Sex and Selection: Nuances in Creating a Global Reproductive Justice Movement

In the past week there have been two sets of startling stories about India and reproductive rights in the news.

The first story is based on a government survey finding that 40% of Indian women have not heard of AIDS. India has 5.7 million people living with HIV/AIDS per UN figures. The National Family Health Survey (NFHS), the most extensive study on health and nutrition in India, said in its latest report only 57 percent of women have heard of AIDS. In rural areas, where most Indians live, a mere 46% of women were aware of the disease.

The second story reports that GE ultrasound machines in India are being used for sex selection. Under Indian law, doctors who operate ultrasound machines can only use them in the case of an abnormal pregnancy and must fill out forms showing the reason for each procedure. However the only machines that the government can monitor are the 25,770 machines that are registered. The London Daily Main places estimates of the actual number of machines in use at anywhere from 70,000 to 100,000, according to the British Medical Journal. The portable ones that make it to rural areas, if unregistered and unregulated can allow any woman to determine the sex of her child. The fetus can then be terminated at a government hospital, where abortions, like other procedures, are free for those who cannot pay.

Each of these stories says something critical about the place of women in Indian society and the importance of education and information in fostering gender justice.

Anjali Gopalan, head of Naz Foundation India, a leading anti-AIDS group, says of the NFHS survey, "This shows women don't have access to information, translating into more women getting infected." In the past few years, there has been a growing "feminization" of the epidemic in India with nearly 40 percent of all those infected now being women, including housewives.

Dr. G. Shivaram, district health officer for Bangalore, oversees the city's health care out of a rundown hospital off Old Madras Road. Behind him is a poster: "Female feticide is cruel and barbaric. It is illegal and punishable under the PNDT Act," referring to the 1994 law barring the use of ultrasound for sex determination. Although the penalty for breaking the law was increased in 2002 to three years in jail and a $230 fine for the first offense and five years jail and $1,160 for the second, it is almost never enforced. Some activists are trying to establish a nationwide network of orphanages and hospitals where unwanted girl infants can be dropped off. For an excellent discussion of all the issues involved here, see an article recently published in the Guardian—it addresses topics like patriarchy, the culture of marriage, and the increase in trafficking of women due to the statistical shortage of women and girls in many parts of India.

Each of the stories, especially in the case of female foeticide, we, as reproductive justice advocates, have to understand and oppose these phenomena without jeopardizing our belief that all women everywhere should have access to the full range of reproductive health services.

The question remains: How, exactly, can we do that?

A great post over at the Campus Progress Blog addresses some of these questions. The author labels her views as being both "pro-choice and anti-selection." I like it.

One of the important things to note, if we are to hold such a seemingly contradictory position, is that these are matters of culture and education in addition to ones of policy and legislation. In the case of India, we see the inefficiency of policies that are meant to prevent female foeticide if there isn't a corresponding change in the mainstream culture. This, from what I understand, is how progress is made.

It will require that we come to terms with the elements of eugenics in the history of the reproductive rights movement in the US, the way that poor women and women of color have often been excluded and the limitations of the choice framework in setting up a viable and inclusive agenda. These conversations and acknowledgements are a crucial part of creating and sustaining a pro-choice movement that understands the nuances of reproductive justice and doesn't support or use selection related policies and language. Instead of weakening the reproductive justice agenda, such conversations and measures strengthen the ability of the movement to be globally relevant and useful. In the same breath, we could push for the education of women and girls about HIV/AIDS, challenge anti-feminist ideologies, and call for the unequivocal right of women to the full range of reproductive healthcare.

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