What is sexual and reproductive health?
Reproductive health is a term that has generally referred to an array of concerns and capacities to support and promote the health of everything that has to do with reproduction. Until recently, the focus of reproductive health was on all aspects of pregnancy and childbirth, in particular those that result from heterosexual penile-vaginal intercourse. This concept has generally had a narrow focus on women’s bodies or the physical bodies of those born with female and male physiological and anatomical reproductive organs, (i.e., uterus, vagina, Fallopian tubes, breasts, testicles, penis, etc.), redressing infertility, or having access to gynecological or urological care. “Reproductive health” has encompassed both medical care associated with women’s decisions about preventing pregnancies, as well as the ability to become pregnant and supporting pregnancies to term, through to the birth of a (“healthy”) child. “Sexual health” has referred to the various ways that being sexual or having sex can be done in ways that avoid disease or other unwanted consequences, including prevention (and testing and treatment) of sexually-transmitted diseases (i.e., chlamydia, HPV, HIV/AIDS), and freedom from sexual coercion and violence. Since they are so linked, the term “sexual and reproductive health” is often used.
What are sexual and reproductive rights?
Sometimes explicitly and sometimes indirectly, particularly in the US, reproductive (and increasingly sexual) rights have also referred to the individual civil rights that ensure women’s ability to have control over, make choices about, and access the appropriate health care having to do with reproduction and the reproductive parts of their bodies. The most well-known are abortion rights and being able to access medical care, contraception and protection from sexually-transmitted diseases or infections, and even medically accurate sex education. Reproductive and sexual rights have an increasingly expansive definition and include: reproductive technologies and legal and health policies for abortion and choosing to end a pregnancy as well as to foster our bodies’ capacities for reproduction and the health needs of pregnant women.
What is sexual and reproductive “justice” and how is it different from “rights”?
Reproductive justice (RJ) is a relatively new concept that includes but also goes beyond sexual and reproductive rights that have been pursued in legal battles, such as abortion rights, the right to engage in forms of sexual expression that have been outlawed (i.e., fellatio), and gay marriage. Developed by Black women activists and scholars 20 years ago, RJ is anchored in a human rights framework that reframes “rights” beyond those of the individual citizen established by countries (i.e., the US legal system) to basic human rights to dignity and well being, regardless of race, gender, ethnicity, socioeconomic status, citizenship or nation. Reproductive and sexual rights are rights conferred by moral principles rather than laws. Reproductive and sexual health are resources that individuals, families and communities deserve and have the right to as human beings. A human rights framework connects sexual and reproductive rights to instances of unfairness, violation, and denial of basic resources, including for instance, access to reproductive healthcare, sexual health services, contraception, abortion, reproductive technologies, infertility treatment, access to PReP and std testing, parental rights, the right to give birth safely and with dignity, the right to live as and have the body of one’s self-defined gender, education, including sex education, freedom from sexual violence and violence of all kinds, as well as the rights to “enabling conditions,” such housing and food — what we all need to create and raise our families and protect and support our communities with dignity and well being. While all of those topics are integral to justice, the use of the word justice is intentional in recognizing not only self-determination over one’s body as a civil right (i.e., laws and policies about the right to choose to have an abortion). The point of RJ is that one’s reproductive choices is dependent on many factors — including laws, economic systems, policing and justice systems. The term intimate justice draws attention to the right to know about and have free, safe and pleasurable sexual desires and expression.
The right to bodily integrity and justice through the legal system for rape survivors, for example, often reflect the lack of justice (i.e., lack of autonomy and control) for groups of people over time. Some of these include the assertion of control over women’s bodies, including cis and trans women, the racialization and assertion of control over Black people’s bodies, the sterilization of women of color over the course of the United States’, and a plethora of other countries’, histories, the medical research done on people of color, and many many more. RJ insists on the complexity and realities of people’s choices. Sex work for instance, might be the only way for disenfranchised people to earn enough money to live, might be forced on people (children, migrants or refugees) against their wills or might be chosen as a lucrative profession for more privileged people.
Is sexual and reproductive justice and health mostly for girls and women?
Absolutely not! Sexual and reproductive justice is everyone’s issue. It affects people of different genders, with different reproductive organs (e.g., ovaries, testes), of different races and classes, people with different types of dis/abilities and people with different mental health statuses. Reproductive and sexual health historically focused on women, and often the issues that mattered most to white women with resources to act on their individual rights, but the ways in which marginalized or oppressed populations are denied and need to have access to their sexual and reproductive rights are increasingly being recognized. Some people who are denied reproductive and sexual health care (and often the means to have dignified lives and well being) include people (women, youth, trans) who are trafficked; disabled; incarcerated; refugee; undocumented; migrant; LGBTQ+ or gender non-conforming; older folks; teens; people with mental illness or disability; sex workers; child brides. Many people have multiple oppressions get in the way of their knowing, accessing and being given their rights, i.e., trans women of color; Latino migrant workers; queer teens. Denial of reproductive and sexual justice is often particular to specific groups of people and makes it even more important for us to pay attention to the conditions that we live in.