With Great Power, Comes Great Responsibility: Lancet Series on Sexual and Reproductive Health

Tyler LePard

According to a new series in Lancet, a well-respected, peer-reviewed, medical journal:

"Every year, 340 million new patients acquire gonorrhoea, syphilis, chlamydia, or trichomonas, more than 120 million couples have an unmet need for contraception, 80 million women have unintended pregnancies, and an estimated 19 million women undergo unsafe abortions; 70,000 of them die as a result."

There are cheap and effective ways to prevent unintended pregnancy and sexually transmitted infections, provide safe abortions, assist healthy pregnancies and delivery, and support children and families. With advances in medicine, access to health and education, why do these critical issues still threaten women's health? Politics. Clear and simple. Conservative ideology endangers women's health.

Yesterday, Lancet launched the new series on sexual and reproductive health worldwide. This study is based on the first ever global research of this kind - real data from researchers who took a fact-based approach to sexual and reproductive health and practices around the world.

According to a new series in Lancet, a well-respected, peer-reviewed, medical journal:

"Every year, 340 million new patients acquire gonorrhoea, syphilis, chlamydia, or trichomonas, more than 120 million couples have an unmet need for contraception, 80 million women have unintended pregnancies, and an estimated 19 million women undergo unsafe abortions; 70,000 of them die as a result."

There are cheap and effective ways to prevent unintended pregnancy and sexually transmitted infections, provide safe abortions, assist healthy pregnancies and delivery, and support children and families. With advances in medicine, access to health and education, why do these critical issues still threaten women's health? Politics. Clear and simple. Conservative ideology endangers women's health.

Yesterday, Lancet launched the new series on sexual and reproductive health worldwide. This study is based on the first ever global research of this kind – real data from researchers who took a fact-based approach to sexual and reproductive health and practices around the world. Lancet Editor Richard Horton explains why they focus on sexual and reproductive health:

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"Mainly because it's an issue of incredible intrinsic importance to the lives of women in the world today… but also, and this is particularly neglected I think, it's a critical foundation for many of the other issues that are supposedly top of the international health agenda."

Sexual and reproductive health influences a wide-range of issues including social, economic, and environmental development. (Listen to Horton's introduction and some of the main authors' key findings.) This series draws on the International Conference on Population and Development (ICPD), declaring that sexual and reproductive health was left out of, but essential for the attainment of, the Millennium Development Goals. Unfortunately, social conservatives' increasing influence has challenged the progress made since the ICPD.

Despite the evidence against them, social conservatives cling to ideology over science and are determined to mold everyone around the world – from single Americans in their 20s to married women in Kenya – to their narrow beliefs. Conservative ideologues would rather prohibit abortion (and contraception) and deny funding to family planning services than acknowledge effective preventative services and safe medical procedures. They don't trust women to make the "right" decision, when in reality women make the decision that is right for their situation. In placing religious, political or cultural beliefs ahead of real evidence-based information, conservatives create the barriers which lead to sexually transmitted infections, unsafe abortions, child poverty and sexual and reproductive ill-health. We all have a responsibility to advance sexual and reproductive health and move beyond the taboo on this subject.

Rewire welcomes the new Lancet series. Our staff and guest bloggers will continue to expose social conservatives propagating ideology at the expense of peer-reviewed scientific evidence on reproductive health.

News Politics

Sen. Tim Kaine Focuses on Reproductive Rights Amid Clinton’s Looming Decision on Vice President

Ally Boguhn

Last week, the senator and former Virginia governor argued in favor of giving Planned Parenthood access to funding in order to fight Zika. "The uniform focus for members of Congress should be, 'Let's solve the problem,'" Kaine reportedly said at a meeting in Richmond, according to Roll Call.

Sen. Tim Kaine (D-VA) appears to be rebranding himself as a more staunch pro-choice advocate after news that the senator was one of at least three potential candidates being vetted by presumptive Democratic nominee Hillary Clinton’s campaign to join her presidential ticket.

Last week, the senator and former Virginia governor argued in favor of giving Planned Parenthood access to funding in order to fight the Zika virus. “The uniform focus for members of Congress should be, ‘Let’s solve the problem,'” Kaine reportedly said at a meeting in Richmond, according to Roll Call. “That is [the] challenge right now between the Senate and House.”

Kaine went on to add that “Planned Parenthood is a primary health provider. This is really at the core of dealing with the population that has been most at risk of Zika,” he continued.

As Laura Bassett and Ryan Grim reported for the Huffington Post Tuesday, “now that Clinton … is vetting him for vice president, Kaine needs to bring his record more in line with hers” when it comes to reproductive rights. While on the campaign trail this election cycle, Clinton has repeatedly spoken out against restrictions on abortion access and funding—though she has stated that she still supports some restrictions, such as a ban on later abortions, as long as they have exceptions.

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In what is seemingly an effort to address the issue, as Bassett and Grim suggested, Kaine signed on last week as a co-sponsor of the Women’s Health Protection Act, which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services. As previously reported by Rewire, the measure would effectively stop “TRAP (targeted regulation of abortion provider) laws, forced ultrasounds, waiting periods, or restrictions on medication abortion.” TRAP laws have led to unprecedented barriers in access to abortion care.

Just one day before endorsing the legislation, Kaine issued a statement explicitly expressing his support for abortion rights after the Supreme Court struck down two provisions of Texas’ omnibus anti-choice law HB 2.

“I applaud the Supreme Court for seeing the Texas law for what it is—an attempt to effectively ban abortion and undermine a woman’s right to make her own health care choices,” said Kaine in the press release. “This ruling is a major win for women and families across the country, as well as the fight to expand reproductive freedom for all.”

The Virginia senator went on to use the opportunity to frame himself as a defender of those rights during his tenure as governor of his state. “The Texas law is quite similar to arbitrary and unnecessary rules that were imposed on Virginia women after I left office as Governor,” said Kaine. “I’m proud that we were able to successfully fight off such ‘TRAP’ regulations during my time in state office. I have always believed these sort of rules are an unwarranted effort to deprive women of their constitutionally protected right to terminate a pregnancy.”

Kaine also spoke out during his run for the Senate in 2012 when then-Gov. Bob McDonnell (R) signed a law requiring those who seek abortions to undergo an ultrasound prior to receiving care, calling the law “bad for Virginia’s image, bad for Virginia’s businesses and bad for Virginia’s women.”

Kaine’s record on abortion has of late been a hot topic among those speculating he could be a contender for vice president on the Clinton ticket. While Kaine’s website says that he “support[s] the right of women to make their own health and reproductive decisions” and that he opposes efforts to overturn Roe v. Wade, the senator recently spoke out about his personal opposition to abortion.

When host Chuck Todd asked Kaine during a recent interview on NBC’s Meet the Press about Kaine previously being “classified as a pro-life Democrat” while lieutenant governor of Virginia, Kaine described himself as a “traditional Catholic” who is “opposed to abortion.”

Kaine went on to affirm that he nonetheless still believed that the government should not intrude on the matter. “I deeply believe, and not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm,” Kaine continued. “They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As the Hill noted in a profile on Kaine’s abortion stance, as a senator Kaine has “a 100 percent rating from Planned Parenthood’s scorecard, and has consistently voted against measures like defunding Planned Parenthood and a ban on abortions after the 20th week of pregnancy.”

While running for governor of Virginia in 2005, however, Kaine promised that if elected he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

After taking office, Kaine supported some existing restrictions on abortion, such as Virginia’s parental consent law and a so-called informed consent law, which in 2008 he claimed gave “women information about a whole series of things, the health consequences, et cetera, and information about adoption.” In truth, the information such laws mandate giving out is often “irrelevant or misleading,” according to the the Guttmacher Institute.

In 2009 he also signed a measure that allowed the state to create “Choose Life” license plates and give a percentage of the proceeds to a crisis pregnancy network, though such organizations routinely lie to women to persuade them not to have an abortion.

Q & A Sexuality

White Southern Girlhood and Eugenics: A Talk With Historian Karin Zipf

Tina Vasquez

The same white supremacy that declared Black men and women to be hypersexual also subjected troubled or abused white girls to incarceration and state-sponsored sterilizations to make sure the teens did not pass on "bad" genes and "ruin the race."

From 1929 to the mid-1970s, North Carolina sterilized about 7,600 people in the nation’s most aggressive program of its kind. It was all in the name of eugenics, a coin termed by Francis Galton to describe efforts to “improve or impair the racial quality of future generations.” The program stopped as opinions began to shift surrounding eugenics—and lawsuits were filed against North Carolina’s Eugenics Board on behalf of those who had been sterilized—but 30 states participated in similar ones targeting a wide range of people, including people with disabilities and other disadvantaged groups.

Seventy-seven percent of all those sterilized in North Carolina were women; about 2,000 were people 18 and younger. Before the 1960s—when Black people became the majority of those sterilized—poor, rural white girls were the primary targets of authorities and women reformers. Girls were punished for engaging in so-called “deviant” behaviors, such as sexual activity or crossing racial lines in their romantic interests. Poor white girls who were sexually abused were also criminalized, labeled “feeble-minded,” and institutionalized.

This is the history explored by East Carolina University professor Karin Zipf in her new book, Bad Girls at Samarcand: Sexuality and Sterilization in a Southern Juvenile Reformatory. Samarcand Manor, North Carolina’s “industrial school” for girls, was a juvenile facility designed to keep troubled girls “in line.” In reality, this whites-only institution in the town of Eagle Springs was a violent place where courts, social workers, and parents committed young white girls for not adhering to social norms or the rules of white supremacy.

Founded in 1918, the institution began sterilizing girls after 16 girls set fire to two Samarcand dormitories in 1931. Officials believed that sterilizing the girls by tubal ligation would stop them from passing on “defective” genes. Though the justifications for the so-called treatments varied among groups in power, the prescription remained the same. Hundreds of girls and young women suffered forced sterilizations before the state sterilization program ended. Samarcand closed in 2011, but it was reborn as a new law enforcement training facility in 2015.

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Author Zipf spoke to Rewire about early 20th-century eugenics beliefs, the dangers of Southern white womanhood, and Samarcand Manor’s legacy.

Rewire: How do you remember first hearing about Samarcand Manor?

Karin Zipf: There were about two or three articles that came out in the late ’90s on institutions, [which] referenced the arson case at Samarcand where the girls burned down their dormitories. The girls at Samarcand were arrested on arson, which at the time could result in a death penalty charge. [The charges were reduced, and some of the girls were incarcerated.] So, historians knew of this case, but few had written on it. One book that was particularly interesting to me is by a historian named Susan Cahn—I have to shout out to her. Her book, Sexual Reckonings: Southern Girls in a Troubling Age, was really inspiring. She wrote one chapter on the fire.

Rewire: What were some of the challenges of tackling Samarcand’s history?

KZ: The research was challenging. I didn’t have any oral history to rely on because everyone I might have interviewed was deceased. State restrictions were hard to get around because we’re dealing with sensitive information here and generally, health records are closed to the public too. It’s a double-edged sword because obviously, policies are put in place to protect people’s privacy. But on the other hand, it makes it very difficult for researchers to go in and see how the state treats children.

Rewire: Often when we talk about white supremacy, the focus is how it affects people of color. But it was very interesting to explore how white supremacy affects white girls and women in particular. In some ways, is Samarcand is a direct result of white supremacy and wanting young girls to conform to feminine representations of it?

KZ: This is what I find to be the real topic here. I teach and research U.S. Southern history, so race is obviously a very important part of that. When I learned this was an institution only for white girls, I knew white supremacy was central to the story, especially because I knew that African-American girls in need at the same time were literally left on the street.

The state and upper-class women reformers believed these young white girls to have fallen from some sort of grace by becoming [sex workers] or choosing sexually active lifestyles. Reformers—those who pushed for the [initial] creation of Samarcand—believed that when [a white girl] falls from grace, she can get back up again. If you were a white girl, it was their job to help you get back up again.

At this same time, there was a white supremacy movement that was impacting how eugenics was viewed. … This wasn’t just in North Carolina, of course, but here eugenics beliefs were on the upswing, especially this idea that there were genetic defects that caused differences in society. Eugenicists believed genetic defects caused poverty, promiscuity, delinquency, etc.

There were people at the time who called themselves mental hygienists, who had a different understanding of womanhood than the Victorian reformers who saw “fallen” girls as disgraced. For example, they saw sexuality as a positive thing, provided it occurred within the confines of marriage. They believed women had sexual desires, that they were sexual beings, but that girls who were “mentally defective”—as they called it—gravitated to promiscuity or delinquency.

Victorian reformers and mental hygienists expressed two different attitudes about womanhood, but both were informed by constructions of whiteness and how that should look or be defined. Mental hygienists believed these girls had become so impoverished, they could not be saved. [Their behavior] was believed to be a genetic impurity that was going to spoil the white race, so they needed to be institutionalized and segregated from society at places like Samarcand—and this often also meant being sterilized.

Rewire: Some of the most interesting areas of your book delved into the historical meaning of Southern white womanhood and how this particular racist brand of womanhood deeply influenced eugenic science, especially in North Carolina. Talk to me about that.

KZ: The concept of Southern white womanhood is very much a multitiered system defined by race and sexuality. White men are at the top, they’re the top tier. They are seen as the protectors, and they are seen as the breadwinners. They believe themselves to be providing law and order, especially when it comes to race.

Next are white women, who are seen as chaste, virtuous, passive, obedient, domestic, and motherly. If they do enter into the public arena, it’s for the purpose of “public housekeeping,” [such as social work and advocacy for children].

Southern white womanhood rests on this ideal these young girls could not really meet. These were girls from the very bottom of the white social ladder; they were in abject poverty. These girls were out in the street hanging out with all kinds of people; they weren’t at home doing domestic chores. The big fear was that these girls were going to have children with Black men. White supremacists saw these girls’ lifestyles as the worst-case scenario for white supremacy; they believed these white girls were going to spoil the race by having children with men of color. This is why these girls were so strictly policed, perhaps more than other demographic group.

African-American men occupy the third tier. According to white supremacist beliefs, African-American men are aggressive. If you look at images from this time, they’re really horrible. Black men are portrayed as beastly, as predators, and what they want is access to white women. I strongly believe that so much of what Jim Crow was about was to separate Black men from white women.

In this system, Black women are at the bottom. They are seen as the opposite of pure, virtuous white women. The word often used at the time was “lascivious,” and African-American women were often referred to as “Jezebels.” The reason why reform efforts were focused on white girls is because white reformers assumed that Black girls and girls of color couldn’t be saved.

Rewire: I assumed that the way we put white womanhood on a pedestal protects all white women, but your book is an example of how that’s not always the case. Upholding Southern white womanhood in particular is also harmful to certain kinds of white women. How much is class responsible for this?

KZ: Around the same time as the early days of Samarcand, there were a number of textile strikes, which [often] involved young women. Some of the girls at Samarcand were cotton mill workers or the children of cotton mill workers. Affluent whites already had negative associations with textile workers because of the strikes, so there’s already a sort of demonization of the working class—and this is part of our history we don’t talk about enough. There were strikes all over the South, but it’s a part of North Carolina history that’s almost been lost.

You have these girls who are wearing overalls with caps twisted backwards, and they’re protesting and yelling in the streets. Today, society views protesters as socially disruptive at best, but back then these young girls were seen as ruining the race.

Rewire: Your book has an entire chapter on Kate Burr Johnson, who is written about rather favorably in North Carolina history, even while promoting eugenics and white supremacist ideals as the first woman state commissioner of public welfare from 1921 to 1930. She emphasized the interplay of culture and biology, which was, at the time, a pretty common stance in the South among intellectuals. Why was this such a popular idea?

KZ: Eugenicists generally agreed with the idea that “cultural” characteristics like juvenile delinquency, promiscuity, and poverty were passed through genes. The belief was that once those genes get into the line, there is no getting them out—and it didn’t matter what race you were.

But Southern eugenicists, such as Kate Burr Johnson, formulated a different theory to protect their belief in “white purity.” Southern eugenicists didn’t want to say that there was something in white people’s genetics that made them defective; that meant whites couldn’t be inherently superior. They had to get around that idea somehow, so Southern white eugenicists adopted a theory from a biologist named [Jean-Baptiste] Lamarck, which said that genes can mutate based on the environment and then those mutated genes can be passed on and introduced into the DNA of offspring.

The way that Southern eugenicists were able to sidestep any contradictions poor whites posed to white supremacy was by explaining that some white people became impoverished, for example, and when their poverty continued for generation after generation, then that environment of poverty affected their genetic makeup. Kate Burr Johnson really believed that poor whites’ DNA became disfigured to the point that they lost their whiteness. Other eugenicists weren’t buying it, but the Southern eugenicists were trying to figure out a way to modify the eugenics argument in order to meet their need of carrying on this idea of the “purity” of the white race.

Rewire: The ableism of the time was also pretty extreme. Young girls who were sexually assaulted were deemed “mentally defective” or “feeble-minded.” How was ableism used to further stigmatize these girls?

KZ: That was a really hard part of this research, honestly. In some instances, we’re talking about girls as young as 10 years old, raped by their own fathers, yet they’re being labeled as “mentally defective.” These girls were forced to take IQ tests designed for 19-year-old World War I-era soldiers. When these girls failed the tests—especially those already labeled as promiscuous—they were classified as “feeble-minded.”

In my reading of these records, so many girls were clearly exhibiting symptoms of post-traumatic stress disorder after repeated sexual assaults—and no one thought to question what they’d been through. It created this added layer of discrimination against these girls. The injustice was so deep, and no one called what happened rape or incest or sexual assault. If it was acknowledged that there was a problem at home, rather than address the perpetrator, Samarcand became a place to send the girls who were victims of assault, effectively punishing them for something horrible that happened to them.

Rewire: Was Samarcand an example of how white womanhood is placed on a pedestal and the lengths people will go to uphold and protect this idealized version of white Southern womanhood, or is it more of an example of what happens to young women who don’t conform to very particular ideas of what womanhood should look like?

KZ: I think it’s both. White Southern womanhood is this ideal that so many were desperate to meet because it had huge implications for the preservation of the white race. They would do anything—including isolate, segregate, quarantine, and sterilize young white girls—just to uphold the ideal.

But ultimately what I’m really trying to talk about here is the fluidity of white supremacy. In the effort to defend the “purity of whiteness,” white supremacists often disagreed with one another about the mechanisms for doing so. “Whiteness” appeared to be a fixed category, but Victorian reformers and mental hygienists disagreed sharply on the treatment of poor white girls who did not meet the purity ideals. I hope this encourages more dialogue about the construction of whiteness and the dangers of it.

Rewire: Do you think any of the themes surrounding your book or any themes around Samarcand are present in today’s culture and how we view womanhood?

KZ: I think that our concerns today really revolve around the control of women’s reproductive choices. I hope we can think about the ways white supremacists in the past justified the control of women’s bodies. What we see today is another iteration of that.

Why do states invest so much in attempting to control women’s bodies, and for what reasons? What populations of women are most impacted? These are important questions. Why does the state enforce laws to control women’s sexuality? We see it all the time. We should know the motivations and justifications that people have used in the past to restrict women’s sexuality. The lessons of Samarcand hopefully will empower us to better understand our world today.

This interview was conducted by email and by phone. It has been lightly edited for length and clarity.