Roundups Media

Global Roundup: Are Anti-Trafficking Efforts Doing More Harm Than Good?

Jessica Mack

Weekly global roundup: "virginity test" doctor is acquitted in Egypt while women's football gathers momentum; condoms may literally save South Africa; a rosier picture of sex work in Thailand; journalist threatened for exposing female genital cutting in Liberia; and a steamy drama series in Kenya tackles sexual taboos.

Welcome to our new Weekly Global Reproductive Justice Roundup! Each week, reporter Jessica Mack will summarize reproductive and sexual health and justice news from around the world.  We will still report in depth on some of these stories, but we want to make sure you get a sense of the rest and the best.

In Egypt, Women’s Football V. ‘Virginity Tests’                        
Sahar El-Hawary is North Africa’s first female referee, and is pioneering female football in Egypt. Al Jazeera profiled her story and work this month as part of their wonderful Africa on the Move series, which features uplifting stories from across the continent. The piece is beautifully done and well worth the watch. El-Hawary grew up with brothers and a father who were rabid football fans, and dreamed of playing and coaching herself. Two decades ago she began training a girls’ team in the secrecy of her own home, and today she has helped to set up girls teams in almost every region of the country. She recruits female players, coaches and referees, and in the process is helping undo a male-dominated sport and culture. Her son Omar helps manages the team. “Women can change the structure of societies in these areas,” she says. Here’s a video of one girls team playing back in 2007, which is pretty bad ass.

Meanwhile, women in Egypt are facing other setbacks. Last week a military court acquitted an army doctor accused of conducting forced “virginity tests” on female protesters last year. Activist Samira Ibrahim, who initially brought the charges, said the entire trial and resulting acquittal was “a joke, a theatre.” Ibrahim and other female detainees had alleged that military personnel sexually assaulted, harassed, and abused them in various grotesque ways – including “testing” to see whether they were virgins. (Let’s remember that penetration by any object without consent is rape, folks.) In response, one Army general deflected: “We didn’t want them to say we had sexually assaulted or raped them, so we wanted to prove that they weren’t virgins in the first place.” Wow, just wow. Via Al Jazeera and VOA.

Thank You, Condoms: South Africa’s New HIV/AIDS Infections Plummet
South Africa, where 17 percent of adults ages 15 to 49 are HIV-positive, shoulders a heavy AIDS burden, but the rate of new infections in the country has dropped dramatically in the last decade. A study released last month suggests that this is largely due to increased condom use. In 2009, 75 percent of young South African men reported condom use at their last sexual encounter, compared to just  20 percent in 1999. It’s a significant revelation that such a simple and widely available tool can be so effective, given some setbacks and delays with other prevention options. Lack of condom use has been attributed to cultural attitudes toward masculinity, perceptions of promiscuity, and taboos about sex more broadly, but that is changing and national leadership on this issue has stepped way up. Remember when the Pope claimed that condoms would not help Africa’s AIDS crisis? Still a ways to go, but it’s looking like he was wrong. Via Economist.

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A New Snapshot of (Positive) Sex Work in Thailand
A new report by the Empower Foundation, a sex workers’ rights group in Thailand, offers a more nuanced picture of the country’s sex work industry – a well-developed, perhaps world-famous, and now increasingly legitimate sector for many. Hit & Run: Sex Workers’ Research on Anti-trafficking in Thailand is the result of a year-long survey implemented by sex workers among sex workers, to uncover the state of the industry. The report finds that sex workers are better off and better connected than many thought. Sex workers have access to hi-tech tools (e.g. smart phones) and use them to stay connected and safe; migration is part of the culture of sex work, and often helpful/voluntary (i.e. sex ‘trade’ not ‘trafficking’); and the average sex worker makes enough money to comfortably take care of his/her family. Of course it’s not positive all the time for everyone. But anti-trafficking groups and initiatives in Southeast Asia are a dime a dozen with many ineffective, oppressive, or all together useless. Everyone from Nicholas Kristof to Ashton Kutcher is trying to “save” girls and women and while these efforts may be well-meaning they tend to erase critical nuances in the issue and drown out the voices and agencies of sex workers themselves. “There are more women in the Thai sex industry being abused by anti-trafficking practices than there are women exploited by traffickers,” Empower director Chantawipa Apisuk said.  Via Nation Multimedia.

Story on Genital Cutting in Liberia Draws Threats
A Liberian journalist who published a piece on the persistence of female genital cutting in the Sande tradition this week has received threats to her wellbing. Mae Azango, a fellow for New Narratives and the Pulitzer Center, said that just days after her piece was published she received phone messages threatening to injure her for speaking out. Azango has not been sleeping at her house since. Signaling just how sensitive this issue is, Azango’s interview subject requested a pseudonym as protection for even speaking about her experience with the practice. As she point out, Liberia is one of five countries in Africa still holding on to the practice and little data exists to depict its magnitude. Other countries, including regional neighbor Senegal, have been open about the challenges in uprooting the practice but have become well-known for their rapid abandonment of the practice. It does beg the question though: why has this issue remained so rooted and clandestine in Liberia? Why, especially, when the country is under the tenure of Africa’s first female president (now in her second term) Ellen Johnson-Sirleaf, who won a Nobel Peace Prize last year along with her country-woman (and fellow activist!) Leymah Gbowee. The Committee to Protect Journalists (CPJ) yesterday issued a letter to President Johnson-Sirleaf requesting formal protection for Azango. Via CPJ.

Drama Series in Kenya Takes on Sexual Taboos

Shuga: Love, Sex, Money is a six-part drama series based in Nairobi, Kenya and looks pretty awesome. It’s racy, soap operatic, filled with good-looking and talented African actors, and meant to address persistent health and social taboos that have gone unaddressed for too long. A joint effort by MTV, the Partnership for an HIV-Free Generation, UNICEF and others, the series looks at rape, transactional sex, and other issues young people are navigating without many resources. It will be shown in 70 countries around the world. The series is also being used in youth HIV prevention and education programs, and has an accompanying toolkit to facilitate discussions and encourage status knowledge and testing. You can join discussions of “Shuga” online here. Via Humanosphere.

Analysis Abortion

Legislators Have Introduced 445 Provisions to Restrict Abortion So Far This Year

Elizabeth Nash & Rachel Benson Gold

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. Of these, 35 percent (445 provisions) sought to restrict access to abortion services. By midyear, 17 states had passed 46 new abortion restrictions.

Including these new restrictions, states have adopted 334 abortion restrictions since 2010, constituting 30 percent of all abortion restrictions enacted by states since the U.S. Supreme Court decision in Roe v. Wade in 1973. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

Mid year state restrictions

 

Signs of Progress

The first half of the year ended on a high note, with the U.S. Supreme Court handing down the most significant abortion decision in a generation. The Court’s ruling in Whole Woman’s Health v. Hellerstedt struck down abortion restrictions in Texas requiring abortion facilities in the state to convert to the equivalent of ambulatory surgical centers and mandating that abortion providers have admitting privileges at a local hospital; these two restrictions had greatly diminished access to services throughout the state (see Lessons from Texas: Widespread Consequences of Assaults on Abortion Access). Five other states (Michigan, Missouri, Pennsylvania, Tennessee, and Virginia) have similar facility requirements, and the Texas decision makes it less likely that these laws would be able to withstand judicial scrutiny (see Targeted Regulation of Abortion Providers). Nineteen other states have abortion facility requirements that are less onerous than the ones in Texas; the fate of these laws in the wake of the Court’s decision remains unclear. 

Ten states in addition to Texas had adopted hospital admitting privileges requirements. The day after handing down the Texas decision, the Court declined to review lower court decisions that have kept such requirements in Mississippi and Wisconsin from going into effect, and Alabama Gov. Robert Bentley (R) announced that he would not enforce the state’s law. As a result of separate litigation, enforcement of admitting privileges requirements in Kansas, Louisiana, and Oklahoma is currently blocked. That leaves admitting privileges in effect in Missouri, North Dakota, Tennessee and Utah; as with facility requirements, the Texas decision will clearly make it harder for these laws to survive if challenged.

More broadly, the Court’s decision clarified the legal standard for evaluating abortion restrictions. In its 1992 decision in Planned Parenthood of Southeastern Pennsylvania v. Casey, the Court had said that abortion restrictions could not impose an undue burden on a woman seeking to terminate her pregnancy. In Whole Woman’s Health, the Court stressed the importance of using evidence to evaluate the extent to which an abortion restriction imposes a burden on women, and made clear that a restriction’s burdens cannot outweigh its benefits, an analysis that will give the Texas decision a reach well beyond the specific restrictions at issue in the case.

As important as the Whole Woman’s Health decision is and will be going forward, it is far from the only good news so far this year. Legislators in 19 states introduced a bevy of measures aimed at expanding insurance coverage for contraceptive services. In 13 of these states, the proposed measures seek to bolster the existing federal contraceptive coverage requirement by, for example, requiring coverage of all U.S. Food and Drug Administration approved methods and banning the use of techniques such as medical management and prior authorization, through which insurers may limit coverage. But some proposals go further and plow new ground by mandating coverage of sterilization (generally for both men and women), allowing a woman to obtain an extended supply of her contraceptive method (generally up to 12 months), and/or requiring that insurance cover over-the-counter contraceptive methods. By July 1, both Maryland and Vermont had enacted comprehensive measures, and similar legislation was pending before Illinois Gov. Bruce Rauner (R). And, in early July, Hawaii Gov. David Ige (D) signed a measure into law allowing women to obtain a year’s supply of their contraceptive method.

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But the Assault Continues

Even as these positive developments unfolded, the long-standing assault on sexual and reproductive health and rights continued apace. Much of this attention focused on the release a year ago of a string of deceptively edited videos designed to discredit Planned Parenthood. The campaign these videos spawned initially focused on defunding Planned Parenthood and has grown into an effort to defund family planning providers more broadly, especially those who have any connection to abortion services. Since last July, 24 states have moved to restrict eligibility for funding in several ways:

  • Seventeen states have moved to limit family planning providers’ eligibility for reimbursement under Medicaid, the program that accounts for about three-fourths of all public dollars spent on family planning. In some cases, states have tried to exclude Planned Parenthood entirely from such funding. These attacks have come via both administrative and legislative means. For instance, the Florida legislature included a defunding provision in an omnibus abortion bill passed in March. As the controversy grew, the Centers for Medicare and Medicaid Services, the federal agency that administers Medicaid, sent a letter to state officials reiterating that federal law prohibits them from discriminating against family planning providers because they either offer abortion services or are affiliated with an abortion provider (see CMS Provides New Clarity For Family Planning Under Medicaid). Most of these state attempts have been blocked through legal challenges. However, a funding ban went into effect in Mississippi on July 1, and similar measures are awaiting implementation in three other states.
  • Fourteen states have moved to restrict family planning funds controlled by the state, with laws enacted in four states. The law in Kansas limits funding to publicly run programs, while the law in Louisiana bars funding to providers who are associated with abortion services. A law enacted in Wisconsin directs the state to apply for federal Title X funding and specifies that if this funding is obtained, it may not be distributed to family planning providers affiliated with abortion services. (In 2015, New Hampshire moved to deny Title X funds to Planned Parenthood affiliates; the state reversed the decision in 2016.) Finally, the budget adopted in Michigan reenacts a provision that bars the allocation of family planning funds to organizations associated with abortion. Notably, however, Virginia Gov. Terry McAuliffe (D) vetoed a similar measure.
  • Ten states have attempted to bar family planning providers’ eligibility for related funding, including monies for sexually transmitted infection testing and treatment, prevention of interpersonal violence, and prevention of breast and cervical cancer. In three of these states, the bans are the result of legislative action; in Utah, the ban resulted from action by the governor. Such a ban is in effect in North Carolina; the Louisiana measure is set to go into effect in August. Implementation of bans in Ohio and Utah has been blocked as a result of legal action.

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The first half of 2016 was also noteworthy for a raft of attempts to ban some or all abortions. These measures fell into four distinct categories:

  • By the end of June, four states enacted legislation to ban the most common method used to perform abortions during the second trimester. The Mississippi and West Virginia laws are in effect; the other two have been challenged in court. (Similar provisions enacted last year in Kansas and Oklahoma are also blocked pending legal action.)
  • South Carolina and North Dakota both enacted measures banning abortion at or beyond 20 weeks post-fertilization, which is equivalent to 22 weeks after the woman’s last menstrual period. This brings to 16 the number of states with these laws in effect (see State Policies on Later Abortions).
  • Indiana and Louisiana adopted provisions banning abortions under specific circumstances. The Louisiana law banned abortions at or after 20 weeks post-fertilization in cases of diagnosed genetic anomaly; the law is slated to go into effect on August 1. Indiana adopted a groundbreaking measure to ban abortion for purposes of race or sex selection, in cases of a genetic anomaly, or because of the fetus’ “color, national origin, or ancestry”; enforcement of the measure is blocked pending the outcome of a legal challenge.
  • Oklahoma Gov. Mary Fallin (R) vetoed a sweeping measure that would have banned all abortions except those necessary to protect the woman’s life.

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In addition, 14 states (Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, South Carolina, South Dakota, Tennessee and Utah) enacted other types of abortion restrictions during the first half of the year, including measures to impose or extend waiting periods, restrict access to medication abortion, and establish regulations on abortion clinics.

Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.

News Law and Policy

Court Blocks Two Extreme Alabama Anti-Abortion Provisions

Jessica Mason Pieklo

The temporary order prevents officials in Alabama from enforcing a ban on later abortions and implementing a law that would regulate abortion clinics in a similar fashion as sex offenders.

A federal judge on Wednesday temporarily blocked two Alabama abortion restrictions set to take effect August 1 that would ban abortion clinics near schools and criminalize the most commonly used later abortion procedure.

In May, Alabama Gov. Robert Bentley (R) signed into law a ban on abortion clinics within 2,000 feet of public K-8 schools. He also approved a separate measure banning the most common method of performing a later abortion, known as dilation and evacuation, or D&E, abortions.

The American Civil Liberties Union (ACLU) challenged both provisions on behalf of providers in the state, arguing they were unconstitutional. According to attorneys for the ACLU, the location restriction would close the state’s two busiest abortion clinics, while the method ban would hamper access to later abortions.

The first blocked measure would prohibit the Alabama Department of Public Health from issuing or renewing a health center license to an abortion clinic or reproductive health center close to some public schools. As reported by Rewire, this would effectively regulate abortion clinics in the same manner as registered sex offenders. In Alabama, sex offenders cannot reside within 2,000 feet of a school or child-care facility.

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The second blocked measure would outlaw most surgical abortions. Dilation and evacuation, the most common form of surgical abortion, is used in the majority of abortions after 13 weeks of pregnancy, according to the American College of Obstetricians and Gynecologists. It is extremely safe, with less than one in 1,000 patients experiencing complications.

Dr. Willie Parker, a physician who provides later abortions in Alabama, wrote in a statement to the court that, if allowed to take effect, the law would prevent him from performing abortions after 15 weeks of pregnancy.

According to Dr. Parker’s submission to the court, the only alternative to D&E is to induce labor in a hospital, a much riskier and expensive alternative for the patient.

U.S. District Judge Myron Thompson Wednesday issued a temporary restraining order to block the state from enforcing the provisions until after an October 4 hearing. In the meantime, both sides were ordered to submit written arguments to the court in advance of that October hearing.

Alabama is not the only state to attack later abortion access. Kansas and Oklahoma both passed similar bans, but those laws remain blocked by court order.