Commentary Sexual Health

Unpacking a Bag Full of STI Stigma

Heather Corinna

Feeling awful about having contracted a sexually transmitted infection? Here's the nitty-gritty on the stigmatization of STIs and people with them and how to deal.

fairies asks:

I’m 20 and have been with my partner for about two and a half years. We have a great relationship and are happy together. However, two years ago, when we first started sleeping together, I contracted genital herpes, even though we used condoms. I was a virgin before I slept with him so I knew it had come from him. I was angry and upset but he kept telling me he had tested clean at his last STI check and couldn’t understand that he must have it. When we went to the GUM clinic (together) they confirmed that I had herpes but told me that they don’t test for herpes unless there are symptoms present. Therefore when my boyfriend had his previous check-up (symptom free) he tested clean for everything they test for and then went on to sleep with me. My boyfriend was upset that I was blaming him and was tested again for everything they test for to prove to me he wasn’t lying when he told me he was clean. He was negative for everything they tested him for….except like last time, they didn’t test for Herpes and told him they didn’t test for it unless there were symptoms, which there wasn’t. He says he doesn’t remember ever having symptoms hence why he’s never had a physical check for it. I KNOW I didn’t do anything wrong, and neither did my boyfriend, but I feel so bad about myself. I feel like I should have done something before we slept together, but I don’t know what. I asked him to make sure he was clean: he did. We had no idea that they didn’t do standard tests for herpes.

How do I stop feeling dirty and like I was irresponsible?

Heather Corinna replies:

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Fairies’ question continued:

99% of the time I don’t feel bothered about it. But recently I had my first flare-up since I was infected two years ago and I feel so embarrassed that I let myself contract it. Worse, I row with my boyfriend about it because I feel like he wants to deny he gave it to me or that I even have it. I think he’s embarrassed and he always tells me that he didn’t know and he had all his checkups and doesn’t understand how he had had it without realizing. He also doesn’t seem to get why they don’t test for it, he keeps saying that he tested clean in his checkups and I keep getting mad and trying to explain that there isn’t a standard test they do so unless he had symptoms they wouldn’t have tested him for it.

Please help. I love my boyfriend very much and I hate feeling guilty about contracting herpes because my decision to have sex was something I really thought hard about and took all the precautions I thought were needed (we were even using condoms despite me being on the pill, though I now know you can contract herpes through skin-to-skin contact after sex). The nurses at the GUM clinic were wonderful and kept telling me I shouldn’t feel guilty and that I took all the precautions I could, but I still feel awful.

I don’t think you or your boyfriend are dirty. I think you’re people who have one of the most common infections in the world, an infection that’s usually pretty harmless to most people, even though you feel ashamed about it right now and understandably upset, both about contracting the infection and about how your boyfriend has been reacting.

For most people, honestly, having herpes is pretty equivalent to having chronic acne: it can be painful with any outbreaks, but is mostly a cosmetic issue that’s unlikely to impact your physical health, even though it can certainly can take a toll on your mental health and how you feel and can be treated by others socially. I also don’t think you have been irresponsible. You both engaged in safer sex, including testing and latex barrier use, well and within the level of access you had from your healthcare services.

I want to make sure you know that illness, of any kind, is rarely about people being “dirty.” Even when you use the word “clean” here, that supports that idea. It’s such a pity that language is so often used when people test/are negative for things, a term I’d suggest you swap out “clean” for. People without certain infections or diseases aren’t automatically “clean” — they’re just people who don’t have certain infections and diseases, or who, in tests, have had negative results when tested for them. How clean or not someone is has nothing to do with this, just like how “dirty” someone is or isn’t.

Sure, if we get a wound and don’t tend to it properly, it will tend to get infected because of bacteria, and would have been less likely to if we cleaned the wound and kept it clean. As well, some kinds of illness are impacted by hygiene: in a real way, by how clean we, parts of our bodies or things we take into our bodies have or have not been, in the free-of-bacteria sense. For example, that can be a factor in urinary tract, E. coli and staph infections. Herpes (HSV), however, isn’t a kind of infections where hygiene is a factor.

The idea that sexually transmitted illness, specifically, is about anyone being “dirty” is really about ignorance, misinformation and social stigma, not about science or medical facts. Very unfortunately, and quite maddeningly, we have a long cultural history of stigma around STIs being cultivated primarily out of the desire for social control. In other words, the idea that scaring people about sexually transmitted illness, or shaming people about it, will make it more likely for them to only have the kinds of sex, or sex in the kinds of contexts or relationships, other people want them to have because of their own personal beliefs, which they feel are superior to different beliefs others may have.

One of the reasons we know HIV became so epidemic is that for years (and sometimes still) after the infection came to light, it was publicized as “the gay disease,” a half-witted and homophopbic tag that resulted in far more people acquiring it than would have otherwise, which has an impact still, and which also played a negative part in how research was done to try and treat people with and prevent the further spread of HIV: that stigma made, and still makes all the wheels to help everyone turn much more slowly. Still today, stigma with HIV — based on both it so often being sexually transmitted and on myths it only can happen to certain people — results in more people acquiring the infection, less people knowing how to prevent it and being supported in prevention, limited access to healthcare and in the funding for developing better care for HIV-positive people. Similar harm has been done when other groups in history — unmarried working-class women and people of color, for instance — were stigmatized about sexually transmitted illness. It’s safe to say that stigma placed on STIs has, in a lot of ways, done just as much harm or more to people as the infections themselves have.

And ultimately, the idea that STIs are about anything dirty is about the fact that some people think that because they think of sex — or some kinds of sex, some ways of having it, or having it with certain kinds of partners or relationship models — as dirty. In other words, you were doing something which, in their minds, was “dirty” and thus, getting an illness through that activity proves that “dirtiness.” It’s flawed logic and much of it is based on shame about sex and things that just aren’t true, but which people really wish were (like the idea that not being gay means you’ll be safer, or that being married, all by itself, means people won’t get STIs), but it’s the heart of where this framing of sexually transmitted illness comes from.

I don’t think sex is dirty (messy, sometimes, sure, but not dirty). I don’t think illness is dirty. And I don’t think you’re dirty. You’re a person who has engaged in sexual behavior the vast majority of people around the world and through history have, and in doing that, you acquired up an infectious disease, one of many — some sexually acquired, some in other ways — in our world people get and pass along just by being in close contact with each other, be that sexual or not sexual at all. Herpes, like other infections, is an illness. It’s not a judgment from on high, a kind of mark on or of your character, and it doesn’t have a thing to do with what kind of person you are or how much people who transmit illness between one another do or don’t care about each other, especially when everyone involved did all they knew to do to prevent transmission, like i seems clear you both did here.

I thought you might appreciate some perspective on this from someone who knows a whole lot about infectious disease, but who doesn’t share my politics or my job. So, I asked my mother. That’s less random than it sounds: my mother is the longtime, big-shot manager of infectious disease and control at one of the largest children’s hospitals in the United States.

I told her about your question, and she said a few things I thought we really spot-on that might give you some comfort.

She agreed with me that stigmatizing sexually transmitted infections arises primarily out of stigmatizing sex and certain people and out of ignorance and attempts to socially control people. She also agreed with me that stigmatizing sexually transmitted illness, or any kind of illness, does people real harm, both in terms of making them feel crappy, like you do and like it sounds like your boyfriend does, but also in terms of how it impacts public health. In other words, she agreed that stigma on sexually transmitted illness makes people sick. After all, it’s this stigma, more than anything else, that keeps people from getting tested, keeps people from talking about sexual health and making responsible choices like you did and impacts things like how accessible testing and treatment for STIs is to people around the world.

She also mentioned that some infections classed as sexually transmitted, and which often are, but aren’t only transmitted that way — like Herpes, HIV or hepatitis — are often transmitted from mother-to-child. Yet, we do not often hear people say that that kind of transmission or relationship is about anyone being dirty. She also brought up allergies. She said allergies are about a foreign antigen being introduced to our bodies, and us having a reaction to it, the exact same thing that happens with a virus like Herpes. And yet, we don’t hear people saying things people are allergic to like pollen, peanut butter, grass, strawberries or cute little kittens are nasty or dirty, nor that people with allergies are dirty. She went on a bit after that, bringing up what I often do that infectious disease is infectious disease: because some kinds are associated with or transmitted by sex doesn’t mean people who have or get them are any more “dirty” than people with other kinds of infectious disease, like who get the flu, a cold or chicken pox (which is a varicella-zoster virus like Herpes is).

My Mom and I also talked about how STI testing, when tests for all STIs are actually done (bearing in mind we’re still without a means to test men for HPV), can be very accurate, but are not infallible. In other words, tests are more often right than not, but not always. We also don’t have all the best technology for testing yet, and all tests aren’t available to all people, based on things like our income or our particular national healthcare system and its policies.

We can say similar things about other parts of safer sex. Latex barriers used properly and consistently for all oral, vaginal and/or anal sex do an excellent job of reducing the risks of STIs, but they only reduce the risks: they don’t make those risks go away. So long as we have the kinds of contact, sexual or otherwise, where we can transmit or acquire infections or diseases, there is always going to be some risk of them, even when we do all we can to reduce those risks. And with an infection like Herpes, unless you live your whole life in a plastic bubble, it’s virtually impossible not to be exposed to it at least a few times in life, because it is so, so common and so easy to transmit or acquire.

It sounds to me like you did all you could do here, save choosing not to ever have sex at all. You used barriers. You asked about testing and insisted your partner be tested. You partner also did his part, too: he went and asked for STI testing and the clinic gave him the tests they thought he needed. These are things you probably already know you’ll want to keep doing through your life.

One thing for both of you to know is that the policy that clinic system had isn’t unusual, especially in healthcare systems where the patient isn’t paying for the tests themselves. Testing for HSV can be tricky, as it is, because it’s so common that almost everyone has been exposed, even though everyone doesn’t have Herpes. Testing for Herpes is much more accurate when someone has an outbreak, which is one reason why most providers don’t test for it otherwise. While there are some common blood tests for HSV, the most reliable kinds of testing for HSV without outbreaks are costly and are not widely available, so you’re not likely to see them used much, especially in public healthcare. It’s not uncommon for a doctor or clinic not to use the most widely available blood tests for HSV because that kind of testing is known to often be unreliable.

It also is an infection which, for most people, doesn’t usually present big health risks, just like, for most people, chicken pox doesn’t. Save for some specific populations with certain health conditions, like pregnant people, those with suppressed immune systems or those at high risk of HIV infection (which I assume you’d have mentioned were these things currently issues for you), Herpes typically isn’t a major public health concern, nor an infection a healthcare provider will usually need to be concerned will create health issues for an average patient. To boot, it’s not something we have treatment for, beyond medications to help suppress outbreaks: in other words, unlike an infection like Chlamydia, there’s no medication we can take to make the Herpes virus go away. So, even when someone has it, there’s nothing a healthcare provider can usually do, save providing a medication to reduce the symptoms of HSV if a patient wants to do that. The only advice they’d give someone they knew had it to protect partners would be mostly about what you already knew and do: to use barriers for any oral, vaginal and/or anal sex. Additionally, they’d advise that when someone feels an outbreak coming on or has one, they avoid intimate contact, but that wouldn’t have helped your boyfriend any here since he didn’t experience an outbreak or notice if he had one.

So, those are all some of the reasons why, unless someone asks specifically for a Herpes test (or a full panel for all STIs, rather than leaving it up to the healthcare provider to decide what tests to run), that test often won’t be done. In the future, you can both make sure that with STI testing you always ask for a full panel, but you still may not get it when you do in healthcare systems where you’re not actually paying for all of those tests yourselves, or when a provider feels a test just isn’t warranted or won’t give reliable results.

It might also help you both to know that most people with most STIs, including Herpes, don’t have obvious symptoms, and with Herpes specifically, only around 75% of people at a maximum ever see or recognize symptoms to know they have it. In the UK, around 25% of your population who has had any kind of genital sex has HSV-2. To be clear about the information you took away on acquiring it, even with condom use, the deal is that because Herpes isn’t just transmitted by fluids, but also by skin contact, and condoms don’t cover all of genital surfaces, it can still be acquired/transmitted when using condoms. All infections can, but condoms provide more protection (around 10% to over 20% more) with infections spread only by fluids, unlike infections like Herpes and HPV. So, this isn’t just about contact after sex, but during any kind of sex.

Both of you really did do all you could do here. No one can ever have complete control over acquiring or transmitting all kinds of illness or not, including sexually transmitted illnesses. Medical science also has its limits, even for the rare individuals who have access to absolutely anything and everything in terms of tests and care.

One thing I think would make you feel a lot better, since this seems to be a major part of your question, is if you and your partner could come to some kind of resolution about this. It’s very clear you feel like he’s avoiding responsibility, and I can certainly see why you feel that way. It seems likely he doesn’t feel good about this either; that he feels as pissed and embarrassed about getting the virus as you do, and probably just as upset about feeling like this should have been something you two could have controlled. In other words, he seems to be feeling a lot like you are, he’s just dealing with it and communicating about it in a way that’s probably making you both feel worse. Too, he may have his own additional feelings about this that are different and distinct from yours that are having an impact on the way he’s feeling and behaving.

What I’d suggest is making clear to him that you don’t want to fight about this. I’d add — and if you’ve done this already a bunch of times, figure you make it clear one last time — that you know he didn’t do you any harm on purpose, and know, understand and believe that he thought he really had done all he could when it came to his testing, and that when it comes to possible limitations of your healthcare system, he may well have done so. In other words, that even if he had asked for a test, he probably would not have gotten one, and even if he got one, it may not have provided accurate results, so this still could have happened.

But then what you add is that you know all of that, but you feel like you’re alone in this and really don’t want to be, both because you’re not, and because it makes you feel worse about everything. You’re not looking to blame him: you’re looking for him to share responsibility so you don’t have to be the only one feeling responsible, especially since you’re not. You can tell him what you want and need is just for him to be with you in this so it’s something you both deal with together, especially since it is about both of you. You might even ask him to talk more about his feelings, maybe bringing up that he might have his own difficult and complex feelings about how he picked it up himself (if he knows), and feelings of guilt for inadvertently passing it on to you, and offering to listen to him and support him in those feelings.

Another helpful move might be for both of you to go back to that GUM clinic once more and ask one of those awesome nurses to talk with you two about all of this. They can fill you both in more about all the questions you each have and the things your boyfriend doesn’t seem to be getting or accepting, and may even be able to give you some help in dealing with this well as a couple. I’ll leave you some links for more information on HSV, but if either of you still have any lingering questions about this as a healthcare issue, it’s always wise to ask your healthcare provider directly.

You might also want to check in with yourself and make sure this relationship is still working for you and is really as awesome as it has been in the past. If this is the only area where you two are having the kind of emotional dynamics you have been, and everything else is great and feels great, then you can probably work this out. But if he’s doing things like avoiding responsibility for other things, or not being supportive of you in other ways, it may be time to make sure this is really about Herpes and not about bigger things.

One last thing you might need to unpack that might part of how you feel are ideas people will often have that genitals need to be somehow perfect. In other words, that they always need to look awesome, whether that’s having whatever someone feels is the “right” amount of hair, the “right” size of penis or labia, the “right” smell or color. People can feel that way about bodies as a whole, too. But bodies and all their parts, including genitals, aren’t perfect: they’re human, just like us. Sometimes we’re going to have zits or ingrown hairs. Sometimes our genitals are going to smell funky or look weird. And sometimes, just like with any other part of our bodies, we’re going to have an illness or health condition that’s going to impact how our genitals look, smell, taste or feel and how we feel about them. If and when we’re already not at the point in our lives where we’re pretty comfy with our genitals as a whole, having something noticeably wrong with them can be even tougher. So, I’d suggest checking out your feelings about this stuff, too, and trying to adjust your thinking — something your boyfriend might also need to do — to accept that it’s always okay when bodies, or genitals, aren’t “perfect.” We get to be sick sometimes. We get to be imperfect, and even if we don’t feel like that’s okay or allowed, we’re going to be imperfect in many ways no matter what we do or who we are, whether we get ill or not, so if we don’t get pretty okay with that, it’s going to be hard to feel good no matter what. In other words, if some of how you feel is about being physically “imperfect” now? Welcome to the club: it’s one everyone is a part of even when they don’t think they’re a member.

I hope that at least some of what I said here will help you feel better, but it still might take some time to absorb all of it and also to accept it all, both for you and your partner. Just shrugging off things that are socially stigmatized, even when we know that that stigma is based on things that aren’t sound is rarely something anyone can just do and be done with all zippy-like. It tends to take time. It’s also tough to have any kind of illness or change to our bodies, especially when we know that change is in some way permanent, even when we know it’s common and not going to kill us. If you’ve never had any experiences dealing with ongoing illness before this, that alone tends to be its own process. Humanity and mortality are hardly minor issues to grapple with, after all.

Here are those extra links on this site about herpes and safer sex (seeing that you were doing all you could in another context might help you feel better), a couple that might help you and your partner work through stuff in your relationship, and I’m also passing along a good support site specifically for folks in the UK with genital herpes you might find helpful.

News Politics

Anti-Choice Democrats: ‘Open the Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Read more of our coverage of the Democratic National Convention here.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

Analysis Economic Justice

New Pennsylvania Bill Is Just One Step Toward Helping Survivors of Economic Abuse

Annamarya Scaccia

The legislation would allow victims of domestic violence, sexual assault, and stalking to terminate their lease early or request locks be changed if they have "a reasonable fear" that they will continue to be harmed while living in their unit.

Domestic violence survivors often face a number of barriers that prevent them from leaving abusive situations. But a new bill awaiting action in the Pennsylvania legislature would let survivors in the state break their rental lease without financial repercussions—potentially allowing them to avoid penalties to their credit and rental history that could make getting back on their feet more challenging. Still, the bill is just one of several policy improvements necessary to help survivors escape abusive situations.

Right now in Pennsylvania, landlords can take action against survivors who break their lease as a means of escape. That could mean a lien against the survivor or an eviction on their credit report. The legislation, HB 1051, introduced by Rep. Madeleine Dean (D-Montgomery County), would allow victims of domestic violence, sexual assault, and stalking to terminate their lease early or request locks be changed if they have “a reasonable fear” that they will continue to be harmed while living in their unit. The bipartisan bill, which would amend the state’s Landlord and Tenant Act, requires survivors to give at least 30 days’ notice of their intent to be released from the lease.

Research shows survivors often return to or delay leaving abusive relationships because they either can’t afford to live independently or have little to no access to financial resources. In fact, a significant portion of homeless women have cited domestic violence as the leading cause of homelessness.

“As a society, we get mad at survivors when they don’t leave,” Kim Pentico, economic justice program director of the National Network to End Domestic Violence (NNEDV), told Rewire. “You know what, her name’s on this lease … That’s going to impact her ability to get and stay safe elsewhere.”

“This is one less thing that’s going to follow her in a negative way,” she added.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Pennsylvania landlords have raised concerns about the law over liability and rights of other tenants, said Ellen Kramer, deputy director of program services at the Pennsylvania Coalition Against Domestic Violence, which submitted a letter in support of the bill to the state House of Representatives. Lawmakers have considered amendments to the bill—like requiring “proof of abuse” from the courts or a victim’s advocate—that would heed landlord demands while still attempting to protect survivors.

But when you ask a survivor to go to the police or hospital to obtain proof of abuse, “it may put her in a more dangerous position,” Kramer told Rewire, noting that concessions that benefit landlords shift the bill from being victim-centered.

“It’s a delicate balancing act,” she said.

The Urban Affairs Committee voted HB 1051 out of committee on May 17. The legislation was laid on the table on June 23, but has yet to come up for a floor vote. Whether the bill will move forward is uncertain, but proponents say that they have support at the highest levels of government in Pennsylvania.

“We have a strong advocate in Governor Wolf,” Kramer told Rewire.

Financial Abuse in Its Many Forms

Economic violence is a significant characteristic of domestic violence, advocates say. An abuser will often control finances in the home, forcing their victim to hand over their paycheck and not allow them access to bank accounts, credit cards, and other pecuniary resources. Many abusers will also forbid their partner from going to school or having a job. If the victim does work or is a student, the abuser may then harass them on campus or at their place of employment until they withdraw or quit—if they’re not fired.

Abusers may also rack up debt, ruin their partner’s credit score, and cancel lines of credit and insurance policies in order to exact power and control over their victim. Most offenders will also take money or property away from their partner without permission.

“Financial abuse is so multifaceted,” Pentico told Rewire.

Pentico relayed the story of one survivor whose abuser smashed her cell phone because it would put her in financial dire straits. As Pentico told it, the abuser stole her mobile phone, which was under a two-year contract, and broke it knowing that the victim could not afford a new handset. The survivor was then left with a choice of paying for a bill on a phone she could no longer use or not paying the bill at all and being turned into collections, which would jeopardize her ability to rent her own apartment or switch to a new carrier. “Things she can’t do because he smashed her smartphone,” Pentico said.

“Now the general public [could] see that as, ‘It’s a phone, get over it,'” she told Rewire. “Smashing that phone in a two-year contract has such ripple effects on her financial world and on her ability to get and stay safe.”

In fact, members of the public who have not experienced domestic abuse may overlook financial abuse or minimize it. A 2009 national poll from the Allstate Foundation—the philanthropic arm of the Illinois-based insurance company—revealed that nearly 70 percent of Americans do not associate financial abuse with domestic violence, even though it’s an all-too-common tactic among abusers: Economic violence happens in 98 percent of abusive relationships, according to the NNEDV.

Why people fail to make this connection can be attributed, in part, to the lack of legal remedy for financial abuse, said Carol Tracy, executive director of the Women’s Law Project, a public interest law center in Pennsylvania. A survivor can press criminal charges or seek a civil protection order when there’s physical abuse, but the country’s legal justice system has no equivalent for economic or emotional violence, whether the victim is married to their abuser or not, she said.

Some advocates, in lieu of recourse through the courts, have teamed up with foundations to give survivors individual tools to use in economically abusive situations. In 2005, the NNEDV partnered with the Allstate Foundation to develop a curriculum that would teach survivors about financial abuse and financial safety. Through the program, survivors are taught about financial safety planning including individual development accounts, IRA, microlending credit repair, and credit building services.

State coalitions can receive grant funding to develop or improve economic justice programs for survivors, as well as conduct economic empowerment and curriculum trainings with local domestic violence groups. In 2013—the most recent year for which data is available—the foundation awarded $1 million to state domestic violence coalitions in grants that ranged from $50,000 to $100,000 to help support their economic justice work.

So far, according to Pentico, the curriculum has performed “really great” among domestic violence coalitions and its clients. Survivors say they are better informed about economic justice and feel more empowered about their own skills and abilities, which has allowed them to make sounder financial decisions.

This, in turn, has allowed them to escape abuse and stay safe, she said.

“We for a long time chose to see money and finances as sort of this frivolous piece of the safety puzzle,” Pentico told Rewire. “It really is, for many, the piece of the puzzle.”

Public Policy as a Means of Economic Justice

Still, advocates say that public policy, particularly disparate workplace conditions, plays an enormous role in furthering financial abuse. The populations who are more likely to be victims of domestic violence—women, especially trans women and those of color—are also the groups more likely to be underemployed or unemployed. A 2015 LGBT Health & Human Services Network survey, for example, found that 28 percent of working-age transgender women were unemployed and out of school.

“That’s where [economic abuse] gets complicated,” Tracy told Rewire. “Some of it is the fault of the abuser, and some of it is the public policy failures that just don’t value women’s participation in the workforce.”

Victims working low-wage jobs often cannot save enough to leave an abusive situation, advocates say. What they do make goes toward paying bills, basic living needs, and their share of housing expenses—plus child-care costs if they have kids. In the end, they’re not left with much to live on—that is, if their abuser hasn’t taken away access to their own earnings.

“The ability to plan your future, the ability to get away from [abuse], that takes financial resources,” Tracy told Rewire. “It’s just so much harder when you don’t have them and when you’re frightened, and you’re frightened for yourself and your kids.”

Public labor policy can also inhibit a survivor’s ability to escape. This year, five states, Washington, D.C., and 24 jurisdictions will have passed or enacted paid sick leave legislation, according to A Better Balance, a family and work legal center in New York City. As of April, only one of those states—California—also passed a state paid family leave insurance law, which guarantees employees receive pay while on leave due to pregnancy, disability, or serious health issues. (New Jersey, Rhode Island, Washington, and New York have passed similar laws.) Without access to paid leave, Tracy said, survivors often cannot “exercise one’s rights” to file a civil protection order, attend court hearings, or access housing services or any other resource needed to escape violence.

Furthermore, only a handful of state laws protect workers from discrimination based on sex, sexual orientation, gender identity, and pregnancy or familial status (North Carolina, on the other hand, recently passed a draconian state law that permits wide-sweeping bias in public and the workplace). There is no specific federal law that protects LGBTQ workers, but the U.S. Employment Opportunity Commission has clarified that the Civil Rights Act of 1964 does prohibit discrimination based on gender identity and sexual orientation.

Still, that doesn’t necessarily translate into practice. For example, the National Center for Transgender Equality found that 26 percent of transgender people were let go or fired because of anti-trans bias, while 50 percent of transgender workers reported on-the-job harassment. Research shows transgender people are at a higher risk of being fired because of their trans identity, which would make it harder for them to leave an abusive relationship.

“When issues like that intersect with domestic violence, it’s devastating,” Tracy told Rewire. “Frequently it makes it harder, if not impossible, for [victims] to leave battering situations.”

For many survivors, their freedom from abuse also depends on access to public benefits. Programs like Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), the child and dependent care credit, and earned income tax credit give low-income survivors access to the money and resources needed to be on stable economic ground. One example: According to the Center on Budget and Policy Priorities, where a family of three has one full-time nonsalary worker earning $10 an hour, SNAP can increase their take-home income by up to 20 percent.

These programs are “hugely important” in helping lift survivors and their families out of poverty and offset the financial inequality they face, Pentico said.

“When we can put cash in their pocket, then they may have the ability to then put a deposit someplace or to buy a bus ticket to get to family,” she told Rewire.

But these programs are under constant attack by conservative lawmakers. In March, the House Republicans approved a 2017 budget plan that would all but gut SNAP by more than $150 million over the next ten years. (Steep cuts already imposed on the food assistance program have led to as many as one million unemployed adults losing their benefits over the course of this year.) The House GOP budget would also strip nearly $500 billion from other social safety net programs including TANF, child-care assistance, and the earned income tax credit.

By slashing spending and imposing severe restrictions on public benefits, politicians are guaranteeing domestic violence survivors will remain stuck in a cycle of poverty, advocates say. They will stay tethered to their abuser because they will be unable to have enough money to live independently.

“When women leave in the middle of the night with the clothes on their back, kids tucked under their arms, come into shelter, and have no access to finances or resources, I can almost guarantee you she’s going to return,” Pentico told Rewire. “She has to return because she can’t afford not to.”

By contrast, advocates say that improving a survivor’s economic security largely depends on a state’s willingness to remedy what they see as public policy failures. Raising the minimum wage, mandating equal pay, enacting paid leave laws, and prohibiting employment discrimination—laws that benefit the entire working class—will make it much less likely that a survivor will have to choose between homelessness and abuse.

States can also pass proactive policies like the bill proposed in Pennsylvania, to make it easier for survivors to leave abusive situations in the first place. Last year, California enacted a law that similarly allows abuse survivors to terminate their lease without getting a restraining order or filing a police report permanent. Virginia also put in place an early lease-termination law for domestic violence survivors in 2013.

A “more equitable distribution of wealth is what we need, what we’re talking about,” Tracy told Rewire.

As Pentico put it, “When we can give [a survivor] access to finances that help her get and stay safe for longer, her ability to protect herself and her children significantly increases.”