I’m co-delivering a sex education class about condoms and barrier methods. My co-trainer shows the class an Internal Condom (branded Femidom) and proceeds to say, “a lot of people think this is a condom for a Black man, because it’s so big”. They sit back down completely unphased by what they have just said.
After this encounter I wonder how many sex educators hold this inherent bias and the continued impact that has on Black and people of colour in their class. I wonder if you, reading this now, are wondering what the issue with their statement is. I wonder, how many people have succumbed to the fetishisation of People of Colour in porn and the media, so much so, that they no longer realise their own racism.
Angela Davis said that “in a racist society it is not enough to be non-racist. We must be anti-racist.”
I try to carry this principle with me when I teach people about sexual health. Black People and People of Colour (BPoC) have far worse outcomes in terms of sexual health than their white counterparts. For instance, rates of chlamydia and gonorrhoea in people from BPoC communities are three times higher compared with the national average rate. Race is not the issue, but a sector which still holds inherent racial biases from its colonial roots.
As a Jewish woman of colour, who is white passing, I too have a lot of work to do. I must reflect on the role I play in this sector and space. Anti-racism isn’t a badge you gain once you have completed a number of tasks. It is a continual journey of listening and learning. For that, I am continually grateful for the work of Decolonising Contraception, SIECUS and Charity so White, for providing me with evidence and knowledge, so I can continue to grow.
In this post I am going to reflect on my learning to present how Sexual Health services can do better. This is not just for BPoC but also for others who have been ignored or fetishised in service and educational provisions.
Internal Reflection on Anti-Racism
Many sexual health organisations and teachers already believe that they are anti-racist. Their resources are diverse and represent different communities, and they feel this is enough – but this is the bare minimum. In order to be truly inclusive, practitioners must also reflect on their individual biases, values and judgements. Without this ongoing internal reflection, delivery of these services can be implicitly biased. They can be steeped with prejudices, and gender and racial tropes that cause harm to those they seek to support.
If someone lives their whole life absorbing information that is euro-centric and full of racial stereotypes, it’s unlikely that they will be able to see beyond those, especially at a subconscious level. So, when that person delivers any content, including about sexual health, those racial values will play out. For BPoC attending these sexual health services these interactions play out with providers. For example when providers deliver harmful information, as the primary example. Or as awful an instance as underplaying the level of pain medication BPoC need when having contraceptive devices inserted.
Without recognising the way that our current social structures, which have been built on colonialism and racism, shape our knowledge and practices, sexual health services will continue to provide bias services to BPoC.
Stop Saying Hard to Reach
I hear it time and time again in the sexual health space. Organisations talk about ‘hard to reach’ communities, rather than actively working to address the unique needs of BPoC. This problem-centred language places blame on BPoC for not accessing resources rather than placing blame on organisations for not creating content which is relevant and engages these communities. To bridge these gaps, the Sexual Health space should ask the question: ‘what are the systematic issues which mean these communities aren’t accessing our services?’ in order to get to the heart of engaging those communities.
Being a Person of Colour is not a risk factor, mainly because People of Colour are not a homogenous group. Rather than seeing race as a risk factor, organisations should look to understand the lived realities of the communities they work with and the intersections of identity which take place.
Center Real Voices
Sexual health services must first and foremost listen to communities. That doesn’t just involve waiting for feedback after a person has attended the service. Instead they should center the voices of communities from the very start.
Every approach should begin by asking communities: ‘what do you need from us?’. The importance is working with the community to develop a program or service which fits their needs. Too often the statistics from baseline data are used to bid for grants. Very rarely is this information gathering used as a tool to work with the community to build the best results for that community.
If organisations held community-led forums, worked with grassroots organisations and activists, and included cultural and religious leaders in decision making, projects would actually represent the needs of the people.
Black and People of Colour, as well as people from other minority communities, must be at the decision-making table.
In my experience in the space, those making the project decisions are most often White, heteronormative, able-bodied managers, who have never even met the community they are speaking about.
When educators, practitioners and other employees in Sexual and Reproductive Health (SRH) services don’t represent the community they marginalise the very communities they set out to serve. Not only because people immediately feel marginalised when they enter those spaces, but because strategically, mistakes can prevail. When there is no representation of communities, communications and decisions will continue to marginalise the very community SRH set out to serve.
As a sector we must do better. We must place value and power in community understanding and real lived-experience.
Understanding the additional barriers communities face in accessing sexual health services involves reflecting on the historical legacies of colonialism and the ongoing presence of systematic racism. We cannot understand the present without reflecting on the past. This is specifically true when communities have faced multiple traumas within the SRH space.
Undoing some of these traumas means more than diversifying resources. As an educator, practitioner or organisation you must actively think about how the services you provide are steeped within historical, social and political racial ideas. Ideas that affect communities of colour differently to their white counterparts. You must think about how
- the health implications of STIs and contraception will affect people of colour differently. Mostly due to the lack of research afforded to these minority groups and the stereotypes attributed to these communities.
- ideas of beauty, body shape and dieting will negatively affect self-esteem, fetishise communities of colour and impact on their interaction with pornography, body image and sex.
- communities of colour are less likely to receive pain medication or have their conditions acknowledged by healthcare professionals when seeking medical interventions.
- legacies of colonialism have created cultural practices and ideas which may inform reproductive rights, gender identities and access to SRH services.
Are these thoughts a part of your strategy every time you create a new project or session? If not, you as an individual or organisation, are actively contributing to health inequalities.
Without a reflection of how colonialism has impacted communities’ of colour, these communities will continue to be failed. As a result, they will continue to have poorer sexual health outcomes.
Of course, this is not an exhaustive list of how the SRH space can do better. I intend for this to be the beginning of a new direction for SRH that is actively anti-racist and inclusive. An SRH space that speaks to the people we work with and improve the sexual health of all.
So, the next time you are planning a SRH lesson or project ask yourself this. As someone who is not a member of this community, am I best placed to make decisions about what will benefit this community? And, if not, which community members and experts can I listen to in order to better shape this project?
That simple question will lead to much greater outcomes for all.