Harm Reduction Lessons for Reproductive Justice

Jaspreet Chowdhary

Harm reduction is a public health philosophy that emphasizes individual safety, regardless of lifestyle choices, over prohibition. How can this approach make sex work safer?

Drug policy has benefited from the harm reduction movement’s innovative approach to improving personal safety.  The
application of a harm reduction model to reproductive justice has the
potential to transform the way we view reproductive justice issues and
mobilize support for issues that are traditionally marginalized within
the movement.  I want to consider what we can learn from
the harm reduction movement in advocating for sex workers’ rights and
comprehensive sex education.

Harm reduction is a public health philosophy that emphasizes individual safety, regardless of lifestyle choices, over prohibition.  This
approach acknowledges that some individuals may continue to engage in
risky behaviors and aims to address the needs created by those
behaviors.  The
harm reduction movement spearheaded efforts to improve safety and
provide services to substance abusers, such as safer injection sites
for heroin addicts – the theory being that if addicts were going to use,
at least providing them with clean needles would benefit the addicts
themselves as well as the overall public health.  Because harm reduction focuses on social and environmental aspects of risky behavior, its application to sex work is intuitive.  

Sex
workers face violations of basic human rights on a daily basis,
including violence at the hands of clients as well as police brutality.  Additionally, many sex workers must cope with homelessness, substance dependency, and extreme poverty and desperation.  Because street-based sex workers are predominantly indigent women of color, selective law enforcement practices disproportionately target poor, minority women.

Sex
workers are isolated from health care services because of fear of
arrest and prosecution, as well as the increasingly inaccessible cost
of such care.  Street-based sex workers in particular face
health risks that the average worker does not, such as violence
(perpetrated by police and clients), exposure to sexually transmitted
infections and HIV/AIDS, and exposure to the elements.  When
sex workers do access health care services, it is generally because of
an emergency; thus, lack of access to preventative services is a
serious health concern for sex workers.

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In
the context of providing services and outreach to sex workers, then, an
application of the harm reduction model must take into account how
various and overlapping forms of oppression create unique challenges
for sex workers:  namely, substance abuse problems and lack of resources to access health care.  Services
should include the provision of safer sex kits to sex workers and
training in condom-negotiation skills, as well as free and confidential
STD testing and information about HIV/AIDS.  Holistic services should also embrace substance abuse counseling and clean needles for drug use and hormone injections for transgendered sex workers who utilize hormone therapy.  Programs
that collaborate across disciplines would address sex workers’ needs
the most effectively by tackling substance abuse, safe housing,
domestic violence, and health care.

So,
why is this an issue of reproductive justice? First, this approach
recognizes that sex workers are often in the industry for reasons
beyond their control, such as economic hardship or inability to enter
or reenter the workforce due to lack of recognized work experience or a
criminal record.  In this respect, this acknowledgement of
the multiplicities of oppression reflects the values of the
reproductive justice movement-harm reduction recognizes that the
decision to enter or remain in the sex industry can be (but is not always) a result of economic, racial, and gender injustice.  Accordingly,
rather than criminalize, patronize or demonize sex workers, harm
reduction seeks to provide safer options for those who choose to
continue in the sex industry.  And, because a harm
reduction approach ascribes no moral judgment to the activities of
others, the traditional hierarchy assumed by service provision is
disrupted.  Significantly, this challenges the notion that
those in positions of power "know best" while empowering sex workers to
make the healthiest choice possible for themselves under their
individual circumstances.  This approach also empowers sex workers to use contraceptives and educate themselves on sexual health issues.  Importantly,
then, application of the harm reduction model does not demean the work
that sex workers do because it both identifies the intersection of
race, class, and gender-based oppression that often create the need to
continue working in the sex industry and recognizes that some sex
workers remain in the industry by choice.

I have previously blogged about abstinence-only programs, but I think it’s important to consider sex ed in light of harm reduction as well.  The
philosophies which underlie harm reduction call for the elimination of
funding for abstinence-only education in schools and implementation of
comprehensive, sex-positive sex ed.  Abstinence-only education does not actually result in teens abstaining from sex, and instead denies them critical information about sexually transmitted diseases, pregnancy prevention, and, yes – sexuality itself. 

Harm
reduction acknowledges that people – and, in this case, young people – make
choices that may put their health or well-being at risk, and seeks to
provide information to most safely make those choices rather than
administer judgment or condescension.  Like the earliest
manifestations of the harm reduction movement-safer injection sites
combined with resources and support for substance abusers who were
trying to stop using drugs-comprehensive sex education presents young
people with information and options.  And, like its predecessors in the movement, this information is health- and life-saving.  For
teens who are having sex or are going to have sex, comprehensive sex
education equips them with the tools and information they need to make
that decision in a way that protects them from diseases and unwanted
pregnancies as well as providing them with a healthy outlook on
sexuality. 

Reproductive justice posits that all people have a right to information required to attain sexual and reproductive self-determination.  Providing
students with comprehensive sex education reflects the principles that
motivate the harm reduction movement, and as such gives students the
tools they need to make healthy decisions about their bodies, their
relationships, and their futures.

This post first appeared on Repossess Reproductive Justice.

Commentary Race

Black Lives Matter Belongs in Canada, Despite What Responses to Its Pride Action Suggest

Katherine Cross

Privileging the voices of white LGBTQ Canadians who claim racism is not a part of Canada's history or present ignores the struggles of Canadians of color, including those who are LGBTQ.

As I walked the streets of Toronto last month, it occurred to me that Pride Week had become something of a national holiday there, where rainbow flags and the Maple Leaf banners flying in honor of Canada Day on July 1 were equally ubiquitous. For the first time in my many years visiting the city—the place where I myself came out—the juxtaposition of Pride and the anniversary of Confederation felt appropriate and natural.

For some, however, this crescendo of inclusive celebration was threatened by the Black Lives Matter Toronto (BLMTO) protest at the city’s Pride March, often nicknamed PrideTO. The group’s 30-minute, parade-stopping sit-in has since come in for predictable condemnation. The Globe and Mail’s Margaret Wente dubbed BLMTO “bullies,” sniffed that its tactics and concerns belonged to the United States, and asked why it didn’t care about Black-on-Black crime in Canada. The Toronto Sun’s Sue-Ann Levy, meanwhile, called BLMTO “Nobody Else Matters,” also saying it “bullied” Pride’s organizers and suggesting we all focus on the real object of exclusion within the LGBTQ community: gay members of the recently ousted Conservative Party.

There is a lot to learn from this Torontonian incident, particularly around managing polite liberal racism—an especially important civics lesson in light of the past month’s tragedies in the United States. Privileging the voices of white LGBTQ Canadians who claim racism is not a part of Canada’s history or present means ignoring the struggles of hundreds of thousands, many of whom are LGTBQ themselves.

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Pride has always been a thoroughly political affair. It is, thus, hardly an “inappropriate time and place” for such a protest. It began as, and remains, a public forum for the unapologetic airing of our political concerns as a community in all its diversity. We may have reached a new phase of acceptance—the presence of Prime Minister Trudeau at Pride was a beautiful milestone in both Canadian and LGBTQ history—but Pride as a civic holiday must not obscure the challenges that remain. It is not a coincidence that the majority of transgender people murdered worldwide by the hundreds every year are Black and Latina, and that many of them are sex workers. That is part of the reality that BLMTO was responding to—the fact that racism amplifies homophobia and transphobia. In so doing, it was not just speaking for Black people, as many falsely contended, but advocating for queer and trans people of many ethnicities.

Even so, one parade-goer told the Globe and Mail: “It’s not about them. It’s gay pride, not black pride.” The very fact that Black LGBTQ people are asked to “choose” validates BLMTO’s complaint about Pride’s anti-Blackness, suggesting a culture where Black people will be thinly tolerated so long as they do not actually talk about or organize around being Black.

Indeed, BLMTO’s much-criticized list of demands seems not to have been read, much less understood. While drawing attention to the Black Lives Matter collective, it also advocated for South Asian LGBTQ people and those in First Nations communities, whose sense of not-entirely-belonging at an increasingly apolitical PrideTO it shares.

In each paint-by-numbers editorial, there was lip service paid to the “concerns” BLMTO has about Canadian police forces and racial discrimination, but the inconvenience of a briefly immobilized parade generated more coverage. Throughout, there has been a sense that Black Lives Matter didn’t belong in Canada, that the nation is somehow immune to racist law enforcement and, in fact, racism in general.

Yet to listen to the accounts of Black Canadians, the reality is rather different.

Janaya Khan, one of the co-founders of BLMTO, recently spoke to Canadian national magazine MacLean’s about the activist’s views on structural racism in the country. As a native of Toronto, they were able to speak quite forthrightly about growing up with racism in the city—up to and including being “carded” (a Canadian version of stop-and-frisk, wherein officers have the right to demand ID from random citizens) at Pride itself. And last year in Toronto Life, journalist and writer Desmond Cole talked about his experiences being raised throughout Ontario. He told a story of a traffic stop, none too different from the sort that killed Philando Castile earlier this month, after a passenger in his father’s car, Sana, had tossed a tissue out the window onto the highway. The officer made the young man walk back onto the highway and pick it up.

Cole wrote, “After Sana returned, the officer let us go. We drove off, overcome with silence until my father finally exploded. ‘You realize everyone in this car is Black, right?’ he thundered at Sana. ‘Yes, Uncle,’ Sana whispered, his head down and shoulders slumped. That afternoon, my imposing father and cocky cousin had trembled in fear over a discarded Kleenex.”

This story, of narrowly escaping the wrath of a white officer on the side of a motorway, could have come from any state in the Union. While Canada has many things to be proud of, it cannot claim that scouring racism from within its borders is among them. Those of us who have lived and worked within the country have an obligation to believe people like Cole and Khan when they describe what life has been like for them—and to do something about it rather than wring our hands in denial.

We should hardly be surprised that the United States and Canada, with parallel histories of violent colonial usurpation of Native land, should be plagued by many of the same racist diseases. There are many that Canada has shared with its southern neighbor—Canada had a number of anti-Chinese exclusion laws in the 19th and early 20th centuries, and it too had Japanese internment camps during the Second World War—but other racisms are distinctly homegrown.

The Quebecois sovereignty movement, for instance, veered into anti-Semitic fascism in the 1930s and ’40s. In later years, despite tacking to the left, it retained something of a xenophobic character because of its implicit vision of an independent Quebec dominated by white francophones who could trace their ancestry back to France. In a blind fury after narrowly losing the 1995 referendum on Quebecois independence, Premier Jacques Parizeau, the then-leader of the independence movement, infamously blamed “money and ethnic votes” for the loss. More recently, the provincial sovereigntist party, the Parti Quebecois, tried to impose a “Values Charter” on the province aimed at criminalizing the wearing of hijab and niqab in certain public spaces and functions. Ask Black francophones if they feel welcome in the province and you’ll get mixed answers at best, often related to racist policing from Quebec’s forces.

Speaking of policing and the character of public safety institutions, matters remain stark.

A 2015 Toronto Star special investigation found hundreds of Greater Toronto Area officers internally disciplined for “serious misconduct”—including the physical abuse of homeless people and committing domestic violence—remained on the force. In 2012, the same outlet documented the excessive rate at which Black and brown Torontonians were stopped and “carded.” The data is staggering: The number of stops of Black men actually exceeded the number of young Black men who live in certain policing districts. And according to the Star, despite making up less than 10 percent of Toronto’s population, Black Torontonians comprised at least 35 percent of those individuals shot to death by police since 1990. Between 2000 and 2006, they made up two-thirds.

Meanwhile, LGBTQ and Native Ontario corrections officers have routinely complained of poisonous workplace environments; a recent survey found anti-Muslim attitudes prevail among a majority of Ontarians.

Especially poignant for me as a Latina who loves Canada is the case of former Vancouver firefighter Luis Gonzales. Gonzales, who is of Salvadoran descent, is now filing a human rights complaint against Vancouver Fire and Rescue Services for what he deemed a racist work environment that included anti-Black racism, like shining a fire engine floodlight on Black women in the street and joking about how one still couldn’t see them.

One could go on; the disparate nature of these abuses points to the intersectional character of prejudice in Canada, something that BLM Toronto was quite explicit about in its protest. While anti-Black racism is distinct, the coalition perspective envisaged by Black Lives Matter, which builds community with LGBTQ, Muslim, South Asian, and First Nations groups, reflects an understanding of Canadian racism that is quite intelligible to U.S. observers.

It is here that we should return again to Margaret Wente’s slyly nationalistic claim that BLMTO is a foreign import, insensitive to progressive Canadian reality. In this, as in so many other areas, we must dispense with the use of Canadian civic liberalism as a shield against criticism; the nation got this far because of sometimes intemperate, often loud protest. Protests against anti-LGBTQ police brutality in the 1980s and ’90s, for example, set the stage for a Toronto where the CN Tower would be lit up in rainbow colors. And any number of Native rights actions in Canada have forced the nation to recognize both its colonial history and the racism of the present; from Idle No More and the Oka Crisis to the 2014 VIA Rail blockade, that movement is alive and well. Indeed, the blockade was part of a long movement to make the government acknowledge that thousands of missing and murdered Indigenous women constituted a crisis.

If we must wrap ourselves in the Maple Leaf flag, then let us at least acknowledge that peaceful protest is a very Canadian thing indeed, instead of redoubling racist insults by insinuating that Black Lives Matter is somehow foreign or that institutional racism is confined to the United States. Canada has achieved little of worth by merely chanting “but we’re not as bad as the United States!” like a mantra.

Far from being a movement in search of a crisis, Black Lives Matter and its intersectional analysis is just as well-suited to Canada as it is to the United States. In the end, it is not, per the national anthem, God who keeps this land “glorious and free,” but its people.

Commentary Human Rights

Love, Respect, Accountability: What We Need in This Time of Tragedy and Crisis

Jodi Jacobson

Speaking up, speaking out, changing systems... This is not disrespect or lack of love and support. It is the essence of the struggle for the rights of all people. It is democracy.

In a time of great strife, in which those who seek to divide us have a very large platform, I remember that these things are all true:

You can oppose an illegitimate or unnecessary war, and still individually and collectively honor and love the troops that serve.

You can honor and love the troops that serve, but protest the ways in which war is waged and abhor the behavior of individual soldiers who abuse human rights and dehumanize the civilians in a population. You can honor and love and support the troops that serve but still work to change the systems, and hold politicians and individuals responsible for crimes they perpetrate.

You can honor and love any and all public servants—as I do deeply—but still abhor systemic problems in civil services that lead to racist behaviors and outcomes (or those based on class, immigrant status, gender, ability, or any other basis for discrimination).

You can honor, love, and respect police, but abhor the militarization of our police forces; racial and ethnic profiling; abuses of fines, fees, and arrests that both target and most adversely affect the poorest individuals; and the growing dependency of the budgets for police forces based on fines drawn from those who can least afford it. You can honor, love, and respect the police, but still understand why there is a great level of distrust of policing in some communities. You can honor, love, and respect the police, but still recognize real abuses of power by individuals or groups among them, and seek to hold those responsible accountable for their actions.

You can honor and love police for putting their lives on the line for public safety, but recognize the very deeply legitimate concerns of movements—like Black Lives Matter, immigrants’ rights groups, women’s rights groups, LGBTQ rights groups, and others for whom policing often is not about public safety, but is itself a source of fear—because law enforcement is and has been too often used against these groups in ways that are disrespectful, demeaning, and sometimes deadly.

You can honor, respect, and love the police, but support the work of Black Lives Matter, immigrants’ rights groups, women’s rights groups, and LGBTQ rights groups, and defend them against blame for the behavior of someone acting in their name who is not actually acting in their name at all.

You can honor and respect the work of prosecutors, judges, and other law enforcement officials, but recognize when the systems in which they are working are not working for the people or to promote justice, or when individuals within those systems operate more on bias than on integrity.

You can protest and advocate for change in any and all of these systems without dishonoring the individuals within them. Indeed, by protesting and seeking to make them better, you make the world better for those within and outside of law enforcement and, hopefully, promote a more universal justice.

You can and we all must honor and treasure the freedoms of speech and of assembly, and abhor violence, while also recognizing that sometimes it is perpetrated by people, like veterans, whose own needs for health care, love, and honor have not been met by the country that sent them to war, or by people who feel so alienated that they—wrongly but nonetheless—resort to violence.

You can be confused by or even irritated by something you don’t understand, but it is on you, not others, to try to understand it. As Proverbs 4:7 says, “The beginning of wisdom is this: Get wisdom. Though it cost all you have, get understanding.” Read, discuss, challenge yourself. Try to open yourself up to what may seem like radical ideas. Make yourself vulnerable to learning. If you don’t understand the movement for Black lives, women’s rights, LGBTQ rights, immigrant rights, then listen to the very people fighting for their rights in order to better understand them. You may have started from a very different place than they do; you may stand in a very different place today. The issues may seem alien at first. But just because you don’t have cancer does not mean cancer does not exist. Try hard to understand why there is distance, what you don’t understand, and what you can—what we all must—do to narrow that distance in understanding each other.

We can love, honor, and respect each other and still recognize and raise awareness of our collective weaknesses. Indeed, that is the essence of progress and of democracy. Don’t fight it. Try to help it along.

People are human and therefore flawed. The systems we create also are therefore often flawed. We need mutual love and respect, along with vigorous debate and sometimes protest, to right the wrongs that are the inevitable result of our flawed selves and our flawed systems.

Love, honor, respect, and accountability: We need them all. Accountability, along with freedom, is the essence of a functioning democracy and part of the struggle for justice. The right to speak, the right to protest, the right to agitate for changes in systems that are flawed because we are all flawed in some way. The right to make things better.

Speaking up, speaking out, changing systems… This is not disrespect or lack of love and support. It is the essence of the struggle for the rights of all people. It is democracy. Some will tell you that in speaking out you are being disrespectful, but the opposite is true. You are respecting the many who have fought and given their lives—and who continue to be placed in harm’s way—on behalf of all of us so that we may all exercise our basic freedoms.

Let’s embrace the struggle. We can love, honor, respect police and other public servants, politicians, soldiers, and ourselves, and still work to hold them and ourselves accountable. These things are all true. I can hold these true simultaneously.

Can we all hold these things true simultaneously? I hope so, because I fear our failure to do so will only result in more violence and hatred.