Posted in reproductive rights

Bound and Gagged

As a new President has been elected in the US, you might hear campaigners in sexual health talk about ‘The Global Gag Rule’. But what is it and why does it matter to people working in sex and relationship education?

The Global Gag Rule is US policy which forbids NGOs (Non Governmental Organisations – for example, health charities) from taking part in certain activities if they receive US funding.

These activities include providing abortion care directly. But it also includes referring pregnant people to abortion services, simply providing them with information about abortion, or campaigning around legal reform in this area.

So NGOs (Non-Governmental Organisations) that want to receive US funding are effectively ‘gagged’ from working in abortion care – hence the name.

This policy was originally called The Mexico City Policy and was first introduced by the then President Reagan in 1984. Under the Mexico City Policy, the ‘gag’ applies to all of the work that an NGO does. For example, an organisation cannot use funds from another source to fund work in abortion care.

How big a deal is this? Well the US provides a huge amount funding to overseas NGOs. The US can be a major source of funding for NGOs. The Global Gag forces them to balance the importance of abortion care with the need for financial stability.

In addition to this, US culture and political ideology is hugely influential around the world. This is true, even if you are living in a high income country which doesn’t rely on overseas funding from foreign powers, like the UK.

The US position on abortion care is really important right now, at a time when some countries are rolling back on abortion laws – for example in Poland.

Remember, the WHO (World Health Organisation) recognises that abortions are both incredibly common and also continue to take place where they are not legally allowed – but in unsafe conditions.

So why are we talking about the Global Gag Rule at this particular time? Well, since it was first introduced this policy has been removed and reintroduced several times. There has been a pattern of Presidents from the Democratic Party to overturn the Global Gag Rule, and for it to be reinstated the next time a Republican President gets in to power.

The outgoing US (Republican) President – Donald Trump – is noted to have reinstated the Global Gag Rule. In fact, some people say that his version of the Mexico City Policy made it even more restrictive – for example by making it apply to all of the global health assistance funding, not just that set aside for family planning.

Many people hope that new US President will, as the pattern has been, remove the Global Gag Rule and allow NGOs to be supported in providing essential health care. At the time of writing this, there is an international petition to call on him to do just this.

Posted in puberty

The trouble with a textbook example…

A really common idea is that men and women are just fundamentally ‘biologically different’. Perhaps so common that it can lead us as a society to mentally overwrite objectively known facts.

The idea that gender itself is not necessarily related to biological traits is easy enough to recognise and call out. In most countries in the world, genital presentation at birth is how people are assigned a sex of either ‘male’ or ‘female’ – i.e. a penis for a boy, a vulva for a girl. But many of us seem comfortable enough with the idea that gender identity can be separate from the sex someone was assigned at birth. There even appears to be growing recognition that gender identities exist beyond the Western-centric binary standards of ‘man’ and ‘women’ only. In other words, that non-binary people exist.

Even where the above is generally accepted though, the idea persists that there are only two biological sexes and they are enduring different from each other. There is an assumption that everyone can be divided in to one of two groups: people with a penis and people with a vulva. Furthermore, we are taught that these two groups are mutual exclusive – someone can’t fit in to both categories.

Why is this a problem? Well, for a start it isn’t true.

There are a whole range of ways in which some people are born with physical, biological traits that don’t fit neatly in to a binary ‘male’ or ‘female’ presentation. This includes being born with genitals which are not typically or just either a vulva or a penis.

Sometimes when someone is born this way, the term intersex is used – although it might be considered problematic to define people in relation to what they are not. Other phrases like variations in sex characteristics might be more accurate and less emotionally loaded.

The existence of people whose natural biology defies the way in which we commonly define biological sex – as a society, but also in law. Very few countries in the world recognise any sex designation other than male or female in official spaces, like birth certificates or passports. This means that when someone is born with biology that doesn’t conform to our notion of the binary of male/female, we usually simply ignore it. This surely has huge implications for how valid or accepted people feel in bodies not conforming to this binary.

It’s hard to say how common it is for people to naturally not fit in a binary sex category – precisely because most societies pretend that it doesn’t happen. The United Nations say that it may be as much as 1.7% of all people born – which they also note is a similar figure for the percentage of people around the world born with red hair. So while it may not be common, it certainly seems a significant amount!

Other challenges to the binary notion of sex characteristics are very common. Many of these relate specifically to something called secondary sexual characteristics. These are the changes that generally occur during puberty.

A biology textbook-type explanation of these would be something like:

  • Secondary sexual characteristics are some of the changes that occur during puberty because of hormones.
  • People with testicles produce the hormone testosterone, which causes changes in puberty like facial hair to grow, the voice getting suddenly much deeper (‘breaking’) and the body to get muscular.
  • People with ovaries produce the hormone oestrogen, which causes changes like breasts to develop and hips to get wider.

I said this was a ‘biology textbook-type’ explanation. In fact, this is identical in terms of factual content to the BBC Bitesize GCSE biology revision page. Except that I used the phrase ‘people with testicles’ instead of the word ‘boys’ and ‘people with ovaries’ instead of ‘girls’, because I understand the difference between anatomy and gender!

Like a lot of school science, this is a simplified version of what is actually known about biology. And in some ways, this makes sense in the context. However, I would argue that it’s an oversimplification… and a socially damaging one at that.

This explanation gives the impression of a firm dichotomy of biological sex. Biological males make testosterone, which is produced in the testicles and this produces masculine physical characteristics. On the other hand, biological females produce oestrogen because they have ovaries and this leads to well recognised feminine characteristics. This is a neat, comprehensible explanation of biological sexual characteristic traits.

It’s also wrong. For a start, it ignores the fact that oestrogen and androgen hormones (testosterone is a type of androgen) are both made by people with ovaries and by people with testicles – just usually in different amounts. It’s therefore possible for someone with one set of anatomy to show the physical traits that we overwhelmingly associate with the other.

A very common example of this is someone with testicles producing enough oestrogen to develop breast tissue. The medical word for this is gynaecomastia (pronounced guy-nah-coh-mast-ee-ah). It’s reported to be experienced by up to 70% of people with testicles undergoing puberty, exactly because this is a time of hormonal changes within the body.

Despite this meaning that gynaecomastia is very normal and frequently experienced by people with a penis in puberty, it is often described as a medical condition (for which, read: problem) or a hormonal imbalance (for which, read: your body isn’t working properly).

So fixed are our notions of binary sexual male and female characteristics, that it leads us to recognise a common bodily change as a medical condition – to label the majority of peoples’ experiences as abnormal.

Another reasonably common example of this phenomenon is hirsutism. This is when a person with a womb and ovaries has facial hair. The most common reason for this is for someone to have Polycystic ovary syndrome (PCOS). PCOS in itself is not at all rare, with one in ten people who has a womb and menstruates having it. But according to our oversimplified biology textbook definition, beards and moustaches are solidly masculine traits.

Can you imagine learning biology in a way that invalidates your physical experiences and makes your healthy, biologically non-binary body feel like it’s actually a freak of nature? Well, it turns out a lot of us don’t have to imagine, as this is what school curriculums are already teaching many of us!

Further Reading…

Cordelia Fine’s book Delusions of Gender: How Our Minds, Society and Neurosexism Create Difference (2010) is a hefty but excellent book on how science research is influenced by our social constructions of sex.