This healthcare provider has a long, politically-charged history. The first clinic, focused on administering birth control, was founded by Margaret Sanger, Ethel Byrne and Fania Mindel in Brooklyn. Sanger was jailed 30 days after opening the clinic for violating the Comstock law. This

federal law was passed to suppress the “trade in, and circulation of, obscene literature and articles of immoral use”, and criminalized sending information related to erotica, contraceptives, abortifacients, sex toys, letters alluding to any sexual content or information. This law made communication about advances in reproductive healthcare essentially illegal.

Although Sanger is infamous for participating in racist eugenicist politics (PP’s fave is definitely problematic), the lasting legacy of Planned Parenthood has been about empowering women to make their own decisions about reproductive healthcare. This makes the organization a perfect target for the Trump administration.

However, what kind of policy maneuvers will the Republicans have to make to actually “defund” Planned Parenthood? It turns out that the majority of the money that the organization gets from the federal government is from Medicaid reimbursements.

According to Planned Parenthood officials, “Just like other kinds of health insurance, Medicaid reimburses Planned Parenthood’s doctors and nurses for the preventive medical services they provide, including life-saving cancer screenings, HIV testing, and Portia contraceptive and birth control options.” They further explain that the federal government doesn’t provide direct, open funding in the form of a blank-check style grant.

In this way, the incoming administration would have to go after Medicaid funding and programs like Title X, a federal program that provides funding to reproductive healthcare programs that include, but are not limited to, Planned Parenthood clinics. There is no legislation that gives money to Planned Parenthood that Republicans can repeal.

This means that the Republicans can’t just vote to shut down the PP clinics. Instead, they will have to play the long game and dismantle the healthcare system itself to really achieve their goal of disabling Planned Parenthood. It’s not that this is impossible — a lot of change (and damage) can happen during a united Republican government. But this change will not happen immediately or easily.

The conversation about Planned Parenthood “losing funding” is fundamentally about healthcare policy. Obamacare brought some necessary changes to the American system by incorporating guaranteed issue of basic, primary care into all insurance plans and creating the individual mandate that all people must be paying into the new system.

However, many experts argue that the biggest problem with American healthcare is the sheer complexity of the system. Most other developed nations have simpler, streamlined systems where every person has access to the same care, while in the United States there are many different systems for different classes of people. Not only does this

highlight the inequalities between social groups in America, it also contributes to the administrative nightmare that is American healthcare.

For more information about comparative healthcare policy, check out T.R. Reid’s The Healing Of America.

Genuine Justice is a column about reproductive justice focusing on current events, historical perspectives and systematic racism in women’s healthcare.

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There are several dead men named as the “father” of different areas of medicine, but the most shocking is the father of gynecology: Dr. J. Marion Sims. This man was an American slave owner who practiced medicine in the mid-1800s.

Among his many medical experiments and achievements, Sims is widely recognized for his development of gynecological practices that are still in use today. Yes, this man is responsible for an early form of everyone’s favorite, the vaginal spectrum. Useful as it is, I wonder if a better, more comfortable alternative could be found if women had been present in the medical establishment from the beginning.

Dr. Sims misdeeds only begin with the spectrum. He experimented with new surgical solutions to a condition called vesicovaginal fistula, which is a particularly nasty condition that can happen during extended childbirth. He is credited with finding the first surgery that consistently repaired vesicovaginal fistula, something that generations of doctors had tried to solve. However, this important breakthrough in surgery was possible because Dr. Sims experimented on slaves who were subject to his trials without their consent.

Of the fourteen slaves he did experimental gynecological surgery on, he named three of them in his records: Anarcha, Betsy, and Lucy. All three of these women suffered from vesicovaginal fistula. Dr. Sims operated on Anarcha over thirty times. It is important to note that Dr. Sims did not use anesthetics in his experimental surgery, even though they were available at the time.

According to Harriet A. Washington’s book about the history of medical experimentation on black people, Dr. Sims would never have been able to conduct so many experimental surgeries without exploiting slaves, because no white women would have agreed to it. Also, Dr. Sims believed that black women could endure more pain than white women, which is a dangerous and untrue stereotype that still exists today. This is one of the reasons why he never used anesthetics during his experiments.

The idea that black people can endure more pain than other groups comes from the history of undervaluing black people in America. Slave owners perpetrated the idea that black people could work harder and for longer because they are biologically different from white people, who could not withstand the same work.

Like many other manifestations of racism, this concept that black people are somehow unable to feel pain persists. Many white medical doctors believe that black people are biologically different from white people and allow this belief to inform their medical practice. The result of this, among other things, is that black people are substantially less likely to receive pain relief medication than white people.

The story of Dr. Sims and how he was named the “father of gynecology” is one of anti-blackness. It is important to know these stories that create the foundation for medicine, politics, and other areas of our lives. Without an uncensored understanding of how the modern systems of oppression were formed, it is unlikely that we can move forward and create real change.

Genuine Justice is a column about reproductive justice focusing on current events, historical perspectives and systematic racism in women’s healthcare.

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The 1960s are often referenced as a time of liberation in American culture. Free love, drug use, and social movements including women’s liberation and civil rights for Black Americans dominate popular discussion of the 60s. However, during this time of widening freedom for many social groups, Native American women were facing renewed discrimination and violence by the U.S. government.

According to a 2005 study published in Wicazo Sa Review, “from the early to mid-1960s up to 1976, between 3,4002 and 70,0003 Native women—out of only 100,000 to 150,000 women of childbearing age— were coercively, forcibly, or unwittingly sterilized permanently by tubal ligation or hysterectomy.”

Dr. Connie Pinkerton-Uri, a doctor of Choctaw and Cherokee heritage, was the first to notice the pattern of forced sterilizations done by the Indian Health Services (IHS) system. In November of 1972, a 26 year old patient asked Dr. Pinkerton-Uri for a “womb transplant” because an IHS doctor had performed a hysterectomy on her when he diagnosed her with alcoholism. After seeing two other patients who were forced to undergo sterilization by the IHS, Dr. Pinkerton-Uri started to investigate.

One tactic that the IHS routinely utilized was to sterilize women without their consent during other, unrelated surgical procedures. For example, performing a routine appendectomy and then also doing a tubal ligation without consent. According to the American Indian Quarterly in 2000, at least 25% of Native women between the ages of 15 through 45 were coercively sterilized during the 1970s. This is an overwhelming portion of the population.

The Guttmacher Institute finds that today, 25.9% of women have undergone some type of sterilization surgery as their chosen method of contraception. For the rate of Native women who were forced to have a sterilization to be the same rate as the amount of women who haven chosen to have the procedure done demonstrates how far this systematic sterilization campaign went.

It is important to analyze this injustice in the broader context of the relationship between Native people and the United States government. Since the first  Europeans came to the Americas, they have sought to manipulate and eventually exterminate Natives. This happened in many regions of the Americas — indigenous people in what is now Canada, the United States, Mexico, and Central and South American countries were all targeted and brutalized by European settlers. In this way, the violence of forced sterilization is nothing new and in fact only continues the history of genocide of Native people by the U.S. government; according to international law, targeting racial groups and trying to prevent them from giving birth is an act of genocide.

This has had a grave impact on Native communities. Dr. Pinkerton-Uri found that the IHS “singled out full-blooded Indian women for sterilization procedures.”, and had a larger initiative to reduce the birthrate of Native American tribes. From the 1970s to the 1980s, the birthrate among all Native tribes dropped drastically.

The impact of forced sterilization on individuals and communities cannot be overstated. It is one of the most violent ways that the state can destroy a person’s bodily autonomy. Because of the severity of this issue, I will be writing in later columns about other groups that have been targeted by the U.S. government, including Black and Latina women.

Genuine Justice is a column about reproductive justice focusing on current events, historical perspectives and systematic racism in women’s healthcare. 

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Yet, like all things, the language we choose to use when discussing this topic is important and affects what we say. So I wanted to highlight the differences and similarities between the terms reproductive health, reproductive rights and reproductive justice because they aren’t interchangeable (like I once thought).

Reproductive health is a fairly straightforward concept. It’s the health and healthcare

services related to human reproductive systems. Natal care, STI treatment, HPV vaccination and use of contraception are all aspects of reproductive health.

Although easily stated, reproductive health is not easily understood by the American population. According to the Center for Disease Control last November, “The approximately 1.4 million reported chlamydia cases – odds of getting chlamydia are above the average, a rate of 456.1 cases per 100,000 population, is up 2.8 percent since 2013. Rates of primary and secondary (P&S) syphilis – the most infectious stages of syphilis –and gonorrhea have both increased since 2013, by 15.1 percent and 5.1 percent, respectively.”

Of course, there are an incredible number of health determinants that affect reproductive health. But something simple to draw from these statistics is that reproductive health can be tricky, especially when it comes to accessing reproductive healthcare services. This is why it’s important to understand the next two terms, reproductive rights and reproductive justice.

The term reproductive rights may be the most widely used in public dialog about women’s health. Loosely, it is understood to mean “a woman’s right to choose” and is closely associated with abortion. For more about abortion, check out these additional resources.

Use of the word “rights” indicates the legal aspect of fair reproductive healthcare access.

Legal access to abortion is a highly politicized issue in American culture today, but this wasn’t always the case. At the founding of the United States, abortion was much easier to attain than today. According to Rickie Solinger in her book “Reproductive Politics”, women could ask any doctor for an abortion until quickening – when the woman felt any movement fetal movement. It wasn’t until 1821 that Connecticut’s predominantly Catholic population moved to outlaw abortion state-wide. By 1910, every state in the union had anti-abortion laws.

In the 1960s, the reproductive rights movement took off and continued on with the formation of many advocacy groups, including the National Abortion and Reproductive Rights Action League (NARAL Pro-Choice America) and the Committee for Abortion Rights and Against Sterilization Abuse (CARASA).

Reproductive justice broadens the aforementioned concepts by including economic, social and health factors in the conversation. Issues like steady access to WIC (a public program that helps feed mothers, infants and children), publicly supported child-care, an end to forced or coerced sterilization and comprehensive sex education in schools are all central to reproductive justice. While reproductive health and rights are a necessary foundation, advocates working for reproductive justice understand that a lot more goes into decision-making and autonomy than just those factors.

This more holistic approach was pioneered by women of color. While white women led the fight for abortion rights in the 60s, women of color were working together to ensure that women have more options and approaches to live a balanced life. Jennifer Nelson’s book “Women of Color and the Reproductive Rights Movement” cites many organizations formed by women of color during the women’s movement, including CARASA, the Redstockings, the Third World Women’s Alliance, and the National Welfare Rights Organization (NWRO). Given the importance of these organizations to reproductive justice, I plan to profile some of these groups and their leaders later on in this column.

Genuine Justice is a column about reproductive justice focusing on current events, historical perspectives and racism in women’s healthcare. 

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