on polarisations and reductionism


I take words and language quite seriously. Seriously enough that the many meanings and interpretations of words are how I make my daily wage. I endlessly debate-internally as well as with other people- one word over the other, weigh political implications (everything, even a simple ‘and’ holds immeasurable weight*), and wonder about the word in context. Invariably, it drowns in jargon and specificity of the work that we do.

It is funny, then, that given my obsession and fascination with words; I still struggle to fully explain what I do. The question ‘What do you do?’ fills me with about as much discomfort as ‘where are you from?’ does.

I could respond with ‘I work in sexual and reproductive health and rights, particularly for women and young people’. I could add more details about advocacy, policy, lobbying, development agendas, negotiations, and movements but these words- taken out of context- mean nothing really. They get caught up in trying to explain themselves with more nothing-words.

I know this because the follow up question is almost always, ‘What does that mean?’.

And that poses a few dilemmas, not least because if we purport to work on these issues because ‘it impacts and influences every aspect and stage of peoples’ lives’ (that’s paraphrasing many an international consensus document); then how is it that nobody knows what I’m talking about?

In attempting to explain the concept- and when I have the time to unpack as many complexities as possible and people have the patience to hear me out, they usually do agree that it’s foundational- it falls upon me to make a decision on how to frame such a fraught political perspective with my own feminist and kyriarchal analyses and not feel as though I’ve come to some strange cop-out between SRHR as a purely health issue, or within the dreaded; über privileged framework of ‘choice’.

This reduction of a vast, complex issue into health and choice is deeply, deeply problematic. Not only does it gut the entire rights discourse behind it, it removes it from the context of autonomy, of justice, of empowerment; removes it from the context of women’s lives. This false idea of ‘choice’- ‘it’s your choice to have an abortion’, ‘it’s your choice to skip birth control’, ‘it’s your choice to have sex’ – it assumes that most women have choices, overlooks that having choices and options- even knowing that you do- are still privileges. It continues to marginalise and overlook the fact that decision-making (and especially for women and young people) is muddied by a complex set of factors: information, money, access to services, stigma, discrimination, age, caste, race, the village you live in, the gatekeepers of services and information, your marital status…

‘Choice’ is sneaky in that it positions the debates as an issue for the individual to decide on- it posits that decision-making is free of societal, historical, systemic oppressions; which is obviously false. This emphasis on the individual reduces the responsibility of the State to ensure that these are all accessible rights, that these are not privileges accessible to a select few, but are actually available to all people. Marlene Gerber Fried has an excellent piece on ‘10 Reasons to Rethink Reproductive ‘Choice’ that I think should be required reading. So the framework of ‘choice; is filled with things I don’t agree with, making it a taboo-word in the ‘What do you do?’ response-spiel.

Framing it as a purely health-specific (usually ‘public health’) concern is also limiting and tends to grate on my nerves. It is easily reduced into ‘maternal mortality and morbidity’ (hello, MDGs!) that everyone can agree on and garners enough support to make it an depoliticised issue to address. Of course women shouldn’t die when giving birth, these are all preventable deaths. The reasons for why women die/suffer serious injury due to pregnancy and childbirth related complications are more than due to direct health/medical related issues. If you can’t get to a hospital in time because it’s too far away and the roads/transportation are/is inaccessible- that’s more than just an issue of health systems. The medicalisation of our bodies also removes us from a rights perspective- it makes ‘health’ about prevention of disease (and therefore cuts out ‘optional’ procedures) rather than about well-being.

It also fits into the larger struggle within the human rights movements themselves. We all (with nary an eyeroll) agree that human rights are indivisible, interrelated, and interconnected, but when it comes down to it; there is a hierarchy of rights. Civil and political rights are seen as the ‘primary’, more important rights with economic, cultural, and social rights (the right to health being one of them) as secondary rights that we can get to in a while after we sort out this civil & political rights stuff. And I want to call bullshit! on this hideous, hideous idea. Rights aren’t optional: you don’t get to say which ones are more important and which ones are less important. You don’t get to barter one set of rights so you can achieve another set.

And ‘health’ and ‘choice’ don’t even come near talking about sex, sexuality, pleasure, orientation, identity, gender- and all these other beautiful, beautiful, beautiful words that make up our SRHR dictionary. How do I talk about breaking the taboo around these issues if I can’t even explain it to someone in the simplest, most accurate way possible? How do I talk about the spectrum of sexual orientation and gender identity, ‘fixed’ and ‘fluid’?

I have to admit that I struggle with this on a daily basis: how much do I share, how do I explain it, and which tack do I take? Given that I live/have lived in rather conservative contexts and that these are really sensitive issues that could derail years and years of work if mishandled, I try to be cautious around what I say. And no matter what I say, I feel as though I’ve betrayed this cause I believe so very much in. I feel as though I’ve wasted an opportunity to do the work I say I do: challenge the silence, challenge the taboos, challenge the misinformation, begin a discussion… and instead, I choose to cop-out by saying ‘human rights’ or ‘women’s health’. I wonder if I’m doing more damage than I am doing any good. I wonder if I’m sabotaging- not to be melodramatic- the ’cause’ because I cannot explain what I do without reducing it or creating polarisations I don’t believe in.

I have to find a better way to explain what I do, what the work that keeps me up at night is. I have to use all these beautiful, beautiful words that are- at their core- about peoples’ lives, dreams, hurts, identities, experiences, realities and not betray them for ‘convenience’, for ‘ease’, for a soundbite. How else do you shift the discourse, change the priorities if you cannot explain a concept?

*For example, there is a difference between ‘sexual and reproductive health services’ and ‘sexual and reproductive health and services’. The latter is interpreted to mean that it includes services such as access to abortion, which aren’t necessarily/always medically necessary procedures.

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