Feature: Women’s Health in the Age of Trump

by Rosemary Talbot Behmer Hansen

Reproductive justice has been defined as “the complete physical, mental, spiritual, political, social and economic well-being of women and girls, based on the full achievement and protection of women’s human rights” [1]. This concept becomes inclusive, however, when we acknowledge the words of the brilliant reproductive rights author, transgender person Cazembe Murphy Jackson: “in order for any of us to have a taste of reproductive justice, it must be available to all of us.” While this essay oftentimes uses the term ‘women’ to describe issues of reproductive health and justice, all people, including those who are gender fluid, gender queer, gender nonconforming, nonbinary and transgender are affected by changes in women’s health policy.

In the pursuit of reproductive justice, women’s health advocates have been challenged. Between declaring Mexican immigrants are “rapists,” bragging about grabbing women “by the pussy,” and condemning the reproductive health decisions of a 17-year old immigrant, President Donald Trump has proven to have political and personal interests in women’s bodies. In Trump’s America, where fact is up for both debate and negotiation, women’s healthcare and safety have become increasingly politicized. Notions currently found in the realm of abortion policy—ideas that permit women’s choices to be controlled by the public and state—are increasingly being applied to traditionally-less-controversial conversations about contraception, maternal health and sexual violence in the United States (US). In light of this shift in political discourse regarding women, standing in solidarity with those affected can be an effective first step in combating threats to reproductive justice.

The Public Cannot Be Held Responsible for Women’s Healthcare.

As of October 6th, the Trump Administration overhauled the contraception mandate, effectively allowing any employer to seek a moral or religious exemption from providing birth control coverage to their employees. Although the rule has been blocked by Federal Court District judges, the millions of women who had been receiving free or reduced-cost contraception under the Patient Protection and Affordable Care Act (ACA) and the 99% of US women between the ages of 15 and 44 who have used some form of birth control in their lives for family planning, STI protection and/or chronic health conditions have reason to fear.

Also problematic is the Trump Administration’s desire, simultaneous with their overhaul of the contraception mandate, to remove funding for Planned Parenthood services, which provide essential sexual and reproductive healthcare in over 650 clinics across the country to low-income women. When Planned Parenthood was defunded in Texas, for example, rates of teen births surged and “up to thousands of women faced gaps in health coverage.” Similarly, the state’s reduction of teen pregnancy prevention research programs only serves to decrease adolescent access to vital healthcare services.

All attempts to limit public access to contraception threaten the health, wellbeing, and livelihoods of women. To do this on the grounds of moral complicity are murky: if employers wish to not be complicit in supporting women’s healthcare, why not just avoid hiring women altogether? At the core of these policies is the notion that the public should not be expected to support the health of women. This idea isn’t without precedent in the US: the Hyde Amendment blocks federal funds, and by extension taxpayer dollars, from funding abortion for poor women with Medicaid. Even though abortion access is a human right according to the United Nations Human Rights Council, this legislative provision has been renewed each year since 1976.

Women’s Health Decisions Can Be Regulated by The State.

In October we saw the drama surrounding abortion unfold most disturbingly in Jane Doe’s case, when, due to legal stonewalling from U.S. and state officials, a 17-year old immigrant from Central America sought the ability to get an abortion from a federal judge. After a series of protests and appeals, she ultimately obtained an abortion. While abortion procedures are safer than tooth extractions, it is troubling to note that federal discussions regarding the legitimacy of her surgery postponed her procedure to a later gestational date and therefore increased her risk of surgical complications.

On a macroscale, the Trump Administration internationally limits reproductive choices of women under the reinstated Mexico City Policy or Global Gag Rule, where NGOs overseas are denied funding if women are provided with abortion information, counseling or services. The US also stopped funding the international family planning and reproductive health activities of the United Nations Population Fund for similar reasons. It is worth mentioning that, historically and today, those disproportionately impacted by state interference in reproductive rights are poor, young, marginalized and oftentimes minority women [2]. The problematic nature of the US government’s recent meddling in women’s personal reproductive choices was summarized well by Jane Doe herself: “People I don’t even know are trying to make me change my mind… I made my decision and that is between me and God. Through all of this, I have never changed my mind.”

Women Can Be Controlled via Threat.

In September the House of Representatives passed an appropriations bill that included an amendment to repeal the Reproductive Health Non-Discrimination Act of 2014, which made it illegal for employers to target workers for their reproductive decisions such as “going on birth control, deciding to have a child, or opting for an abortion.” This bill threatens the safety of women in the workplace [3]. In October, Education Secretary Betsy DeVos’ department released new campus sexual assault guidelines which permit schools to implement a higher burden of proof in evaluating sexual assault cases—a roll-back of previous guidelines issued by the Department of Justice’s Civil Rights Division in 2011. This is an enormous loss for young women, given that one in five women are sexually assaulted while in college and that underreporting of such events were already commonplace.

President Trump’s own actions have further fueled a culture of intimidation and violence towards women’s livelihoods. He tweeted images of hitting golf balls at Hillary Clinton and has led “lock her up” chants at his rallies., When he stated that he could “stand in the middle of 5th Avenue and shoot somebody and [he] wouldn’t lose voters,” President Trump was tone-deaf to all people, and especially to women given that women are victims of approximately 85% of intimate partner homicides, 50% of which are committed with firearms. While he suggested that the 1/3 of US women who obtain abortions should be punished (later retracted), he has also boasted about his own history of sexually assaulting women. Indeed, President Trump himself has been accused of sexual assault, and while many offenders are increasingly removed from their positions of power (thanks in part to the #MeToo and #TimesUp Movements), Trump remains.

Moving Forward.

People’s abilities to protect and control their bodies are not merely abstract, philosophical or ideological issues; they are personal issues, health issues, family issues, and economic issues [2]. We have already seen the detrimental impacts of stigma on the health and wellbeing of women in the realm of abortion care. In Trump’s America, where issues of broader women’s health become politicized, more and more women are marginalized. The topic of women’s healthcare and safety has become increasingly stigmatized, up for debate, and violent.

In the age of Trump, many commentators worry that the American public has become numb to racist, homophobic, ablest, ageist and sexist comments. As well as being inherently problematic, this public numbing directly threatens women’s health, as the movements of racial justice, disability rights, immigration reform, reproductive justice and LGBT justice are all intricately linked. Justice for all people includes the pursuit of systemic, evidence-based policies regarding safer housing, affordable childcare and paid family leave policies, and livable minimum wages.  We must engage in dialogue regarding women’s health with a focus on reality: society is not strong without healthy women.

It is time to stand actively with our black, brown, female, transgender, nonbinary, dreamer, undocumented, lesbian, gay, incarcerated, veteran, elderly, and disabled neighbors by embracing the ethic of solidarity. This fellowship, “arising from common responsibilities,” calls for us to learn, speak and fight for justice for one another– even if we ourselves are not being directly targeted or harmed at that moment. The world was given a lesson in solidarity in January of 2017—the day after President Trump’s Inauguration– when over four million women and allies rallied for a host of intersectional rights. While The Women’s March was held in Washington D.C., 673 other Sister Marches were held in transnational solidarity around the globe. Combined international marchers totalled an estimated 300,000 people.

Women have led the resistance into 2018 with passionate fights for justice of all forms, in all locations and for all people. The world has never seen an uprising quite like this one, where previously-unspoken stories– including those of sexual violence and harassment in the #MeToo Movement — are finally being told. In the face of threats to life, health and dignity, one thing has become obvious in Trump’s America: women will rise together. We can all stand to learn from these leaders, for as poet Muriel Rukeyser observed [2]: when even one woman tells the truth about her life, the world splits open.

Rosemary Talbot Behmer Hansen is a dual degree graduate student at Case Western Reserve University (May, 2018), pursuing both an M.A. in Bioethics and an M.P.H. with a major in Health Policy & Management. Her academic interests include issues in women’s and reproductive health and she currently is involved in research at Preterm with Dr. Henry Ng and Dr. Natalie Hinchcliffe, the Case Western Reserve University School of Medicine with Dr. Kavita Shah Arora, and the MetroHealth Institute of Burn Ethics with Dr. Monica Gerrek. She lives in Cleveland with her husband Ryan Hansen and hopes to one day become an OB/GYN.

Endnotes

[1] Ross, Loretta. “What is Reproductive Justice?” Reproductive Justice Briefing Book: A Primer on Reproductive Justice and Social Change (2017).

[2] Briggs, Laura. How All Politics Became Reproductive Politics: From Welfare Reform to Foreclosure to Trump. Oakland: University of California Press, 2017.

[3] The deadline for passage of the federal budget has been deferred due to lack of consensus on several issues, including immigration, veterans health, military funding, and CHIP. As of the final editing of this manuscript on February 6, 2018 the budget has not been approved.

 

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