Tag Archives: stigma

HIV and Trans Women

Nearly a fifth of the world’s transgender women are infected with HIV. A recent analysis compiling the results of 39 studies involving 11,000 transgender women from 15 countries came to this startling conclusion. This number is 49 times higher than the general population, 36 times higher than males and 78 times higher than other females. For the study, transgender women were defined as individuals born as biological males who currently identified as female. Transgender women who engaged in sex work were also significantly more likely to be infected with HIV than male and other female sex workers.

So why are transgender women so much more likely to contract HIV? The authors of the report offered several reasons. They believe that many of the infections occurred through unprotected anal sex. Next to direct blood to blood contact through needle sharing, anal sex is the easiest route for transmission. Anal tissue is more easily torn during anal sex than through either vaginal or oral sex. If they have had a recent vaginoplasty/vaginal construction, they are also at greater risk of infection. Transgender women are more likely to be involved with sexual partners who are infected with HIV and engage in sex work.


The stigma, discrimination, and fear of judgement associated with being transgender are significant factors that lead to many women avoiding routine health screenings. And to make matters worse, few health care workers, HIV counselors, and physicians are trained in transgender women’s health care issues.

Hopefully, this study will help open doors to future strategies to help address this overlooked population. To read the entire article, click here.

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Abortion Stigma: What is it?

seachangeRecently at Planned Parenthood, we have been talking a lot about abortion stigma across our affiliates. This is thanks to the work that Planned Parenthood Federation of America is doing alongside organizations like The Sea Change Program which focus on abortion stigma. Sea Change defines abortion stigma as “a shared [mis]understanding that abortion is morally wrong and/or socially unacceptable. The stigma of abortion manifests within multiple levels, including media, law and policy, institutions, communities, and individuals.” While this definition may seem a little hefty, basically it is saying that shame and judgment about abortion combine in different places in our society to create the shared idea that abortion is wrong, and that this judgment and shame negatively affects individuals who seek or have had abortions. And with 1 in 3 women having an abortion during their lifetime, and we need to work to end the silence and judgment so they don’t have to carry around other people’s judgment.

When we think about how abortion is portrayed in our media, how it is talked about amongst our peers, and current restrictive laws that are being passed regarding abortion, this definition makes sense. All of these negative forces combine to make access to abortion more difficult. Practical changes, like laws which create waiting periods, put extra burdens on people who are trying to access abortion. Media representations may present people who have abortions as being “in the wrong” or may not even discuss abortion as an option when a character has an unintended pregnancy. People around us, and unfortunately sometimes we as individuals, may talk about abortion in ways that place blame on those who have them (i.e. “If she had just used birth control she wouldn’t be going through this right now!”) Judgment like this from a loved one or peer can be especially harmful.

Judgment and shame don’t work to stop abortions, but what they do is create an emotionally desctrutive space that prevents people from accessing the support they need. Medical decisions are personal, and don’t affect outsiders. We can help end stigma by being careful about the ways we talk about abortion, and making it clear that lots of people are affected by those who judge and shame!

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Abortion in Film and Television: Why Accurate Representation Matters

Obvious_Child_posterThere has been a lot of discussion recently about the new film, Obvious Child. Written and directed by Gillian Robespierre, the film, a romantic comedy, includes frank and open discussion and representations of women’s reproductive health. This includes the main character, Donna, getting an abortion. The film is receiving particular attention (and harsh criticism) because the abortion is treated as a reasonable decision for Donna to make, and not as a moral device or a non-factual warning about the “dangers” of abortion.

In a way, it is pretty amazing that this frank and honest representation of abortion would be so controversial.  Some estimates conclude that as many as 1 in 3 women will have an abortion in their lifetime. With abortion is as safe and common of a procedure as it is, why are representations of abortion in the media so skewed that a non-judgmental depiction would be viewed with shock? Is it really that uncommon for abortion to be portrayed accurately in our media? Advancing New Standards in Reproductive Health (ANSIRH) sought to understand what most representations of abortion in films and television were like, and found some pretty interesting results.

Overall, ANSIRH found that while the number of abortions in film and television is rising, abortion is found to be riskier than it is in real life, and more women are shown dying directly from abortion (9% verses less than 1% in real life.) This highlights a need for varying narratives, like Obvious Child, which highlight that abortion can be used as more than just a scare tactic in film. Abortion is a part of many women’s lives, and there are a range of stories to be examined. Hopefully, films like this will influence a change in the way that we present abortion in film.

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Didn’t Learn That in Health Class!: STDs and Stigma

The way we talk about sexual health is incredibly important. If we want to reach a place in our society where people can easily gain access to reproductive health care, we need to learn to talk about sex, sexuality, and our bodies in ways that facilitate this change. This is particularly important when it comes to talking about sexually transmitted diseases, as the stakes for breaking away from the shame-based fear currently associated with these infections are incredibly high.

hiv-stigma-cycleOftentimes individuals who have a sexually transmitted diseases face a great deal of ridicule within our society. This scorn is reflected in casual conversations, media representations, and unfortunately even in some education related to sexual health. Negative notions about STDs may portray individuals who have them as being dirty, sexually promiscuous, and irresponsible. This creates a mold in which only “certain types” of people get STDs. The problem with this logic is that research has shown that 1 in 4 Americans currently have an STD, with almost half of these infections taking place in the 15-24 year old age range. If you are engaging in sexual activity, and especially if you are having sex and not using a barrier method (such as condoms and dental dams), it is possible for you to contract an STD. Infections don’t differentiate between “certain types” of people.

It also is important to remember that one reason we hold such negative views about sexually transmitted diseases is because they are contracted during sexual contact. We wouldn’t publicly ostracize someone because they caught a cold, nor would we spread rumors about someone’s character because they contracted a nasty case of food poisoning. Promoting negative ideas about STDs and the people who have them is tied in with our culture’s negatives notions about sex. There ARE risks to having sex, just like there are risks to nearly any type of human contact. However, the current cultural shame around STDs doesn’t promote knowledge or understanding, nor does it propel people into seeking medical care. However, the best way to decrease infection rates and encourage more individuals to seek testing and treatment may just be to highlight the fact that an STD is an infection, and like other all infections requires professional medical help. If we work to remove the cultural stigma surrounding STDs we may be able to start a more genuine discussion about how STDs are spread, what can be done to prevent them, and what to do if you have an STD.

The first of this month represented World AIDS Day. In keeping with a focus on HIV and AIDS, there are some organizations that work to reduce stigma, and provide a great example of how we can communicate about STDss without relying on negative assumptions or misinformation. One such organization is The Stigma Project, which is a “grassroots organization that aims to lower the HIV infection rate and neutralize the stigma associated with HIV/AIDS through education and awareness via social media and advertising.” Another organization is The Sero Project, which is “a network of people with HIV and allies fighting for freedom from stigma and injustice.” Check ‘em out!

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I work with abortion. I will not apologize.

abortion-law-sizeLast week I attended an incredible workshop with my colleagues, where we talked about the emotional side of abortion work. About ten of us, all working in different roles within our affiliate, shared with each other how we cope with the stigmatized nature of our work, and how we deal with protesters both in our communities and in our personal lives (friends, family, etc.). I learned so much about the strength, courage, and absolute commitment to helping women that my colleagues and I share. It was really emotional and absolutely inspiring to recognize the commitment we have to this work. I am so proud to be a part of in the struggle of women; in the herstory of women.

Having said that, it was ironic that a few days later I became involved in a confrontation about my work with a distant relative through, of all places, Facebook. While I honor and love this family member, and have incredibly fond memories of our time together in my childhood, we just don’t agree politically or socially now that I’m an adult. Specifically, when it comes to social issues and the issue of a woman’s right to decide. So, I posted something about an interview with anti-choice protesters, and was issued a moral citation via comment box.

A few days later he sent me an email about the better choice being adoption. I now felt like I needed to explain myself without apologizing or igniting personal defenses. I do not want to fight with family about the work I do. And I will not apologize. Having spent time discussing such awkward and uncomfortable interactions with family a few days before at the workshop, I felt like I was prepared to respond. Awkward? Yes. Impossible? No. In summary:

…I’ve been working one-on-one with women who choose abortion for the past 5 years. I’ve met with hundreds and hundreds, perhaps thousands of women in my office, and my beliefs about choice stem from listening to them and learning their stories. For many, adoption is an excellent choice, and I whole-heartedly support women who choose that route. I am most excited when I meet with a woman who has planned her pregnancy, and is ecstatic when the pregnancy test comes back positive. There is so much joy to share in life.

Though the organization I work for only sees about 10% of clients for abortion services, I travel to our different locations and work predominantly with those clients. I do family planning education and give emotional support to women who are choosing abortion. I feel I am an angel for so many of the women I see, who are ashamed, afraid, stigmatized, guilt-ridden and desperate. I accept them, I accept their choice, and I honor them as human beings trying to do the best they can for themselves, their families, and their futures.

Having said that, I speak with each and every single woman who is considering abortion about adoption. That is a requirement; we talk with women about adoption and how to continue their pregnancies for parenthood, along with abortion education. Over and over and over again, when I talk with women about adoption, many give the same response: there is no way they could spend 9 months becoming emotionally attached to their pregnancy and give it away. The guilt and resentment they would feel knowing they had a child in the world that they had “abandoned” is a worse choice for them than to prevent the pregnancy from continuing. These are their words, not mine. For others, adoption is an opportunity to give their child to a family who is ready and able to provide a quality life for their child. Every woman’s view is valid.

In many cases over the years, I have helped women choose to continue their pregnancies. I support their choice, regardless of the outcome. It is their body, their life, not mine…. Having said that, our perspectives on this issue are different, but I respect your opinion, as your beliefs are just as valid as mine.

This line of work is both incredibly challenging and incredibly rewarding. Our greatest hope and mission is for all children to be wanted children, and for the need for abortion to no longer exist. However, we do not currently live in a world where this is possible, and abortion is a safe option that 1/3 of U.S. women make in their lifetime. I emphasize education and prevention. I will not apologize.


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