunteer for your local Planned Parenthood. Learn about access to contraceptives and reproductive services in your state. Support organizations that advocate for comprehensive and inclusive policies.

You have the biopower — now get out there and do something with it!