Reproductive Control

There are many things for which public health professionals can be criticized. Not vaccinating appropriately, using the wrong vaccine, using an inappropriate control group for a study, not catching an epidemic quickly enough, and on and on…

To me, however, the biggest fault of public health people is that *we* forget that we are also a part of the public. For instance, at the meetings I had for the past two days in DC to talk about major policy change about how we prevent intimate partner and sexual violence, the standard statistics were brought up.

“1 in 4 women and 1 in 5 girls have experienced sexual violence.”

“20% of women report abuse by an intimate partner.”

“Childhood experience of violence has been linked to many different chronic conditions in adulthood.”

In the field, we all know this data. We all work vehemently to change the data, to try to eliminate family and gender based violence. Yet, where I see us failing is that after we talk about those statistics, we say, “How can we help those women? Where are our efforts failing them?” What we forget is that those women are, in fact, us. In a room of 50 women yesterday, at least 12 of them/us had been sexually abused and at least 10 experienced violence at the hand of a partner. And we all know many more in our lives who have experienced the same.

So when we talk about needing a fundamental mind shift in our communities, our country, the world…an absolute philosophical paradigm shift away from accepting violence as just part of our culture…we always talk about social marketing campaigns and education. It’s a lack of education that is a great stumbling block so much of the time (though, admittedly, not the only hindrance to eliminating violence). We discuss what these educational campaigns should entail; we use evidence-based research to support us; we consult the experts; we design these campaigns and roll them out in schools and churches and prisons. We do a good job of reaching our larger communities.

But where we fail (and definitely this is a generalization; there are certainly exceptions) is in educating our own family and friends. How often do I talk to the people in my life about current research in family violence? How often do I volunteer up my sports teams for community-based educational programs? How often do I even think about the interactions between my friends and their relations? The answer: not often enough.

Sure, when you’re in a social service profession, burn out tends to run really high (particularly if you work for the State!), so we don’t want to take the job home. After I look at high school sexual violence data all day, and see that 25% of 10th grade girls in Hawaii have been forced to have sex at some point in their lives (25%!!!), I just want to stop thinking about it when I leave my office.

But I can’t. I was awake last night with the curse of the healer/savior personality. I felt like there was no way in the world that I was ever going to be able to do enough to prevent family violence. I wanted to get up and start doing work at 2 a.m. I’m sure I’ll never feel like I’m ever doing enough, like most people in this field. (Or maybe as I get older, I’ll get so burnt out that I’ll be ready to relinquish to the next generation of people like me).

So what I want to do now, for the few of you who actually read this, is to provide some education, so that I’m not always saying “them”.

Have you ever heard of reproductive coercion/control? Did you know that some women need to hide their birth control pills so that their partners don’t get rid of them? Did you know that there are men who find out their partners have IUDs and forcibly remove them? Did you know that women and girls are being forced to get pregnant so that their partners can control them? Or that in order to not get pregnant, women get undetectable forms of birth control (like the Depo hormone shot)?

These aren’t isolated cases, in uneducated populations. This is happening all over the place. And it’s only recently that we are public health are talking about it.

I think I’m going to stop here because I could go on at length about violence against women. (And I haven’t even mentioned violence against children). But I wanted to make sure that I at least start my own awareness campaign. I hope that I can inform people that I know about these things. I hope that anyone reading this will eventually be able to understand that the sexism and toxic environment in which we live (everything from telling a boy that he “throws like a girl” to whistling at a women walking by) is all a part of the spectrum that leads to a women winding up in a shelter, with a smashed in face, a ripped out IUD and very little options.

My public health message for today: Do the right thing. It’s unbearable difficult to do that in light of peer pressure from so many places. But I ask you, is it better to do what’s right or what’s popular?