The Routledge International Handbook of Social Work and Sexualities

SJ Dodd, SJ Dodd

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000408652
• Edition: 1
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

This Handbook is the first volume to address the dynamic issues related to sexuality from a social work perspective by providing a comprehensive, current and international overview of issues related to sexuality.

It explains how each issue is important and critically discusses the leading views in the area, providing diverse and inclusive perspectives from leading scholars in the field. Divided into seven parts:

• 
  
  

• Structural Context
• Sexual Identities
• Sexuality trough the Lifespan
• Health, Mental Health, and Sexuality
• Sexual Health and Well-Being: Pleasure, Desire, and Consent
• Practice Issues
• Regulating Sexuality: Historical and Contemporary Legislation

It will be of interest to students, academics, researchers, and practitioners of social work and related health and social care subjects, and is particularly relevant for practice courses as well as courses on Human Growth and Development and Human Behavior in the Social Environment.

Part I

Structural Context

1

Social Work and Sexual Health

A History

Sarah Pilgrim, Virginia Ramseyer Winter, and Mackenzie Cook

Sexual health has been the focus of interdisciplinary professionals for centuries. Social work as a profession would be considered new to the field, beginning work officially during the turn of the 20th century corresponding with the advent of the social work profession (Fair, 2018). Despite the delay in social work’s entry into the field, the fit between sexual health, sexuality, and social work was immediately evident. Social work as a profession champions social justice, empowerment, and self-determination. Historically, sexuality has fueled injustice, oppression, segregation, forced sterilization and imprisonment primarily for women, adolescent females, and lesbian and gay individuals. Turner (2016) posits that “sexual justice is social justice” (p. 45), placing sexuality and sexual health directly in the purview of the social work profession.

This chapter will provide a guide through the history of the social work profession in the US and its relationship with the field of sexuality and sexual health. Starting with the settlement houses and ending with advanced technology, this chapter will provide future and current social workers with a road map that will allow them to identify missteps, successes, and areas for growth and improvement.

The Hull House, Charity Organization Society, and the Social Hygiene Movement

Early social work professionals were inspired by the possibility of eradicating prostitution, venereal disease, and early forms of sex trafficking known as “sexual slavery” (Bromfield, 2016, p. 129). Whether it was based in the settlement houses or an aspect of the Charity Organization Societies’ (COS) case management, social work professionals worked to abolish the “social evil” that was infecting their cities in conjunction with the Social Hygiene Movement. Jane Addams created Hull House in Chicago based on Toynbee hall in England, to serve as a community center for immigrants. Over time, the Hull House evolved to provide services that supported the ever-changing needs of the community (Fair, 2018). The Hull House began providing educational services for young, unmarried women. The professionals at the Hull House identified that beyond a lack of education, many young women were putting their lives at risk having unprotected sex, accessing illegal abortion, using untested contraceptives, and giving birth alone in their homes (Fair, 2018). Dr. Rachelle Yarros shared Addams’ passion concerning women’s sexual health and provided sexual health education at the Hull House.

Mary Richmond, an original member of the COS, started her work in New York City, quickly spreading the model using friendly visitors to over 100 cities (Wahab, 2002). The approach of the COS differed from that of the settlement houses as they provided services directly to immigrant women in their homes. The COS identified their roots in the evangelical movement and supported the idea that women were more susceptible to sexual exploitation and needed protection from themselves and male sexual aggression (Wahab, 2002). Richmond and the friendly visitors employed modeling techniques hoping “to transform the social and moral character of their ‘slum’ neighbors through the assumed power of friendship and human interaction” (Wahab, 2002, p. 45). Through data collection, clinical intervention, community organizing, and policy practice, early social work professionals fought in the Social Hygiene Movement to liberate women.

Social Work and the Eugenics Movement

During the height of the Social Hygiene Movement, which began in 1913 and continued for much of the 20th century, interdisciplinary professionals continued to search for solutions to the issues of prostitution and the spread of venereal disease. When segregation, public shaming, and rudimentary treatments failed to stop the rapid spread of disease, physicians, public health, and social work professions turned to the “science” of eugenics (Kennedy, 2008). Termed in the late 1800s by Sir Francis Galton, eugenics is defined as the study of hereditary or inherited characteristics. Proponents of eugenics sought to encourage those possessing desired traits to procreate while preventing persons deemed unfit from having offspring (Haller, 1963). Professionals in the communities utilized the classification of feeblemindedness as a way to categorize and treat individuals they saw unfit to engage with society. The feebleminded included those that were categorized as prostitutes, criminals, those suffering from epilepsy, LGBT, alcoholics, mentally ill, physically and mentally disabled, homeless, sexually active, unmarried women, and adolescent females (Haller, 1963).

The American Social Hygiene Association, with Jane Addams as the honorary vice president, focused part of their intervention on eugenics (Clarke, 1955). Social workers utilized the feeblemindedness test to identify individuals that qualified for intervention. Intervention was defined as segregation in institutions, restricting or voiding marriages between those deemed feebleminded, and forced sterilization (Kennedy, 2008). Marriage laws were a commonly used restriction during the Progressive Era in the US, with 30 states passing laws to restrict or void marriages, and 17 states passing laws mandating sterilization for those who were identified as feebleminded or unfit (Davies, 1923). The majority of those targeted for intervention were female and racial minorities, as women of color (adult and child) were identified as the primary carriers of degenerate characteristics and disease (Haller, 1963). Overall, more than 60,000 individuals were forcibly sterilized during the eugenics movement, which continued in some states until it was officially ended in the late 1970s (Kaelber, 2011). While many “feebleminded” women were being forcibly sterilized, many others were fighting for their rights to plan their families.

Social Work and Reproductive Health: Contraceptives and Abortion

Early social workers were working in reproductive health during a time when many policies restricted access to care. The Comstock Act, an anti-obscenity statute, was one such policy. It was enacted in 1873 and prohibited distributing materials regarding contraceptives and abortion (D’Emilio and Freedman, 1997). Margaret Sanger was arrested for violating the Comstock Act in 1914 and again when she distributed birth control at her New York clinic in 1916 (McCann, 1994); in 1936, the Comstock Act was overturned (D’Emilio and Freedman, 1997). Finally, in 1960, the birth control pill was approved by the Federal Drug Administration, and in 1965 the Supreme Court decision Griswold vs. Connecticut (381 US 479) protected a woman’s right to private medical decisions and expanded access to oral contraceptives within the confines of marriage (D’Emilio and Freedman, 1997). In 1972, the Supreme Court decision, Baird vs. Eisenstadt (405 US 438), further expanded access to all women (Thompson, 2013).

Contraception access by way of the Supreme Court provided a framework for the right to privacy as it relates to reproductive health. As such, in the landmark case Roe vs. Wade, the right to obtain an abortion was granted, as justices deemed it a privacy issue (410 US 113; 1973). Although as of this August 2019, the right to obtain an abortion is legal and abortion is very common with one in every four women obtaining an abortion by age 45 (Jones and Jerman, 2017), many efforts are underway to restrict abortion access (Guttmacher Institute, 2019).

The National Association of Social Workers (NASW; 2012) calls on social workers to support contraceptive and abortion access and policy on behalf of our clients stating, “Every individual, within the context of her or his value system, must have access to family planning, abortion, and other reproductive services” (p. 132). Unfortunately, although social work students in a Southern state report overwhelming support for referrals for contraception, they do not support widespread access to emergency contraception (Flaherty et al., 2012). Social work students in a nationwide sample generally support the idea of birth control as a significant part of responsible sexual health, but almost one-fourth of these students report not supporting legal abortion under any circumstances (Begun et al., 2017). Importantly, although they report not receiving training on contraceptives in their social work classrooms and practicum placements, the vast majority of social work students report that sexual health is relevant to our profession (Ramseyer Winter et al., 2016).

LGBTQIA+ and Social Work Advocacy

The Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual (LGBTQIA+) movement is a fight for justice and civil rights. The history of this movement has not been well documented in interdisciplinary literature or research; however, social work and social workers have been present in the movement since the inception of the profession. Jane Addams and her companion Ellen Gates Starr were strong proponents of platonic love and an admiration of whomever rather than traditional heteronormative definitions of love (Fair, 2018). Organized advocacy groups in the LGBTQIA+ movement were not officially documented until after World War II. During the 1950s we saw the emergence of the Mattachine Society, One Inc., and the Daughters of Bilitis, all of whom engaged in education and outreach for and about gay and lesbian individuals (Byard and Thomas, 1997). The turning point in the LGBTQIA+ movement is often identified as the Stonewall Riots of June 28, 1969 when patrons of a gay bar, the Stonewall in Greenwich, New York, decided to fight back against police raids.

Following the Stonewall Riots, the LGBTQIA+ community began making strides toward visibility and equal rights. Advocates successfully lobbied to have homosexuality removed as a psychiatric disorder from the Diagnostic and Statistical Manual (DSM) in 1973. In 1982, Wisconsin was the first state to pass a civil rights law prohibiting discrimination against gay and lesbian individuals in employment, housing, and public accommodation (Byard and Thomas, 1997). In a landmark decision in Obergefell vs. Hodges (2015), the Supreme Court ruled in favor of same-sex marriage, legalizing it across the US. Social workers have been a part of the fight and will continue to be part of the movement going forward. “Sexuality cannot be cordoned off from some of the key issues to which social work is dedicated: poverty; education and labor force engagement” (Bay-Cheng, 2010, p. 101). With all the gains made in the past several decades, the LGBTQIA+ population still faces discriminatory practices in employment, housing, healthcare, and public accommodations (McCrone, 2018). Thus, social work must find its voice in the civil rights movement and fight with the LGBTQIA+ population toward social and sexual justice.

Social Work and HIV/AIDS

The National Association for Social Workers (NASW) has been very proactive in their support for those affected by Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). Shortly after homosexuality was removed from the DSM, the concept of “sexual health” was developed at a conference of the World Health Organization (WHO) in 1975. It was determined that the sexual health approach would be focused on sexually transmitted diseases (STDs) and reproductive topics (e.g. contraception, abortion, and perinatal problems). In 1981, the Centers for Disease Control and Prevention (CDC) identified the first patient of the AIDS epidemic. Little was known about HIV/AIDS in the beginning, it was first assumed that only gay men or intravenous drug users were susceptible (Avert, 2018). In 1983, AIDS was reported among female partners of identified heterosexual men, which suggested the virus could be transmitted through heterosexual intercourse as well. Also in 1983, the CDC reported HIV/AIDS could not be transmitted through casual contact (e.g. food, air). The WHO also had their first meeting regarding AIDS as AIDS was now discovered across the globe.

Over the next several years HIV/AIDS continued to spread and researchers began to learn more about the virus. Tests were developed to detect the virus in the blood, WHO launched the Global Program on AIDS to raise awareness, generate evi...

Table of contents

• Cover
• Endorsements
• Half-Title
• Title
• Copyright
• Dedication
• Contents
• List of figures
• List of tables
• List of contributors
• Acknowledgments
• Introduction
• PART I Structural Context
• PART II Sexual Identities
• PART III Sexuality Through the Lifespan
• PART IV Health, Mental Health, and Sexuality
• PART V Sexual Health and Well-Being: Pleasure, Desire, and Consent
• PART VI Practice Issues
• PART VII Regulating Sexuality: Historical and Contemporary Legislation
• Index