Commentary Human Rights

The Fight for Reproductive Rights in Spain: Our Struggle Is Yours

Carme Chacon

A new bill in Spain threatens to make abortion a crime. This would be a giant step backward for women and for all of Spanish society.

It is hard to believe for many of my American partners as well as for many young Spaniards: in Spain, just 40 years ago, still in the ’70s, in the final phase of the Franco dictatorship, women needed the permission of a man—her father or husband—to open a bank account, sign a contract, or arrange a passport.

It is hard to believe that in many legal aspects women were treated as children, but it was; and divorce was not allowed nor were contraceptives, and women could be convicted in court for adultery or even accused of abandoning their home if they left after suffering abuse from their husband.

The greatest social transformation achieved by the Spanish democracy has been, in my opinion, ending the discrimination that invalidated half the population. Since the adoption of the Spanish Constitution in 1978, women have joined the workforce and taken positions of power—a revolution in all aspects.

Within a year of Francos’ death in 1975, all political parties were legalized, and Spain celebrated democratic elections—a change that was made possible thanks to pressure from citizens and legal reforms promoted by the King of Spain, Juan Carlos I. The political uprising brought forth other changes across all aspects of life, particularly for women. Democracy and the modernization of the country accelerated when, in 1982, the Socialist Party won the national elections with a very broad majority.

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Over the years, women have staged a peaceful revolution in Spain: We were one of the first countries in the world to make fighting against gender violence a major national priority, to end gender discrimination in all fields (even in the military, where women have access to all positions), and to increase by half the number of women holding political positions at all levels (including at central and regional government offices and municipalities). Women are also the majority of the students at Spanish universities.

For years, progress was spectacular in the battle against gender discrimination. Particularly, when Spain became the third country to legalize gay marriage in 2005.

I still remember the pride I felt in 2005 when I led a Spanish parliamentary delegation that was received with a resounding applause by the United Nations Conference on the tenth anniversary of the Beijing Declaration on the status of women.

However, many of these achievements, including some as crucial as the economic independence of women, are being threatened by the economic crisis, which began in 2008, and the deliberate actions of the conservative government in power since December 2011.

These crises have affected women and female participation in the labor market, which shrunk by 10 percent between 2008 and 2013. The wage gap between men and women has grown, while the presence of women in high positions of government and business has declined.

The government’s conservative agenda has downplayed the issue of gender violence, despite some very disturbing numbers. In the last ten years, up to 700 women have died in Spain because of domestic violence. And up to 22 percent of women reportedly have suffered abuse at the hands of their partners, according to a recent survey by the European Union. Clearly, this problem persists but rarely appears in Spanish conservatives’ public discourse.

But, without a doubt, the biggest setback we are experiencing, the most disturbing, is the attempt to suppress the right of women to freely terminate a pregnancy. After experiencing years of progress under progressive governments, in 2010 Spain passed a law that bans abortion after 14 weeks’ gestation. This law, similar to those passed in the United States, has reduced the number of abortions practiced in Spain and has significant public support. Also like in the United States, among medical professionals there is a widespread opposition to the restriction on the right of women to safe, legal abortion.

The conservative government now intends to repeal this law and replace it with a new one that would make abortion a crime, except in cases of rape or to protect the life or physical or mental health of the pregnant person. Women, then, are treated as minors in that their decision to terminate a pregnancy must be approved as appropriate by a judge, doctor, or psychiatrist, a humiliating process for someone who already is suffering enough.

According to reports, 90 percent of abortions currently practiced in Spain would be illegal under the law the government wants to pass. The only alternative that a Spanish woman with resources would have is to travel to neighboring countries—Portugal, Great Britain, or France, for instance—where abortion is not a crime. But in a country with 26 percent unemployment and a third of children at risk of poverty, many women would be forced to risk their lives—again, like during Franco dictatorship—in a clandestine clinic.

There is no rational or ethical justification for a change like this. To accept this rule means to accept that some men have the right to decide what women can do with their bodies, that men should protect women and women should obey them, and that men are better able to make decisions about sexuality and reproduction than women. In short, this bill is a giant step backward for women and for all of Spanish society. That is why we must do all we can to prevent its approval.

In ancient Greece, the Stoic philosophers held that each of us lived in two communities: the local community, in which we are born, and the human community, where there are no boundaries and no person is alien to us. Women know this particularly. Without the fight of suffragist women in the United States or Great Britain, in New Zealand or Australia, the right to vote would have been delayed much longer for other nations. Similarly, the example set by a democratic Spain has been crucial for the fight for sexual and reproductive rights in Southern Europe and Latin America.

The battle Spanish women are facing now is a battle against an aggression beyond the borders of the local community. Italian women, for example, adopted on International Women’s Day in March the motto “Io decido” (“I decide”) in solidarity with the Spaniards. Our cause is also the cause of American women, and of all women in the world. We need the support of all women in our struggle. As once said by the first woman deputy prime minister of Spain, María Teresa Fernandez de la Vega, “When a woman takes a step, all women go forward.” Thus, it must be all women together who fight to keep Spanish women’s rights from receding into a dark past.

News Law and Policy

Obama Administration Once Again Steps Up for Transgender Rights

Jessica Mason Pieklo

A regulation to be published this week mandates all employees and visitors at federally operated facilities have access to restrooms that align with their gender identity.

The Obama administration this week made another push for advancing transgender rights, announcing a new regulation that requires all people at federally operated facilities, whether an employee or visitor, have access to restrooms consistent with their gender identity.

As reported by Buzzfeed, the regulation, which will be posted this week in the Federal Register, will affect thousands of people and about 9,200 properties operated by the federal government. Those facilities employ roughly 1 million federal civilian workers.

The regulation makes clear that transgender people do not need to complete any medical procedure to qualify to use the restroom that aligns with their gender, nor can transgender people be restricted to single-occupancy restrooms.

This is the latest move by the Obama administration to advance transgender rights in both the workplace and schools. Federal agencies such as the Equal Employment Opportunity Commission and the U.S. Department of Education have issued guidances that state discriminating against transgender people by mandating they use restrooms and facilities that align with their biological sex rather than their gender identity violates federal civil rights laws.

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More than 20 states run by Republican lawmakers have pushed back against the administration’s efforts to protect transgender people from discrimination at work and at school, filing a federal lawsuit arguing the Obama administration has overstepped its authority in issuing the guidance. Those lawsuits argue that legal bans on sex discrimination do not cover transgender rights.

That question—whether existing civil rights laws and their prohibitions on sex discrimination prohibit discrimination against transgender people—could be the next big civil rights case to land before the Supreme Court.

A Virginia county school board adopted a policy that mandates students in their schools use restrooms that align with their biological sex rather than gender identity. Gavin Grimm, a Virginia student, challenged the policy, arguing it violated his civil rights.

Both a federal court and the Fourth Circuit Court of Appeals agreed with Grimm and blocked the school from enforcing the policy. The Roberts Court this month stepped in and ruled the policy should take effect while the Court considers the school board’s request to take Grimm’s case next term. In the meantime, Grimm will start the school year with his school’s policy in place.

Commentary Contraception

The Promotion of Long-Acting Contraceptives Must Confront History and Center Patient Autonomy

Jamila Taylor

While some long-acting reversible contraceptive methods were used to undermine women of color's reproductive freedom, those methods still hold the promise of reducing unintended pregnancy among those most at risk.

Since long-acting reversible contraceptives (LARCs), including intrauterine devices and hormonal contraceptive implants, are among the most effective means of pregnancy prevention, many family planning and reproductive health providers are increasingly promoting them, especially among low-income populations.

But the promotion of LARCs must come with an acknowledgment of historical discriminatory practices and public policy related to birth control. To improve contraceptive access for low-income women and girls of color—who bear the disproportionate effects of unplanned pregnancy—providers and advocates must work to ensure that the reproductive autonomy of this population is respected now, precisely because it hasn’t been in the past.

For Black women particularly, the reproductive coercion that began during slavery took a different form with the development of modern contraceptive methods. According to Dorothy Roberts, author of Killing the Black Body, “The movement to expand women’s reproductive options was marked with racism from its very inception in the early part of [the 20th] century.” Decades later, government-funded family planning programs encouraged Black women to use birth control; in some cases, Black women were coerced into being sterilized.

In the 1990s, the contraceptive implant Norplant was marketed specifically to low-income women, especially Black adults and teenage girls. After a series of public statements about the benefits of Norplant in reducing pregnancy among this population, policy proposals soon focused on ensuring usage of the contraceptive method. Federal and state governments began paying for Norplant and incentivizing its use among low-income women while budgets for social support programs were cut. Without assistance, Norplant was not an affordable option, with the capsules costing more than $300 and separate, expensive costs for implantation and removal.

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Soon, Norplant was available through the Medicaid program. Some states introduced (ultimately unsuccessful) bills that would give cash rewards to entice low-income women on public assistance into using it; a few, such as Tennessee and Washington state, required that women receiving various forms of public assistance get information about Norplant. After proposing a bill to promote the use of Norplant in his state in 1994, a Connecticut legislator made the comment, “It’s far cheaper to give you money not to have kids than to give you money to have kids.” By that year, as Roberts writes, states had spent $34 million on Norplant-related care, much of it for women on Medicaid. Policymakers thought it was completely legitimate and cost-effective to control the reproduction of low-income women.

However, promoting this method among low-income Black women and adolescents was problematic. Racist, classist ideology dictating that this particular population of women shouldn’t have children became the basis for public policy. Even though coercive practices in reproductive health were later condemned, these practices still went on to shape cultural norms around race and gender, as well as medical practice.

This history has made it difficult to move beyond negative perceptions, and even fear, of LARCs, health care, and the medical establishment among some women of color. And that’s why it’s so important to ensure informed consent when advocating for effective contraceptive methods, with choice always at the center.

But how can policies and health-care facilities promote reproductive autonomy?

Health-care providers must deal head on with the fact that many contemporary women have concerns about LARCs being recommended specifically to low-income women and women of color. And while this is part of the broader effort to make LARCs more affordable and increasingly available to communities that don’t have access to them, mechanisms should be put in place to address this underlying issue. Requiring cultural competency training that includes information on the history of coercive practices affecting women of color could help family planning providers understand this concern for their patients.

Then, providers and health systems must address other barriers that make it difficult for women to access LARCs in particular. LARCs can be expensive in the short term, and complicated billing and reimbursement practices in both public and private insurance confuse women and providers. Also, the full cost associated with LARC usage isn’t always covered by insurance.

But the process shouldn’t end at eliminating barriers. Low-income Black women and teens must receive comprehensive counseling for contraception to ensure informed choice—meaning they should be given information on the full array of methods. This will help them choose the method that best meets their needs, while also promoting reproductive autonomy—not a specific contraceptive method.

Clinical guidelines for contraception must include detailed information on informed consent, and choice and reproductive autonomy should be clearly outlined when family planning providers are trained.

It’s crucial we implement these changes now because recent investments and advocacy are expanding access to LARCs. States are thinking creatively about how to reduce unintended pregnancy and in turn reduce Medicaid costs through use of LARCs. The Colorado Family Planning Initiative has been heralded as one of the most effective in helping women access LARCs. Since 2008, more than 30,000 women in Colorado have chosen LARCs as the result of the program. Provider education, training, and contraceptive counseling have also been increased, and women can access LARCs at reduced costs.

The commitment to LARCs has apparently yielded major returns for Colorado. Between 2009 and 2013, the abortion rate among teenagers older than 15 in Colorado dropped by 42 percent. Additionally, the birth rate for young women eligible for Medicaid dropped—resulting in cost savings of up to an estimated $111 million in Medicaid-covered births. LARCs have been critical to these successes. Public-private partnerships have helped keep the program going since 2015, and states including Delaware and Iowa have followed suit in efforts to experience the same outcomes.

Recognizing that prevention is a key component to any strategy addressing a public health concern, those strategies must be rooted in ensuring access to education and comprehensive counseling so that women and teens can make the informed choices that are best for them. When women and girls are given the tools to empower themselves in decision making, the results are positive—not just for what the government spends or does not spend on social programs, but also for the greater good of all of us.

The history of coercion undermining reproductive freedom among women and girls of color in this country is an ugly one. But this certainly doesn’t have to dictate how we move forward.

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