Roe v. Wade: The Baby of Medicine and American Fascism
The state of female bodies has always been a question of control, in which both legislation and medicalization have played a role. In 1973, the United States Supreme Court ruled that restrictive state regulation of abortion was unconstitutional (Encyclopedia Britannica, 2018) through the legal case Roe v. Wade. In mid-2022, the Supreme Court officially reversed the constitutional right to abortion (Totenberg & McCammon, 2022). Given that states now have autonomy over their abortion laws, some are expected to impose laws that have been “designed explicitly to take effect immediately upon the fall of the Roe precedent,” thus banning, and even criminalizing abortion (Totenberg & McCammon, 2022).
In Justice Alito’s 2022 initial draft opinion on the overturning of Roe v. Wade, he presents that the defenders of Roe have historically drawn upon Constitutional amendments relating to the discourse of privacy, rights to the people, and liberty (Staff, 2022). The Fourteenth Amendment specifically promotes liberty in its “prohibition of sex discrimination” (The 14th Amendment and the Evolution of Title IX, 2020). Alito argues that “the regulation of a medical procedure [such as abortion] that only one sex can undergo does not trigger heightened constitutional scrutiny unless the regulation is a “mere pretext designed to effect an invidious discrimination against members of one sex or the other”” (Staff, 2022). I seek to dispute this claim by investigating how the overturning of Roe v. Wade contributes to discrimination against women. Using Justice Alito’s draft opinion as a point of takeoff, I argue that the overturn of Roe v. Wade contributes to the marginalization of racialized women by upholding the American authoritarian culture of reproductive control through medicine. Critical race theory and patriarchy will be used to frame the partnership between healthcare, the rise of American fascism, and how this contributes to discrimination against the female body.
Between 2017 and 2021, Donald Trump was the star of a film I like to call American Fascism in the Flesh— more specifically, Christian fascism. American fascism, as Chris Hedges[1] describes, is “wrapped in the flag and clutching the Christian cross… organizing to extinguish our anemic democracy” (Hedges, 2022). With a prop in either hand, Trump’s presidency carved out a space that normalized reproductive control, thus invalidating the autonomy of women. Arguably, by “allowing employers to deny birth control coverage to female employees on religious grounds” (Liptak, 2020), and by “cutting federal funding for family planning services to low-income women” (Baird and Millar, 2020), he solidified a social linkage between womanhood and reproduction, in which the value of women is grounded in their ability to make babies and be mothers. Such linkage discredits the ability of women to act as autonomous beings who may not want to reproduce. This has especially dehumanizing consequences for racialized and low-income women, who have always been controlled as objects of reproduction. Examples include “enslaved African American women being taken and sold and, more recently, Latina and African American women being subjected to practices such as coerced contraception, unsafe forms of contraception, and forced sterilization” (Baird & Millar, 2020) without consent. Such use of reproduction as a method of control, especially over racialized women, is a tool as old as America. However, Trump’s modern use of Land of the Free and Christian pro-life propaganda in his legislation gives way to its normalization. This even fuels a moral righteousness surrounding reproductive control, wherein we’re doing this for your own good becomes a prominent sentiment. In turn, women are painted as incapable and prohibited from making decisions regarding their reproduction and bodies.
Stigma surrounding female bodies as non-reproductive entities reveals itself in legislation that follows the trends set by the Trump administration. Republican Florida’s House Bill 1069, also known as the “Don’t Say Period” law, took effect in summer of 2023, limiting “K-12 classroom instruction on various topics like reproductive health and gender identity” (Friedman, 2023). More specifically, it restricts instruction on human sexuality, sexually transmitted diseases and menstruation, before sixth grade” (Friedman, 2023). This type of censorship and restriction of information transforms biology into politics, subsequently re-framing women’s bodies as controlled by entities beyond themselves. Consequently, female students are introduced to a culture of confusion and shame surrounding natural function— a phenomenon unheard of by their male counterparts. Given that female bodies can experience menstruation and other physical changes before grade 6, a lack of informative education stands as a threat to their decision-making power, acceptance, and autonomy over their bodies. Supervisor of Health Services at Alachua County Public Schools Johnelly Green agrees that “[female students] are going to think that their body is not normal because they won’t be able to talk to an adult about it” (Friedman, 2023). Alternatively, this law may be viewed as a method of promoting the pro-reproductive agenda of fascists, in the way that menstruation—an ode to not getting pregnant each month—becomes stigmatized, as does any discussion surrounding contraceptives. By restricting the topic of sexually transmitted diseases (infections), education fails to adequately inform students on what might happen if they have unprotected sex. This creates a culture in which young people cannot make informed decisions regarding their reproductive choices—either they don’t have sex, or more likely, find no interest in contraceptives, resulting in health concerns or unwanted pregnancy. With Trump’s legislation allowing employers to deny birth control coverage, young women are already less able to access “contraceptives and other preventive measures… [which] both safeguard women’s health and enable women to chart their own life’s course” (Liptak, 2020). In a combined effort of censored education and limited healthcare resources, women are further restricted from making informed decisions regarding their reproduction and sex lives. In other words, women are discouraged from practicing sex or understanding their bodies when it falls outside the goal of reproduction. This especially threatens racialized women who already face greater barriers to external support or resources when learning about their reproductive choices or accessing care. Moreover, in the case of unintended pregnancy, these women arguably face greater challenges in accessing health support and resources, due to racial inequities within the healthcare system.
Critical race theory is a framework that deconstructs race as a biological fact and redefines it as a social construct that maintains historically standing power relations (Zewude & Sharma, 2021). Within medicine, it “explains why it is so easy to use race as an explanation for health differences between people while overlooking the effects of political and social forces” (Zewude & Sharma, 2021). The history of reproductive and female healthcare is one of control and coercion, influenced by structural racism and social determinants, yet normalized by right-wing, conservative forces in power. Medicine in North America consists of a gritty history of eugenics and scientific racism. Within the 20th century, “racial improvement” and “planned breeding” gained traction through the concept of eugenics, which attempted to eliminate those considered “the other” (National Human Genome Research Institute, 2022). Partnership between legislation and medicine enabled practitioners to meet racist goals through methods such as involuntary sterilization. It wasn’t until 1942 that the Supreme Court rejected eugenic sterilization as a legitimate state goal and recognized procreation as a basic civil right (Medosch, 2021). However, even with legislative changes, as recently as 2020, “more than forty women had come forward with written testimonies stating they received invasive and unnecessary medical procedures while under U.S Immigrations and Customs Enforcement (ICE) care” (Medosch, 2021). Current power of the medical system over those who are powerless demonstrates how easily medicine can blur the lines of legality in the name of “knowing better,” “scientific evidence,” and moral righteousness.
The patriarchal nature of such righteousness is evidenced by medicine’s use of female bodies as weaponized tools to silence, other, and even eliminate entire populations. Given that the field of medicine was founded within colonial, male dominated knowledge, “the female reproductive organs were understood as the physiological cause of psychological illness” (Greenhalgh, 2022). Thus, on a biological level women’s bodies were inherently stigmatized and pathologized at the roots of medicine. The medicalization of their bodies enabled a culture in which physicians knew better than their female patients. In modern society, this pathologization validates the objectification and dehumanization of women’s bodies, enabling medical procedures that use women’s bodies against themselves, often framed as being for their benefit or the benefit of society. Sterilization poses as a prime example of this, wherein female organs are problematized and entirely eliminated on a physical level, in order to eliminate certain groups on a social level. In this way, women’s bodies are a mechanism of social control, not only for those women, but all marginalized groups. Comparatively, reproduction stands as a weapon for men to wield, and throughout history has been a justification for violent or inappropriate action (i.e. boys will be boys). From a biological standpoint, men’s reproduction has rarely been used as a tool of oppression or elimination, thus enabling and encouraging men to use their bodies freely with various options for maintaining their autonomy.
Today, surgical sterilization has become “a relatively permanent form of contraception disproportionately used by Black, Hispanic, and Native American women [as compared to white women] in the United States” (Shreffler et al., 2015). Although it looked different in the past, this time, coercion takes the form of racially inequitable access to health resources including contraception and abortion. “The Center for Reproductive Rights describes this racial–ethnic gap as a human rights issue and suggests that, ‘several U.S. policies may exacerbate these disparities by disproportionately burdening access to health care for women of color’” (Sutton et al., 2021). With limited preventative choices or accessible quality care, women may feel pressured to participate in invasive procedures that they may not actually want. The racial disparity in accessing these procedures is a call to question who exactly the medicine and health care system actually benefits. Overall, forced sterilization, chosen sterilization, and the roots of medicine bring attention to the greater overarching issue: how much autonomy do racialized women really have when it comes to reproductive and sexual health? How has reproduction been historically used as a method of control over female bodies? How has medicine played a leading role in propelling the right wing, fascist agenda?
Structural racism and female control as roots of “objective” medicine evidence themselves through current health inequities. “Data suggests that the disproportionate risk for women of color for reproductive health access and outcomes… are influenced by neighborhood health services, less insurance coverage, decreased access to educational and economic attainment, and even practitioner-level factors such as racial bias and stereotyping” (Sutton et al., 2021). In turn, healthcare fails to prevent disproportionately negative outcomes such as “black women between ages 15-44 having higher rates of unintended pregnancy and abortion, with significantly greater likelihood of contracting a sexually transmitted infection than their White counterparts” (Thompson, Young, et al., 2022). Evidently, marginalized women have fewer choices when it comes to their reproduction, with social determinants and cultural norms being at the forefront of their medical decisions. Arguably, with such a myriad of social, economic, and political barriers, the few choices that marginalized women do have become less so a question of choice and more so a question of survival. In order for racialized women to truly have full autonomy over their reproductive and overall health, institutions must provide them with resources that ensure objectively optimum health and livelihood. However, within a society built upon colonialist, sexist, and racist views, marginalized lives are inherently perceived as invaluable, and thus health is not an objective question. Resultantly, one’s health and care are deeply and inherently intertwined with socio-cultural norms and governmental agendas.
This marriage between medicine and government obnoxiously presents itself through the “neutral” and “non-discriminatory” overturn of Roe v. Wade, as American fascist ideology exemplifies the use of medicine to promote reproductive control, while further marginalizing racialized women who already face reproductive challenges. The picture becomes clearer with Chris Hedges’ explanation of how fascists create parallel institutions and dialogue, while rarely ever being in the majority (Hedges, 2022). In response to Roe’s overturn, “nearly six-in-ten adults (57%) disapproved… including 43% who strongly disapprove” (Pew Research Center, 2022), demonstrating that the majority has little influence when democracy is skewed to amplify the voices of the powerful. Trump was able to immortalize his power even after his exit from office with the appointment of three right-wing justices to the Supreme Court, all involved in the overturning of Roe v. Wade (Hope, 2022).Thus, placed within the context of fascist ideology and anti-democratic influence, Roe v. Wade’s overturn shines a light on the ways in which medicine and legislation dangerously intersect, and essentially fuel each other’s fire. Moreover, it gives way to an analysis of the subsequent child of such a partnership: social control.
Anti-abortion laws place women’s bodies within the hands of societal morality. By politicizing the body and creating moral contention surrounding the life of the fetus, conservatives effectively move away from primary and more pressing concerns such as access to equal health care and quality of life. If this was acknowledged and effectively tackled, women would be more informed, have access to preventative care, and perhaps would not need to seek abortions in the first place. Moreover, even if they did, conversation might focus more on their quality of life, future goals, and mental and physical development. Subsequently, racialized women and girls would have greater opportunity to finally leave cycles of generational trauma and bring their families with them. Entire lineages may be healed this way. However, this would not only require medicine to redefine women’s bodies as inherently capable and strong, it would also require governmental and powerful bodies to surrender control. This directly goes against current fascist and right-wing agendas. By keeping female bodies politicized, politicians can ensure women physically remain within cycles of control, while simultaneously narrativizing them into the role of motherhood. A culture that socially normalizes women as mothers, or even reproductive bodies, subsequently stigmatizes and devalues all other forms of female function and womanhood. In this way, women can more easily be removed from the workforce, social decision making, and perhaps eventually, societal autonomy overall.
With all this said, reproductive justice may act as a framework for countering the inequity within reproductive legislation and medical resources. Accounting for the lack of autonomy present in reproductive healthcare, “the reproductive justice framework was brought to life by twelve Black women who defined [it] as the right to bodily autonomy, to have children, not have children, and parent children in safe and sustainable communities” (Brown et al., 2022). Varying aspects of reproduction are encompassed under this framework including access to contraceptives, abortion, and social supports that allow one to build healthy families (Brown et al., 2022). Currently, limitations include a lack of reproductive justice framework incorporated into reproductive health organizations in the U.S., and little representation of women of color (Onwuachi-Saunders, 2019). Without such representation, abortion and other reproductive rights may be sought through a framework that fails to account for the mistrust held by some marginalized communities of women, and the patronizing and oppressive nature of the medical system experienced by some. Stigma surrounding every aspect of reproduction may also vary based on racial and ethnic background. Thus, histories of unlawful sterilization, and inability to be mothers reign as equal to the opportunity to not want a child, while still engaging in sexual activity. With this in mind, NGOs and grassroots organizations with true democratic voices are currently necessary to carve out a space of protest for various groups at a time when censorship is on the rise. Eventually, this may lead to more permanent legislative reform and a cultural shift towards greater democratic freedom. Ultimately, however, with the rise of American fascism, and its use of legislation to consolidate its ideology, the people must work fast.
Given the varying influences of medicine, governmental policy, and cultural shifts since the Trump era, Justice Alito’s claims that the regulation of a medical procedure which only one sex can undergo does not constitute sex-based discrimination are hard to believe. Given the structural racism and patriarchal control historically present within medicine, especially reproductive medicine, inherent power imbalances reveal themselves through the medical tools used to control how females use their bodies in comparison to their male counterparts. How a woman might access her reproductive autonomy is inherently intertwined with institutions of medicine and legislation that are built within sexist and racist roots, and thus must be viewed through the lens of critical race theory and patriarchal history. Set on the stage of the recent rise of fascism, such as Trump’s restrictive policies against women and a growing culture of censorship, the overturning of Roe v. Wade demonstrates the capacity of the government to socially control female bodies, while by proxy controlling their families and communities. The politicization and debate surrounding women’s choices about their bodies extend beyond an objective matter of life or death; it emerges as a powerful tool wielded by politicians, shaping and reflecting social and cultural influences. Ultimately, the overturn of Roe v. Wade contributes to the marginalization of racialized women by upholding the American fascist culture of reproductive control using medicine.
Notes
[1] American journalist and Presbyterian minister.
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