Timeline: 2023-2028
Funding institution: Swiss National Science Foundation in the framework of project leader Caroline Rusterholz’s Eccellenza Professorial Fellowship.
In 2020, the State of the Nation Report on Sexually Transmitted Infections (STIs) in England highlighted disparities in sexual and reproductive health (SRH), including difficulties in accessing SRH services, delay in receiving treatments and higher rates of STIs. Age, urban vs rural areas, poverty and ethnicity were presented as key factors in explaining these inequities in SRH. While the report stressed differences in STIs rates by ethnicity, it lamented the lack of research on the impact of the wider structural context and called for studies to address ‘the impact of racism’ in particular.
This project answers this call by examining the racialisation of SRH services provided by charities over time, i.e. the processes by which racial meanings are attached to particular issues that are often treated as social problems. During the twentieth century, issues around race (the perceived biological difference linked with physical characteristics), ethnicity (the perceived cultural differences between groups), and SRH generated regular debates. But how did these debates emerge? Who mobilised to bring these issues onto the public health policy agenda and with what results? To what extent have these debates impacted SHR services offered by charities and with what effects on service users? This project will examine the dynamic interplay between changing and manipulated categories of race and ethnicity and medical stereotypes and policies developed by British SRH charities over time, and their impact on minoritised individuals. This project is focused on voluntary organisations, i.e charities, who have lobbied and tried to influence the medical profession and NHS.
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The main hypothesis of this project is that changing national race policies, in line with growing migration and international debates on population policy, shaped the development of services provided by British SRH charities and of SRH activism. The project analyses changes and continuities in the SRH norms and practices aimed at minoritised individuals that were developed by SRH charities in postwar Britain and the extent to which minoritised individuals followed or resisted these norms and practices. Britain offers an ideal case study to assess the racialised legacy of empire due to its colonial past and its increasing postwar migration trend, which created political and public anxieties and resulted in several Race and Relations Acts as well as creating a valuable cultural diversity and economic potential. Moreover, Britain’s cultural and linguistic proximity to the US means that Britain functions as a European entry point for debates about race that have developed on the other side of the ocean. By situating Britain within wider national and international debates about global population, SRH and rights, and migration, this project shows how international and national debates influenced the development of British SRH charities and activism.
By putting past and present SRH activism and service use by minoritised individuals centre stage for the first time, this project will fundamentally challenge our understanding of the aim of SRH services in postwar Britain and generate ambitious findings about the impact of decolonisation on SRH. The project’s aims are
The groundbreaking nature of this research is that it takes equally seriously the role played by SRH charities and by minoritised individuals in the development of SRH in postwar Britain. This project articulates three levels of analysis: the macro level, where international and national SRH policies and laws are made; the meso level, where these laws and policies are translated into norms by sexual and reproductive health workers and activists; and the micro level, which centres on individuals’ experiences and the constraints and opportunities they face in navigating SRH services.
This project uses the reproductive justice framework to achieve a better understanding of disparities in access to, and quality of, care provided by SRH services in postwar Britain up until the present. This intersectional framework originated in the US and is based on the concept of human rights. It refers to the right to have a child; the right not to have a child; and the right to parent children in safe and healthy environments free from violence by individuals or the state. Using a reproductive justice framework means recognising that cultural, political, economic and structural constraints influence individuals’ access to health care and reproductive autonomy. Reflecting this theoretical framework and adapting it to the British context, this research uses a holistic approach that puts minoritised individuals’ experiences at the fore of the analysis. By combining the analysis of SRH policies, norms and practices, with minoritised SRH activism and service users’ experiences, the project deconstructs the working of this racialisation, the resistances it triggered and its impact on minoritised individuals and how the three were closely interconnected.
The first strand of this research project is carried out by Caroline Rusterholz and focuses on the macro level by exploring the ways in which British SRH charities and policies have problematized minoritised SRH needs over time in postwar Britain. It locates British SRH services within the changing landscape of international reproductive politics, more specifically international debates about population policy, overpopulation SRH and rights. It takes a number of SRH charities as case studies, namely the Family Planning Association, the Margaret Pyke Centre, and the Brook Advisory Centre. These charities have been chosen on the criteria that they were, and for some still are, the leading charities in SRH services in Britain. These national charities were also affiliated to international non-governmental organisations, such as the International Planned Parenthood Federation, and had close connections with the Population Council and the World Health Organisation.
Drawing on archival sources from these charities and international organisations (IPPF, WHO, Population Council), medical research publications on minoritised individual’s SRH, clinical trials, SRH policies and campaigns, parliamentary debates, SRH statistics, sexual and demographic surveys, and mass media articles on minoritised populations and SRH (Daily Mail, Daily Mirror, Telegraph, Guardian), this research traces the extent to which British SRH services have been racilialized over time. This analysis rests on the hypothesis that SRH services and provision were based on the idea of middle-class whiteness as the ‘norm’. In so doing, it will show the diversity and multiplicity of those who were deemed ‘the other’ in sexual and reproductive terms, and how this othering process relies on shifting categories or race and ethnicity and how these categories have evolved over time. The stream asks:
This research strand will therefore historicise the ‘othering’ process by paying particular attention to the racial stereotypes underpinning the provision of sexual health services. It will determine the extent to which eugenicist ideas about whose fertility should be encouraged and discouraged remained prevalent in the provision of SRH services in postwar Britain, and whether this idea was reconfigured and applied to minoritised communities. In so doing, it will show the diversity and multiplicity of those who were deemed ‘the other’ in sexual and reproductive terms and how these categories have evolved over time. To do so, this strand explores three key concerns that gave rise to specific politics aimed at minoritised communities but which did not necessarily answer these communities’ needs, not least because some of the politics were physically and psychologically harmful. These concerns were 1) the alleged hyper-fertility of Black families 2) the Black teenage mum and 3) the prevalence of abortion.
The second strand of research is carried out by Naomi Samake-Bäckert and focuses on the meso level and analyses the SRH activism of minoritised communities from the 1970s. From the 1970s onward, Black and Asian women in Britain started to organise autonomously and set up groups to campaign and denounce racist practices in connection with SRH and to improve the SRH of minoritised women (Douglas, 2019; Sudbury, 1998; Thomlinson, 2016). From the 1990s, minoritised individuals set up their own SRH services. It conjectures that minoritised SHR activists’ concerns were taken seriously when they aligned with other political and public concerns and broader public anxieties. Drawing on archival materials from these minoritised SRH activists, medical articles, media analysis, and oral history interviews with key members of the groups, this research stream asks:
To examine these questions, this strand is divided into two research arms. The first explores minoritised SRH activist campaigns and the second the setting up of minoritised individual-led SRH services from the 1990s.
By looking at minoritised SRH activism, this part will provide insights into the contributions it made to SRH policy and the limits of its mobilisation.
The third strand of research is carried out by George Severs and focuses on minoritised people’s lived experiences of SRH services by conducting oral history interviews with former clients and examining how intersection of gender, race, and class social conditions served to enhance or hinder minoritised women’s reproductive freedom. Analysing service users’ experiences is a powerful means to understand the gaps and omissions in the provision of SRH services. This is especially true for communities that have remained somewhat absent in the archives. Indeed, the majority of SRH sources are produced by white-led organisations and feature white experts’ opinions on SRH policy. With this in mind, this stream of the project will shed light on lived experience of SRH services hitherto unexplored. The questions at the heart of the research stream are:
Using micro-analysis by centering on individual experiences also enables the researcher to demonstrate that individuals are not the passive victims of their environment; they develop strategies to reduce uncertainty and to find ways to open up new opportunities. Minoritised individuals might not have had the same access to information on sexuality and SRH services as their white counterparts, and they might not understand or be familiar with the cultural sexual codes and norms of British society. As such, this strand will be particularly sensitive to differentiate between different minoritised groups and individuals, recognising the diversity of their experiences.
