In March, I began consulting with the New York City Department of Health and Mental Hygiene’s Bureau of Maternal, Infant and Reproductive Health around engaging community stakeholders on health equity and reproductive justice. I was initially intrigued because this was the first time I’ve heard of a city health department being interested in incorporating the reproductive justice framework into their work. Last week, the DOHMH held a community gathering of 65 local organizations on how to engage the community in this work, and I assisted in introducing the reproductive justice framework to those in the room who were not familiar with it. It was a great opportunity to assist the DOHMH in utilizing the reproductive justice framework in their work as they connect with local providers, community groups and activists, and I look forward to working with the DOHMH as they become more engaged with the New York City community.
During my presentation, I broke down the differences between the reproductive health, rights, and justice frameworks into two using Forward Together’s groundbreaking report A New Vision for Advancing Our Movement for Reproductive Health, Reproductive Rights, and Reproductive Justice (2005):
Reproductive Health: A service delivery model that focuses on addressing the reproductive health needs of women. The people affected are patients in need of services and/or education, and the key players are people who work as, or are allied with, medical professionals, community and public health educators, health researchers, and health service providers.
Reproductive Rights: A legal/advocacy based model that focuses on the protection of an individual’s right to access to reproductive health services. The people affected are individuals who are encouraged to actively participate in the political process, and the key players are people who work as, or are allied with, advocates, legal experts, policymakers, and elected officials.
Reproductive Justice: A community organizing model that focuses on intersectionality as a way to organize communities to change structural inequalities. The people affected are community members who are organized to lead against reproductive oppression and other injustices, and the key players are people who work as, or are allied with reproductive rights, reproductive health, and social justice and other justice organizations.
To go further, I used a health topic to demonstrate how it could look under each of these frameworks. Let’s take a look at an example on minors consenting to HIV treatment in New York State:
Concern: While minors can consent to HIV testing without parental consent in NYS, they currently cannot consent to HIV treatment without parental consent
RH: Although NYS law does not explicitly allow minors to consent to medical treatment, some adolescent HIV providers allow minors to consent to their HIV medical care, based on the minor’s maturity and individual circumstances. Also, HIV is typically viewed separately from reproductive health issues.
RR: Governor Cuomo recently endorsed a list of 30+ recommendations from leading HIV/AIDS providers, activists, and experts (called “The Blueprint”) on ending AIDS as an epidemic in NYS in the year 2020. Included in the recommendations is advocacy for minors to consent to treatment without parental involvement
RJ: Youth who identify as gay, lesbian, bisexual or transgender are at higher risk of HIV infection due to lack of access to primary care that can address the needs of LGBTQ youth, possibly not being “out” to their family, higher rates of homelessness, lack of HIV education, substance use, etc.
I thought this could be a good exercise to share with you all as a way of discussing how various health-related topics can be viewed under each framework. This can aid in generating more discussion on how interconnected these frameworks are and how we can find ways to make more advancements for our clients, our rights, and our communities.
Here are some health-related topics and suggestions for how they fit under each framework to consider. There are many ways you can do this, so feel free to use these examples to create your own:
Abortion (options counseling, Roe v. Wade, abortion as a right for communities of color but not as a primary focus)
Birth Control (education on contraception options, health care plans covering contraception under the Affordable Care Act, higher promotion of long-acting reversible contraception (LARC) among women and girls of color)
Comprehensive Sex Education (training for teachers and health educators, funding towards abstinence-only curriculum in schools, connecting sex education to spirituality/religion)
HIV (testing and treatment, confidentiality laws and disclosing to partners, employment discrimination)
Pregnancy and Parenting (access to prenatal care, paid maternity leave, shackling of pregnant incarcerated women during childbirth)