A Broken Compass Won't Get Us Anywhere: The Implementation of the Global Gag Rule

Implementing policies such as the Global Gag rule to initiate a political shift in family planning forces women to go without access to reproductive health services, and/or forces them to seek unsafe reproductive health alternatives.  This policy is yet another way where the government tries to control women's bodies under the rouse of the United States' moral compass. I'm not sure if politicians are unaware of these issues or just don't care, but I'm also not sure which of those options are worse. My argument raises concerns among whether or not the government is looking into projected long term effects of the policies they are implementing on the health of vulnerable communities.  

Following a trend of minority oppression in the United States, it is not surprising that women still have to fight for their rights. Currently, abortion and other reproductive health services remain a polarized political debate in the United States. While discourse surrounding this topic calls to question one's morality and typically involves fundamentals of religion, this debate systemically serves as another way to stigmatize reproductive health and oppress women in the United States and abroad. 

Trump introducing Global Gag policy, 2017 

The global gag rule, also known as the Mexico City policy, is a United States federal policy that puts an end to federal funding being provided to non-governmental organizations that provide abortion services; these services include but are not limited to counseling, referrals, and advocating to decriminalize or expand abortion services both in the United States and abroad. As a consequence, non-profit organizations and clinics around the world receiving U.S. family planning funding cannot inform the public or education the community on the need to make safe abortion available, provide legal abortion services, or provide advice on where to get an abortion. The policy was has been in and out of office; the global gag rule was first instated in 1984 by Ronald Reagan, reestablished by George Bush in 2001, and once again reinstated by Trump in 2017. 

Planned Parenthood, 2015

While the policy is supposed to target abortion providers directly, it has a more disastrous impact on women's daily lives and reproductive health than it does on the actual rates of abortion around the world. I hate to be the one to break it to Trump, however the rate of abortions will not decrease under this policy, instead women will continue to seek out alternatives just as they did prior to Roe v. Wade. What this policy does serve as is a direct violation of reproductive justice and undermines one of the key Sustainable Development Goals: hindering the ability to ensure universal access to sexual and reproductive health including free education and access to affordable and safe health services. Under this policy, vital health clinics will continue to close, providing women with little to no affordable reproductive health services available to them. I believe the global gag rule is a direct hit to women's health, affecting our access to affordable contraceptives and necessary health services outside of abortion services. The IPPF, International Planned Parenthood Federation, is a non-profit organization that will refuse to abide by the gag rule, instead standing to lose $100 million from the federal government. Meanwhile, none of that money is actually used towards abortion services. Instead, the monetary cuts will directly affect funding towards affordable birth control, HIV services, neonatal services, general health care, patient education, pregnancy services, and STD testing. 

As a direct consequence of the Mexico City Policy, there will be an increase in unplanned and unsafe abortions, a decrease in affordable contraceptives, an increase in maternal and child deaths, a decrease in HIV/AIDs treatment, a decrease in antenatal care, and defunding to NGOs across the world. As anyone can see, a direct result of the global gag rule is not a decrease in abortion rates among family planning initiatives, but an increase in poor treatment of women and other minority communities. With these staggering facts, I question why this policy is being reimplemented--not only does the global gag rule not serve its intended purpose, but it also introduces a plethora of health related issues to already oppressed communities. Due to the implementation of the global gag rule, the United States is now where we were 35 years ago in regards to family planning and reproductive health. 

Overall, not investigating the effects of a federal policy is concerning, especially when vulnerable communities' health is at stake. Perhaps it is the lack of representation in government that leads to policies that do not reflect the American's views such as the global gag rule. In the picture above of Trump introducing the Global Gag rule into office, it is clear the political representation present does not accurately depict the demographic at risk-- and that is from looks alone. The global gag rule does not even represent the majority of American views; where 57% of Americans believe that abortion should be completely legal in all or most cases, while only 37% of the public believe it should be illegal. 

This policy acts as a push in the morality of American people, stemming from the belief that abortion is immoral. However, the global gag rule is using this belief as a cover to paternalistically organize and control women's bodies. The policy has been implemented without thought into the negative health side effects it would introduce to already vulnerable populations, and the 35 years of reproductive health progress it would eradicate. 

Class Reading: 

Takeshita, Chapter 4 

- Global Gag Rule was causing major setback in regards to distributing contraceptives to the global south

Additional Resources: 

https://www.theguardian.com/world/2017/jan/23/trump-abortion-gag-rule-international-ngo-funding

https://www.plannedparenthoodaction.org/blog/what-is-the-domestic-gag-rule

https://www.hrw.org/news/2018/02/14/trumps-mexico-city-policy-or-global-gag-rule

http://www.pewforum.org/fact-sheet/public-opinion-on-abortion/

Women’s Health: An Umbrella term we use to only Cover our Heads

When the topic of women’s health is discussed, the dominant narrative surrounding the subject is restricted to topics within the realm of reproductive services. Although incredibly vital, a woman’s body is not simply constructed around reproductive organs including the vagina, ovaries, uterus, etc. In today’s political agenda, it is not uncommon to associate women’s health, a very broad and encompassing term, with strictly reproductive health care services such as abortion and birth control access. In turn, this insinuates a diverse, political climate associated to the subject of women’s health due to the current polarized issues within reproductive health care.

Reproductive Health plays a role IN Women’s Health

Vanity Fair, 2017

The Trump Administration has made their positions on abortion, accessible birth control, and other reproductive services incredibly clear-- they are either against it or lack the care to make change, and I am not sure entirely sure which of the two is worse. President Trump continuously nominates people in high power who are against reproductive freedom such as Attorney General, Jeff Sessions, and Supreme Court nominee, Neil Gorsuch. As if these nominations did not prove his intentions clearly enough, he once stated that there “should be some sort of punishment” for women who seek abortions (NARAL, 2018). He even went as far to say that Planned Parenthood, a nonprofit organization dedicated to research and health counseling on a plethora of women’s health related issues regardless of a woman’s socioeconomic status, race, religion, etc., “is like an abortion factory, frankly” (NARAL, 2018). Frankly, I believe President Trump’s anti-woman agenda is once again another instance in which systematic oppression plays yet another role in health care policies and education.

Planned Parenthood, 2018

Due to defunding for nonprofit organizations such as Planned Parenthood, it is becoming increasingly more difficult for women to access birth control, specifically women of color and women of lower socioeconomic status. The Trump administration recently rolled back on the birth control mandate, which now grants employers the right to deny women insurance coverage for contraception (Pear, 2017) and offers religious freedom as a way to deny coverage to certain groups, which may insinuate direct restrictions on the civil rights of the LGBTQPAI+ community.

These topics are very important within the discourse of women’s health, however it is important to note that women’s health is not simply reproductive health. In fact, according to the CDC the leading causes of death of females in the United States are heart disease (22.3%), cancer (21.1%), chronic lower respiratory diseases (6.2%), stroke (6.1%), and Alzheimer’s disease (5.7%) (2015). Among the top 10 reasons, none of them are directly associated with reproductive organs or services. These issues are not commonly associated with the narrative of Women’s Health, and yet they are what is killing women in the United States. Unfortunately, if you were to Google the definition of “women’s health” is it very difficult to come to a consensus of a standard definition. So I decided to define “health” instead, which according to the Merriam-Webster dictionary is “the condition of being sound in body, mind, and spirit”, ”the general condition of the body”, and “a condition in which someone or something is thriving or doing well” (2018). Nowhere in the definition of “health” do we specify bodily organs or parts, instead it is the general state of the body. What is difficult to understand is why when “women” are added to create our topic of discussion, women’s health, we typically focus on women’s reproductive organs and little else. By restricting the definition of women’s health to strictly reproductive health, it leaves women susceptible to other poor health outcomes, while putting an emphasis on the politicization and standardization of the woman body.

Why is knowing Women’s Health is more than just reproductive health important?

It is extremely important to recognize how systematic oppression plays a large role in the health care system and its education of their doctors. The health care system was created as an institution stemming from the patriarchal system. In turn, medicine and science orbits around the standard of the white, male body. In the United States, “women are less likely than men to survive the years after a heart attack, even after accounting for age” (Yong, 2018). Women’s heart attack symptoms present differently from the standard symptoms we all think of when we hear “heart attack”. Typically, we think of severe pain in the left arm, tightness in your jaw, neck, and chest, and severe shortness of breath-- all symptoms usually associated with a male having a heart attack. We have created a standard of symptoms such as this, where we do not take into account the effects of gender on different medical disorders, and instead idealize the male reaction. Due to this, the leading cause of death in women in the United States is due to heart disease (CDC, 2015). Moreover, another interesting study showed that women are more likely to survive a heart attack if they are being treated by a female doctor (Yong, 2018). Yong addressed this subject by also adding on that “overall, the team found that female physicians outperformed their male colleagues, and that their patients were, on the whole, more likely to live” (2018). Is this because female doctors have to prove themselves more so than men do in medical school and on the job? Is this because there are, overall, fewer practicing female doctors than men? Or is this because females feel the need to downplay their pain in front of male doctors? Regardless of the answer, it is something incredibly important in the discourse of Women’s health, however it is often overlooked.

Overall, the need to integrate gender perspective into medicine is becoming increasingly more necessary. When people think of a female’s doctors, they are automatically drawn to the gynecologists and obstetricians because of this emphasis in women’s health on the reproductive system. However, a female’s doctor is not just a doctor that specializes in medicine in respect to the reproductive system. If you were a woman suffering from chest pains, you definitely would not want to call your gynecologist. A female’s doctor is going to include primary care physicians, emergency room doctors, neurologists, cardiologist, etc. Instead of focusing on a standard of care that perpetuates the idealization of the male body, physicians and medical students should be introduced to all types of bodies-- female, transgender, transsexual, intersex, etc., in order to provide equal care across all bodies.

“Women’s health” and “reproductive health” are not interchangeable terms. Women’s health is a term that encompasses mental and physical well being among all individuals who identify as female. Reproductive health is extremely important in women’s health, but to focus solely on reproductive health is dangerous especially when the white, male body is a standard of education and care within the medical system. We created umbrella terms such as these to be able to cover the whole body, not just the reproductive organs.

Referred to the following readings from class:

Yong, Ed. “Women More Likely to Survive Heart Attacks If Treated by Female Doctors.” The Atlantic, Atlantic Media Company, 6 Aug. 2018. 

DUSENBERY, MAYA. DOING HARM: the Truth about How Bad Medicine and Lazy Science Leave Women Dismissed,... Misdiagnosed, and Sick. HARPERONE, 2019.

Additional Material:

“Donald Trump on Reproductive Freedom.” NARAL Pro-Choice America, 2018, www.prochoiceamerica.org/laws-policy/federal-government/donald-trump-abortion/.

“Health Equity.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Apr. 2018, www.cdc.gov/women/lcod/2015/index.htm#modalIdString_CDCTable_0.

Pear, Robert, et al. “Trump Administration Rolls Back Birth Control Mandate.” The New York Times, The New York Times, 6 Oct. 2017, www.nytimes.com/2017/10/06/us/politics/trump-contraception-birth-control.html.