How do you answer the questions of a 14-year-old who's had her period for a year but still doesn't know where it comes from? And where can you send a teen who's only sex ed has come from her private Christian school?
Last night, as so often happens when you work at Planned Parenthood, a good friend of mine came to me with a problem. While usually I get asked about sexual health (remind me to tell you about the time a guy at a party started asking me about the little red bumps on his genitals) my friend Carla* needed advice — for her 14 year old cousin.
See, her cousin lives in Florida, goes to a private Christian school, and, apparently, has had no sex education whatsoever. I get the feeling her school teaches some sort of abstinence program (when Carla mentioned condoms her cousin’s response was ‘but don’t they break?’) and her mom just hasn’t felt comfortable bringing it up. So when she ran into savvy New York City-based cousin Carla at a wedding this weekend, the questions started coming pouring out.
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Carla was *shocked* at how little her cousin knew. Even though her cousin had been getting her period for a year, she had no idea what it was or where it came from. She knew that babies somehow came from sex, but knew nothing about the mechanics or how it happened.
Carla filled her in as much as she could, but as the questions started getting trickier (‘so what exactly would I do if I did have sex and got pregnant?’) Carla started feeling more and more in over her head.
She turned to me for advice, and last night over dinner, after lamenting the fact that a school could even get away with giving kids little to no sex education, we started brainstorming.
In addition to Carla giving her cousin’s mom the PPNYC guide for parents (Hey, What do I Say?) we decided to give her cousin the following:
Send her to the Planned Parenthood web site Teen Talk for reference and information (they have everything about how pregnancy happens, to information about STDs to every form of birth control)
That’s all we could think of for now – I know I’ve had Our Bodies, Ourselves since high school and still refer to it all the time. But any and all other advice is more than welcome. What else have people used? What worked for you? What have you seen that was good?
*Name has been changed to protect her teenage cousin.
A version of this post originally appeared on PPNYC’s blog.
Carmen Rita Wong says the characters in her new novel, Never Too Real, are largely invisible in media, which is why she chose to tell their stories. The fictional work is about Latina women who are both struggling and successful in their various fields. Wong says she’s treating this writing project as a mission, a way to tell the story of women like her: Latina women and other women of color who exist in ways other than the stereotypes so often portrayed on television and in films.
Wong herself is a master of media: She’s written for countless outlets, been the host of her own TV show, written books on finance, and now, she’s turned to fiction.
Rewire had a chance to chat with Wong about her experience finding a place for the work she wanted to create, and what the media often gets wrong when portraying Latina women and other women of color.
Rewire: How did this novel come about?
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Carmen Rita Wong: My a-ha! moment came with my daughter; we were walking together and passed a bus stop with [a poster for] a show and she said, “Mom, that poster, all those women look like you. But why are they maids?”
My daughter’s frame of reference is very different from mine: She’s growing up more privileged and with a Black president, surrounded by family where she happens to be a blonde Latina while her cousins are Black Latinas. I waited tables alongside my mom to put myself through college, so I have a deep respect for every form of work. But it was definitely one of those things where you only see yourself reflected in one way—and that’s how I grew up, seeing Latinas being shown in one way; but this is not how I live, and not how my daughter lives, now.
That same month I was having a party, celebrating my wonderful, successful girlfriends. We all came up together, we’ve all supported each other, and we’re all women of color, mostly Latina. I looked around and wondered, how come nobody knows we exist?
So I thought, all right, you know what? Now’s the time. This has just got to get done. I’m in a position to do this, I need to do it. It was very much a mission; I didn’t approach it as a side project.
Rewire: Kirkus Reviews, a book review site, called Never Too Real a “multicultural edition of Sex and the City.” How would you characterize the book? Would you call it that?
CRW: I think that superficially that’s a nice, easy elevator pitch because there are four of these women, they’re glamorous, and they’re in New York City. I think that’s where the similarities pretty much end. The book goes a lot deeper than that. If you had to categorize it TV-wise, it’s a “dramedy”: There’s some lightheartedness, there’s some playfulness, some glamor, but it is really about real issues in your life as you try to do well, if you try to be the first generation to do better than the previous. I think that’s one of the uniting factors of these four women—they’re all … first [in their families] to be born in the United States, and grow up and finish college. And that’s an important bonding issue that makes it very different [from] Sex in the City.
Rewire: Diversity in literature is a widely-discussed issue in the literary community these days, with hashtags like #WeNeedDiverseBooks. Was it hard for you to find a place for your book, to publish it?
CRW: I don’t know—hard for some people is not hard for others. Let’s just say—my agent’s probably going to kill me—but my favorite rejection from a major publisher, which actually confirmed to me that I was on the right track, was (and I have it memorized): “We are not looking for aspirational in this market at this time.”
Rewire: They called it aspirational?
CRW: Exactly. So it was mildly crushing, and then I realized—I’m on it, I am so on it. Because these publishers, who are they, and what have they published? Books by white men. Yes, those publishers are powerful, and yes, they’re rich, but they don’t get it. They don’t see it. They don’t know we exist. What is “this market,” and what is “aspirational?”
When I was coming up in media, in publishing and magazines, I would hear from people, “Carmen, we know you want to get ahead, but we just don’t know what to do with you.” And that’s code. What it really means is, “Carmen, you’re a brown girl, and we can promote this white guy or girl, but we can’t promote you. We just don’t know what to do with you.” But they would never say that to a white male. They would never say, “You know what, Bob? We just don’t know what to do with you.” So to me that rejection letter was just like that.
I remember back in the ’90s, there was a really great push of [books] like Waiting to Exhale or Joy Luck Club. There was just a lot more in fiction about successful, multigenerational, multicultural families. It just was normal and it was not considered crazy. I think there was a trend, and it just became a different trend. And then there was a push for powerful stories, but stories of only one note, for a long time in Latino fiction. I can’t read that stuff, because I lived it already. I want to read stories that make me escape or make me inspired or make me feel heard.
Rewire: In the book, you introduce women who come from all walks of life and economic backgrounds, but they’re all upper-middle-class at the time of the narrative. Going back to your daughter seeing the poster of Latina women portrayed as maids, do you find that economic diversity is what’s often missing in popular and literary culture?
CRW: My book wasn’t as calculated as that, because this is my life, and these are my friends and the people I surround myself with. I think what I saw missing in these cultures was that niche [of successful Latina women].
Latinos in popular culture … I’ve watched it be a very hard process. For example, when I was in magazines, they tried to push me to the Spanish-language property, and I’d say that I don’t primarily speak in Spanish. Why can’t I be used in the English-dominant space? Why? Give me a reason why! And they’d have to say, “Well, because you’re Latina.” So? Latinos speak English! We’re Americans! If you were Black or Latina you’d have to be in that particular space and you weren’t allowed to exist in the general market. And as we’ve seen, and as we see now, that has changed a lot.
Rewire: How so?
CRW: We have huge growth in numbers, but also too, if you look at, for example, ShondaLand, [the production company] on ABC—it’s an example of an openness to seeing and consuming media from all cultures, whether it’s music or TV. I definitely feel that things have changed, there’s a big shift and a huge push now toward inclusion.
I think with social media too, you see the pressure of people saying, for example, #OscarsSoWhite. I grew up in a time when media was controlled by a small group of people and I’ve watched it change, morph, and transform. Fifteen years ago, when I was co-chair of the Hispanic Affinity Group at Time Inc., I was saying we’re here, we consume stuff in English, and you need to pay attention to us. When the census came out [proving what I had been saying], I said, the census, look at the census!
And still the dollars didn’t come in; but when social media happened, that’s when the money started coming in. And finally people started saying, “Oh, they’re, they’re quite vocal, they exist.” [Laughs.] But our ethnicity or color shouldn’t be our only draw. We’re here and have been here. What they’re seeing shouldn’t come as such a shock.
This interview has been edited for length and clarity.
While attending UC San Diego (UCSD), Ireri Lora used her school ID at the university’s medical school to access birth control and other services.
Lora, who was undocumented then, told Rewire, “Sometimes you would see border patrol agents walking around or parked in their trucks, but they were always parked directly in front of the main hospital entrance. They would take people straight from the hospital [to a border patrol station], and they wanted us to see them do that.”
This behavior wasn’t unique to the UCSD hospital, Lora said. An acquaintance whose family members worked for border patrol in San Diego had told her that federal agents would drive around the perimeter of hospitals and park outside of them, presumably to intimidate non-citizens.
Every time Lora had to get her birth control prescription filled, she would make sure multiple people in her life knew where she was going so that if trouble arose, they would answer her call immediately.
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There are, however, California residents for whom none of this matters.
The reasons vary, but what is true across the board is that the more your identity is layered by race, gender, sexuality, and immigration status and the further your income falls below the federal poverty line, the less access you will have to sexual and reproductive health-care services—even in California. There are community-based groups working to fill this gap, but resources are in short supply for those fighting to expand access to undocumented people.
Stifled by Fear of Deportation
In August 2015, when Blanca Borrego, an undocumented mother of three, was arrested by sheriff’s deputies at her gynecologist appointment in Atascocita, Texas, some in the media rightly expressed outrage. But undocumented communities knew it wasn’t an isolated incident and that immigrants are detained and deported for seeking care all the time. Borrego was yet another example confirming some of their biggest fears.
“The fear that accessing [health] services will get you deported is very real in undocumented communities and what happened to Blanca [Borrego] isn’t at all unusual, so it’s not an unfounded fear,” said Alma Leyva, a research coordinator at the UCLA Labor Center’s Dream Resource Center, a national source for research, education, and policy on immigration issues. “She was insured and had been in the country for a long time. A lot of people think, ‘If that could happen to her, why couldn’t it happen to me?'” Leyva told Rewire.
Nearly three years ago, the Dream Resource Center sought to document the experiences of immigrant youth and their families in navigating California’s health-care system as part of its 2013 Healthy California Survey Project. From June 2013 to August 2013, a research team comprised of 37 immigrant youth surveyed 550 undocumented and “DACA-mented” young people. What resulted was Undocumented and Uninsured, the first statewide research project by and about immigrant youth on health access.
As the report explains, while Deferred Action for Childhood Arrivals (DACA) recipients under the age of 21 are eligible for Medi-Cal—the state’s free or low-cost health coverage for children and adults with limited income and resources—that doesn’t resolve a primary reason undocumented people and DACA recipients do not seek care: fear.
National policies contribute to high numbers of deportations and increase immigrant communities’ mistrust, such as the Priority Enforcement Program (PEP), which requires that all fingerprints of arrested persons taken by local law enforcement be sent to ICE to check against immigration databases, and Section 287(g) of the Immigration and Nationality Act, which allows DHS to “deputize selected state and local law enforcement officers to perform the functions of federal immigration agents.”
According to the Undocumented and Uninsured:
The police and Immigration and Customs Enforcement (ICE) are not only in immigrant neighborhoods but also in the minds of undocumented people, triggering constant anticipation of harm and hypervigilant behavior. Emerging research indicates that immigrant youth experience feelings of shame, anger, despair, marginalization, and uncertainty stemming from discrimination, anti-immigrant sentiment, xenophobia, fear of deportation, and institutional barriers. Daily economic uncertainties elevate the risk of anxiety, depression, and vulnerability to mental illness for immigrant youth. Emotional traumas manifest in poor physical and mental health, which often goes untreated.
Leyva told Rewire that she has heard stories “where an undocumented youth was asked by a doctor to relay really complicated medical jargon to their mom as she was giving birth. They were so afraid they wouldn’t translate the information properly that it would be dangerous to their mom,” she said.
“There is anxiety around simple check-ups and fear around obtaining resources to get healthier. We’ve come to believe that this is just the price of being undocumented in this country, and that’s not OK. We too deserve the right to not just survive, but to live full, healthy lives. Health care is a right, not a luxury,” Leyva said.
Dire Circumstances in Rural California
Lora became a legal permanent resident in 2015, but while living in San Diego as an undocumented college student she said her “biggest fear” was a scenario like what happened to Borrego in Texas. In 2009, while working on college campuses and connecting with undocumented families, Lora learned that it was a universal fear among undocumented women.
“When I asked the moms [I worked with] if any of them, about 20 in all, had visited any particular clinics, they all shared that they were scared to because they heard border patrol patrolled the area or that vans waited outside to get people who were leaving the clinic, especially if the clinic was one that primarily served the Latino community. Fortunately, none of the mothers I ever worked with had been stopped by border patrol for seeking services, but that environment made them too scared to go to a clinic,” Lora said.
By that time, she and a friend had started a program where they brought different workshops onto campus based on the expressed needs of the community. Overwhelmingly, Lora said, undocumented mothers requested workshops about sexual education and birth control.
Lora worked with local community clinics from the Barrio Logan area of San Diego to do biweekly workshops in Spanish about sexual health. That experience led her to ACCESS, an Oakland-based organization “founded in 1993 by clinic escorts who were moved to action after witnessing the many barriers women were facing—especially young or poor women—to actually obtain an abortion.” ACCESS further explains on its website that the organization combines direct services, community education, and policy advocacy to promote reproductive options and access to quality health care for California women. It is one of the only organizations in California that helps to provide abortion access to undocumented women while also using a reproductive justice framework created by women of color for women of color.
Lora, who is now on ACCESS’ board of directors, began working with the organization as a healthline intern. The healthline, as Lora explained, empowers callers by giving them all of the information they need to advocate for themselves. It was at this time Lora learned of the very specific barriers undocumented women living in rural areas face.
“They always voiced fears about visiting any government agency to get Medi-Cal or a clinic like Planned Parenthood because they thought they’d be deported or profiled for showing a foreign ID,” Lora said.
Vanessa Gonzalez-Plumhoff, Planned Parenthood’s director of Latino outreach and engagement, made it clear that the health-care provider would not put a patient in harm’s way. She told Rewire that Planned Parenthood is serious about addressing the needs of the undocumented community, asserting that Planned Parenthood will provide health care no matter what, regardless of immigration, citizenship, or income status.
The reason why the services provided to undocumented women may differ by location, Gonzalez-Plumhoff said, is because of the legislative, political, and financial climate of a particular area. As reproductive health care continues to be attacked, it limits what services are made available from clinic to clinic.
Unlike most states, California allows low-income women to obtain public funds for abortion and also provides them with co-pay-free family planning services. Abortions are legal up to viability and California’s AB 154, which took effect in January 2014, increased the number of abortion providers in the state. The law authorized nurse practitioners, certified nurse midwives, and physician assistants to perform vacuum aspiration abortion, which previously only doctors were allowed to do.
But, like in most states, there are districts in California where abortion providers are nonexistent. According to the LA Times, UC San Francisco’s Bixby Center for Global Reproductive Health is largely responsible for the passage of AB 154, but just a handful of the clinicians trained under the six-year study are practicing in remote corners of California. Schools like the UC San Francisco School of Nursing are developing new training programs, but at this point, half of California’s 58 counties currently have no readily available provider. And even when new programs roll out in rural communities, they will only benefit women seeking abortions during the first trimester, leaving out a segment of the population at risk of fetal anomalies or later pregnancy complications.
The process of obtaining an abortion as an undocumented woman living in a rural area is complicated. Lora said these women often work in the fields and live in migrant camps, which makes obtaining the passport that some clinics require as a valid form of ID challenging—and that’s mostly because of the lack of transportation, which Lora said is a “huge barrier” for undocumented women seeking such identification.
In addition, these women often have to travel to reach one of the few clinics providing later abortion care in the state.
“A lot of clinics near women in rural areas only offer abortion until the first trimester,” Lora said. “By the time they’re referred to us, they’re often beyond that point, so they have to get transferred to a clinic that’s even farther away. Transportation comes up again and again.”
This is where ACCESS’ “practical support program” comes in. The organization helps callers navigate paying for care, leveraging over $200,000 of coverage per year for medical procedures. Also, with support from its network of volunteers around the state and the organization’s pool of funds, ACCESS provides around $25,000 annually to help with transportation, housing, meals, child care, medical costs, and doula support.
One of the toughest cases Lora ever handled on the Spanish healthline was an undocumented rape survivor who lived in a rural area. Her family didn’t know of the rape or the resulting pregnancy. By the time ACCESS could walk her through all of the steps, she was in her 20th week. Following the multi-week process, which included acquiring an appointment and bus tickets, she then had to come up with a lie to tell her family as to where she was going for two days.
“The information is not accessible and the barriers can seem endless. That’s why it’s especially upsetting to me when ACCESS constantly hears this misconception that people in California—and women of color in particular—purposefully wait until the last minute to get abortions. It’s simply not true. Most of the women I’ve spoken to were very clear that they wanted to terminate their pregnancies early on, but they were forced to wait weeks because of limited access to information, limited access to clinics, and because of transportation barriers and language barriers,” Lora said. “If abortion was as accessible in California as they paint it to be, all women who wanted to terminate their pregnancies would be able to do it in a week.”
Community Groups Are Working to Replace Fear With Trust
There is no telling how many women ACCESS has helped, but what is clear is the ripple effect of the progress the group is making. ACCESS alumna La Loba Loca, who identifies herself as a queer, machona, brown South American migrant, formed Autonomous Communities for Reproductive and Abortion Support (ACRAS) three years ago. La Loba Loca’s collective, comprised of mostly queer people of color, provides free and low-cost abortion support to Angelenos. Her personal project, Serpiente Birth & Spectrum Services, supports individuals and families during life transitions through bilingual full-spectrum companionship and doula work.
La Loba Loca takes a multifaceted approach to her companion work, coupling an academic framework with traditional knowledge gained through personal research and non-Western education, which she calls “abuelita knowledge.”
“I got into birth work because of abortion. To me, there’s no place people can go that will holistically support them getting an abortion,” La Loba Loca said. “I want to normalize abortion as just another aspect of reproductive health and remind people of the ways our grandmothers took care of their health and well-being outside of the medical industrial complex. It’s medicine and knowledge that is generational and that shouldn’t be lost.”
Above all else, ACRAS works to share knowledge and resources within communities. La Loba Loca has tirelessly compiled documents about abortion and reproductive health for the purpose of being used by undocumented people who don’t have easy access to clinics and hospitals. “The idea was also to include people in the collective who have historically been left out of these conversations or who have been denied the same kind of access to reproductive justice as other people,” she said.
La Loba Loca has been a major proponent of queer and trans people of color receiving the proper training to be both birth and abortion companions. The language used around reproductive justice isn’t inclusive, she said, and it can make queer and trans people of color afraid to discuss their bodies and their needs and afraid to access services.
“I’m hearing a lot of queer and trans people try to figure that out, just because accessing abortion as a queer or trans person can be difficult or when you do obtain one, it can be dehumanizing,” she said. “Right now, there are queer and trans people doing reproductive justice work, but it’s very isolating and frustrating to never receive the funding that’s needed to provide education for and about different bodies.”
To La Loba Loca, the answer to the lack of access and the poor treatment that undocumented people and other low-income communities of color often receive at clinics and hospitals is not working to change these systems, but rather using community-based resources to find ways around the structural hurdles. Roxana, an ACRAS member who requested that Rewire not use her last name, said that the road to sexual and reproductive justice has been built on the backs of women of color and the long history of institutions being harmful to communities of color who are already vulnerable is not something that can easily be overcome.
“I think of the Latinas in L.A. who were coerced into sterilization in the 1970s and how that distrust lingers in the community,” Roxana said. “The trauma stays, and it continues to be a barrier that scares people from going to an institution that historically been violent to people who look like them. It’s only harder when you’re undocumented.”
Like Lora, Roxana realized through her work that immigrant communities, Latino communities, and undocumented communities are all in need of sexual and reproductive health information that is in their language and that comes from people they trust.
At an ACRAS workshop around reproductive justice, according to Roxana, the age of attendees ranged from 15 to 65. A woman specifically asked if it was OK that her teenage daughter was there because she wanted her to have the information that she never did. ACRAS workshops bring a LGBTQ lens and the mother and her daughter were eager to learn about reproductive health for different communities and learn about gender and sexual identities that go beyond the binary. Roxana said the interest is there; it’s just a matter of providing it in a way that’s accessible.
“We’re having real conversations about real experiences and for me, as a person who does this work, it’s very political and very personally meaningful. It’s heart work; it comes from the heart,” Roxana said, growing emotional. “I want to go beyond ‘your body, your choice.’ I’m not really into that, especially because for a lot of us, what happens to our bodies isn’t a choice. For me, it’s more like ‘I got your back.’ ACCESS and collectives like ACRAS serve a very important purpose in our communities. We’re creating alternatives to a system that wasn’t meant for us and we’re providing access to people whose existence was never even considered. We have each other’s backs.”
CORRECTION: This piece has been updated to clarify ACCESS’ funding for “practical support.”