A Meditation for Black History Month: Why the AMSA Reproductive Health Project Follows the Moral, Ethical, and Political Vision of the Reproductive Justice Movement

February 10, 2024

A Meditation for Black History Month: Why the AMSA Reproductive Health Project Follows the Moral, Ethical, and Political Vision of the Reproductive Justice Movement

Written by Jeff Koetje, MD, AMSA Reproductive Health Programming Strategist

When people who don’t know me ask me what I do, I feel a little bit of a thrill, knowing that most of these inquirers are not anticipating the answer I’m about to give, or that I’m about to use the “a” word. “I work in support of educating and training future abortion providers…” I think what catches people off-guard the most is not that I say the word abortion, but that I – a (cis) white (gay) man – goes about his workday in service to the goal of increasing access to abortion care. It hardly needs to be said that in this country (US), if a white man is talking about abortion, he’s probably trying to make abortion harder, not easier, to access. Even I find myself caught off-guard when I occasionally encounter other white men, outside of white male abortion providers themselves, who work in support of abortion care access.

As a cis white man who works as one of the staff of the AMSA Reproductive Health Project, I realize that anytime I enter a space within which the work of reproductive health, rights, and justice is being done, I unavoidably carry with me into that space the embodiment of the oppressor. I am white; I am cis; and I am male. The fact that I’m gay is personally (and politically) relevant to the work I do but that fact does not do anything to automatically mitigate the most visibly apparent aspects of my particular embodiment. What this means, for me, is that I must take very seriously a need to constantly interrogate how I “show up” in these spaces, because while I can’t help but show up as a cis white man, I absolutely have the power and responsibility to reduce the many ways that the oppressor could show up in these spaces through me: in my attitudes, actions, and energy. This practice of self-interrogation – of my own whiteness; my maleness and masculinity; my cis-ness; and the totality of my identities, the sum of which is my physical embodiment and my sociopolitical positionality – is something that I’ve been engaged in, in sustained and ever-deepening ways, for the past 25 years. It’s a practice; it’s on-going; it will never end; and there is no state of “perfection” toward which I am moving.

I’m using this personal anecdote to get to a larger point, which has to do with the question(s) – and the necessity to answer the question(s) – that those of us who embody to one degree or another the oppressors of our present era must address: how do we show up in spaces of justice-making in ways that enable us to minimize our capacity to cause harm and maximize our capacity to contribute to the common cause? How do I show up in these spaces ethically? Even the question, Should I show up in these spaces at all? If and when and where I do, how do I navigate and negotiate power with those already in the space?

These are questions that apply not only to individuals, but also to the aggregate of individuals who may come together in some organization or entity that sets about to contribute in some way to the projects of justice-making and collective liberation. The AMSA Reproductive Health Project is one such aggregation of individuals who have come together for precisely this purpose: to contribute in a meaningful way to the projects of justice-making and collective liberation, in the realm of reproductive health.

The AMSA Reproductive Health Project has a primary purpose of supporting and nurturing future abortion providers, and so, we are a project that is primarily about reproductive health medical education and training. We are not a Reproductive Justice project, per se, but we have committed ourselves to doing our work – in our lane – in alignment with and in response to the moral, ethical, and political vision put forward by the Reproductive Justice Movement. In making this commitment to align with the principles and practices of the RJ framework, we allow ourselves to be in a position of accountability to those leading the movement(s) for reproductive justice. Specifically, this puts us into relationships of accountability with those most directly targeted and harmed by systemic oppressions.

The founding mothers and the rightful leaders of the Reproductive Justice Movement are Black and Indigenous women, birthing people, and femme and queer people. It was a group of 12 Black women who came together in 1994 at a Chicago conference on women’s rights, who knew that the framing of “choice” as a political rallying cry for women’s (reproductive) rights did not actually apply to them in real life; their lived experiences were evidence that “choice” was possible, realistic, and relevant mostly to white women with economic and social privilege, and was rarely possible, realistic, and relevant to them as Black women living in a white supremacist heteropatriarchal society. In a Chicago hotel room, these 12 Black women conceptualized the framework that they would call Reproductive Justice (RJ), a framework that starts not with the notion of choice, but with a full-throated assertion of the centrality of the human rights, starting with the universal human right to bodily autonomy, which Black people – and Indigenous people, and poor people, and people of the Global Majority – have been systematically denied under colonial regimes of heteropatriarchal white supremacy. (This is why I, personally, cannot dismiss the significant potential for harm that my presence and participation in RJ spaces could cause.)

There is so much analytical power in the Reproductive Justice framework. It is a framework that, of course, has a lot to say about the universal human right to abortion care and family planning services. Moreover, because it is an analytical framework that centers the most violated and oppressed people, it is incredibly comprehensive in its scope: it is a framework within which so many dots can be connected – prison abolition, environmental justice, voter rights, economic justice, children’s rights, and so on. Any issue that has an impact on the capacity of a person or people to control their own bodies, determine their own reproductive destinies, or raise their families in safe, supportive, and sustainable communities is an issue that can be analyzed and worked on through the lens of Reproductive Justice.

Beyond its analytical power, the RJ framework is powerful and compelling because it is actually inspiring! It is enlivening! It is visionary! It is imaginative! It is also open and inviting! It presents an invitation to join in the work of embodying the vision for a future world in which everyone experiences freedom, in which everyone’s bodily autonomy is honored, in which everyone has what they need to thrive and flourish. It invites dreaming, and validates desires, but it doesn’t indulge in intellectually lazy utopian fantasies. Getting free and being free requires intentional, sustained, dynamic and oftentimes difficult work, and this work – if it is to be effective – must be done in contexts of deep relationality, vulnerability, and accountability. But, truly, the invitation to join in the work is a generous one, because the RJ Movement also recognizes that there can be a role for anyone and everyone who is compelled by the vision for justice and who is willing to do the work to live into that vision now.

The Reproductive Justice Movement has a lot to say to the House of Medicine, about the House of Medicine. About modern medicine’s ideological foundation in heteropatriarchal white supremacy. About modern medicine’s abuse of power through domination, control, and dehumanization. About modern medicine’s violations of the bodily autonomy of Black women, Indigenous women, people of the Global Majority, poor people, and queer people. About modern medicine’s violences against the bodies of these same people. About modern medicine’s eugenicist origins, its ableism, and its impulse to pathologize natural and normal human variation and difference.

The RJ Movement has a lot to call the House of Medicine out for. But I’m grateful to the RJ Movement that it doesn’t just call out the House of Medicine; it calls in the House of Medicine to allow itself to be transformed by principles of justice and a new commitment to human rights as the foundation for a radically transformed ethical framework for practices of medical care. If anything, it invites the House of Medicine to abandon the long-dead, so-called “Fathers of Modern Medicine” of the mid-1800s and 1900s – Sims, Storers, Davis, Atlee, and Flexner to name just a few. These men sought to make a new medical profession in their image – and in doing so, they founded what we now recognize as today’s medical profession upon a morally indefensible ideology of white male supremacy, which of course informs the foundational anthropology of the profession as well: the premise that the normal, normative, and fullest human embodiment is that of the wealthy, white, Euro-American, able-bodied, neurotypical, cis-heterosexual male. From this anthropological premise, it follows that any and every other human embodiment is some lesser degree of human and, more or less, a pathological aberration.

The House of Medicine is now at an inflection point, and those of us in the profession must address the question in front of us, which we can no longer refuse to engage: whose moral imagination are we going to follow and carry with us into the future of our profession? The moral imagination of the white Fathers of Modern Medicine, whose commitment to the false ideology of white male supremacy set the stage for modern medicine’s easy participation in sociopathic behaviors (such as the so many incidents of barbaric experimentation on enslaved and/or colonized women)? Or the moral imagination of the Black and Indigenous Mothers of the Reproductive Justice Movement and the interconnected movements for justice and collective liberation?

For our part, we who are the flesh-and-blood humans of the AMSA Reproductive Health Project are clear about whose moral vision we will follow and carry with us into the future of medicine. We are committed to showing up for the work that needs to be done. We are here to step up and step into the significant gaps of reproductive health medical education and training; to stand up with clarity of moral vision and conviction in support of protecting and ensuring access to abortion care wherever and whenever it is needed by advocating for the protection and preservation of abortion care education and training for all future physicians; to fight back with collective and unified force against the authoritarian political movements that seek to dominate and control people; and, ultimately, to keep doing the work that contributes to the manifestation of a transformed society within which everyone has what they need to thrive and flourish on lands restored by justice and nourished by the reign of Reproductive Justice.