Reproductive Justice
The human right to control our sexuality, our gender, our work, and our reproduction
What is Reproductive Justice?
Reproductive Justice is defined by Sister Song as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.”
Rising out of the frustration about the health status of Black women and the limitations of a “pro-choice” framework where Black women had minimal choices, the term Reproductive Justice was coined by the Black Women’s Caucus of the Illinois Pro-Choice Alliance in 1994.
“Adopting human rights, social justice and reproductive rights tenets, these women created a transformational and grassroots-based movement for social change. With the definitions and concepts of Reproductive Justice in place, the Black Women’s Caucus sought affirmation and support from the cadre of women of color working domestically on reproductive health and rights.”
Reproductive Justice and Reproductive Rights
While there are several definitions of reproductive rights, it’s largely understood as the right of a person to decide their own sexual reproduction, whether or not to have children, space pregnancy, and access contraception.
Reproductive rights are an aspect of Reproductive Justice, but there is an important distinction. Like other rights, reproductive rights have been largely understood as individual rights. The reproductive rights framework has historically focused on achieving women’s individualistic reproductive freedom through the legal system and has historically focused on the abortion debate, sex education, and family planning.
Focusing on these narrow individual rights fails to account for the ways systems of oppression interact with these rights, keeping communities unable to exercise or access these rights – even when legally available. The Reproductive Justice framework considers the ways that race, class, gender, ability, and sexuality intersect with reproductive rights.
While Every Body Texas is not a reproductive justice organization, we believe in the principles of reproductive justice and use this as a driving force behind our work in sexual and reproductive healthcare.
Understanding Reproductive Justice
This page is an introduction to some reproductive justice issues in our society and in Texas today. We discuss how access to sexual and reproductive care is impacted by race, ethnicity, economic status, white supremacy, and historical systems of oppression. This is not a comprehensive analysis of reproductive justice or systems of oppression, but intended to give readers a basic understanding of the issues surrounding access to sexual and reproductive healthcare. To learn more and to dive deeper into the topic of Reproductive Justice, please see the resource links at the bottom of this page.
Legacies of Oppression in Sexual and Reproductive Healthcare
To begin to understand Reproductive Justice, it’s important to understand the structures and systems of oppression that impact client care. The video below focuses on the history of oppression in the field of family planning and how it contributes to current health inequities in sexual and reproductive health.
This video is part of a learner-led, justice-informed curriculum called Structures & Self: Advancing Equity and Justice in Sexual and Reproductive Healthcare. While this resource is intended for clinicians, it’s also a great tool for anyone involved in sexual and reproductive healthcare. We encourage you to spend some time with it and consider how you can work towards greater justice in your work.
Intersectionality, Power, and Reproductive Justice
An important framework at the heart of Reproductive Justice is intersectionality. First coined by legal scholar Kimberlé Crenshaw, intersectionality is the idea that different systems of oppression interact with each other to have different outcomes. Crenshaw identified how laws meant to protect against racial discrimination in the workplace and laws meant to protect against sexist workplace practices failed to account for people who were experiencing workplace discrimination based on both sex and race: specifically Black women.
This video describes how intersectionality isn’t just about a stacking of personal identities and oppressions, but that it’s a more complex experience of how various identities and structures of oppression interact.
Reproductive Justice isn’t just about alleviating unjust outcomes; it is a framework which calls for an end to hierarchical systems of power that prevent individual autonomy and collective liberation. Historically, the mainstream pro-choice feminist movement centered the needs and experiences of non-disabled, white, cisgender, heterosexual women. In doing so, it meant that the problems were defined by the experiences of the women leading the movement, as were the solutions. The video below from the Liberated Bodies project by Color of Change, gives a clear history of the Reproductive Justice movement, as well as examples of how power and intersectionality are at play within the work around sexual and reproductive care and rights.
Reproductive Justice Resources
To learn more about Reproductive Justice and get more involved in the movement, click on the links here.
Sexual & Reproductive Healthcare in Texas
Policy and Political Barriers to Accessing Care
Political choices by power structures within the state of Texas have resulted in an increasingly restrictive environment, lack of access to basic sexual and reproductive healthcare, and increasingly poor health outcomes. To understand the context in which we operate in Texas, this section lays out the political and legal barriers to sexual and reproductive healthcare in this state.
Accessing sexual and reproductive healthcare in Texas can be difficult, especially for those in need of abortion care or contraception and who are uninsured, underinsured, or a minor (someone under the age of 18). Texas has the highest rate of uninsured residents in the country.
There are certain policies in Texas that make it hard for Texans to get comprehensive sexual and reproductive healthcare. Some of these policies make it harder for some groups of Texans than others. Every Body Texas disagrees with these policies and works to improve them every single day.
Click the + to expand the sections below to read more.
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Providers are Leaving Texas
The growing shortage of sexual and reproductive healthcare providers in Texas make it particularly difficult for people living in rural areas and uninsured people to get care. Because of recent policy changes, including criminalizing abortion care, providers are not always able to provide appropriate and ethical care to their patients. This hostile environment drives many healthcare professionals to choose to leave the state.
Rural hospitals have had to close their labor and delivery departments due to staff shortages and budget cuts, forcing pregnant people to travel hours to receive care and give birth. Other factors like appointment availability, transportation, childcare, managing work and school schedules, and language barriers contribute to people not getting the care they need.
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Abortion is Illegal
As of August 2022, abortion is illegal in Texas. Texans can travel to other states to access abortions, but there are many barriers—financial, logistical, geographic—that make doing so unrealistic for many.
Information about abortion access throughout the United States can be found at ReproductiveRights.gov or AbortionFinder.org.
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Certain Providers are Blocked from Medicaid
In 2016, the Texas government made the harmful decision that Planned Parenthood could no longer receive payment from the state’s Medicaid program. They did this in order to limit access to person-centered reproductive healthcare for historically marginalized populations and further their anti-abortion agenda, an example of systemic racism and discrimination.
Texans can no longer use Medicaid to pay for any services provided by Planned Parenthood, so there aren’t enough providers available to treat them. It has become increasingly difficult for these individuals to access vital healthcare services like cancer screening, prenatal care and STI testing, and to exercise their right to their first choice of contraception, especially if that choice is an IUD or another form of long acting reversible contraceptive.
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Minors Without Parental Consent Blocked from Prescription Birth Control
Previously, minors were able to get prescription birth control without their parent’s knowledge at Title X clinics, but a federal court ruling changed that in December 2022. As of October 2023, minors must have consent from their parents in order to access prescription birth control. This decision is still being fought in court, and we are hoping that minors can again independently access birth control.
By the Numbers
12.6 million people of reproductive age live in TX
59% of counties in Texas do not have a practicing OBGYN
30% of Texas women haven't had a cervical cancer screening in the past 3 years
In one survey of sexually active women in Texas, almost half were not using their preferred contraceptive method – often because of cost.
Health Outcomes
Health outcomes in our communities are impacted by lack of access to needed comprehensive sexual and reproductive healthcare. Below are just a few of the areas of negative health outcomes that stem from limited access to sexual and reproductive healthcare in Texas.
Click the + to expand the sections below to read more
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Pregnancy planning and spacing
In 2019, 55.2% of births in Texas were “unintended”. An unintended pregnancy is not necessarily an unwanted pregnancy, but we know that when someone isn't able to plan their pregnancies, they may be less likely to seek prenatal care in the first trimester.
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Teen Pregnancy and STIs
It can be hard for teens and young adults in Texas to get accurate and comprehensive sexual and reproductive healthcare and education. Texas has the 3rd highest teen pregnancy rate in the country and in 2018, about 64% of chlamydia cases were among Texans under the age of 24.
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Cervical Cancer Deaths
Texans with cervical cancer also have worse outcomes when compared to the rest of the country, even though cervical cancer is often preventable. The rates of cervical cancer in Texas are the 7th highest in the country, and Texans die from cervical cancer at higher rates than the national average.
Black people assigned female at birth are more likely to die from cervical cancer than any other racial or ethnic group in Texas
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Black Maternal Mortality
Most alarmingly, Black women in Texas are twice as likely to die from pregnancy and childbirth related complications than white women. The maternal mortality crisis among Black pregnant and birthing people has been known for more than a decade, with little systemic or material change implemented to improve outcomes.
Resources
Learn more about sexual and reproductive healthcare in Texas from these helpful resources.
Why this matters
At Every Body Texas, we believe that all people deserve access to the safe, high-quality, unbiased sexual and reproductive healthcare they want and need. By using a Reproductive Justice framework to approach our work, we put the needs of the client at the center of everything. We recognize that every person is coming from their own unique set of circumstances, with their own culture, histories, and desires.
A clinician, social worker, or social service provider discussing reproductive life goals or contraception will be coming with their own experiences and biases. It’s essential that folks engaged in the work of expanding access to sexual and reproductive healthcare do so in a way that prioritizes the client’s needs, is conscious of the fraught history of oppression in family planning, and knows that the best outcome to any conversation about sexual and reproductive health is one where the client is heard, understood, and supported.
In the United States, especially in a state like Texas, sexual and reproductive healthcare isn’t as simple as just seeing a doctor or getting on birth control. Competing social pressures, policy choices, and personal experiences complicate an individual’s ability to access the care they need and want. We want you to keep this in mind as you interact with the toolkits below and think through how your organization can work to expand access to sexual and reproductive healthcare that is person-centered and just.