Women everywhere are fighting for control of decisions that affect their health. They are struggling with political and religious leaders who are defining the parameters of sex, sexuality, and gender. They argue with doctors, public health bureaucrats, medical and pharmaceutical companies, the health insurance industry, politicians, and religious authorities who regulate health care within countries. They also debate with agencies like the United Nations Development Program, the UN Population Fund, the United Nations Childrenâs Fund, the United States Agency for International Development, the World Health Organization (WHO ), and the World Bank, which are determining health policy at the international level. Some of these agencies are more receptive to advice from womenâs organizations than others, but women have learned that changing the language used in debates and lodged in conventions does not entail alteration of power structures.
Three examples illustrate the struggles. Women know that rapid population growth is a problem deeply rooted in economic and social realities, and they argue convincingly that reproductive health services cannot solve population problems. Yet, some aid agencies still maintain that family planningâthe use of contraception to space and limit birthsâis womenâs most important health care issue. Second, women recognized that violence against women was a health issue much earlier than governmental or medical authorities did, but few governments condemn femicide or have a truly protective system in place. Third, women saw that defining health care as a financial issue deprived the poor of services long before policymakers admitted the failure of projects that imposed fees on users. Women understand that governments bear responsibility for basic health care services, that public policy determines who gets what kind of care while money governs access to the private sector, and that preventive services deserve priority over curative care.
Where women enter, the discussion depends on their intersectional position, which varies over time, from one place to another, and on the strength of their mobilization. When white middle-class women started public debates about womenâs health in the United States in the 1970s, they focused on doctor-patient relations and their desire to legalize abortion. But for black women, the discussion had a much more basic starting pointâwith access to any health care and with the desire for healthy pregnancies and healthy children, which sterilization abuse and poor living conditions denied them. In international discussions, women in the Global South also have to start the discussion with basics like their countryâs debt crisis; lack of access to clean water, nutritious food, and adequate shelter; inadequate basic health care and services for the prevention and treatment of epidemic diseases like acquired immune deficiency syndrome (AIDS), malaria, and tuberculosis; the need to access to accurate information and gainful work; and, finally, an end to conflicts and wars.
Why Women Organize
Organizing does have its rewards. In the first two decades of the twenty-first century, women scored several important victories. The decline of population control programs and the concurrent shift to plans for sexual and reproductive health services were huge wins for women. Maternal mortality declined after women pushed the issue as a human rights imperative. Over 24 countries have liberalized their abortion laws since 1998, and in 2017, some 37 percent of the worldâs women of reproductive age lived in countries where abortion is available without restriction.
In the arena of violence against women, women gained significant advances in law and public attitudes. The repeal of colonial-era laws that allow rapists to escape prison if they marry their victims was achieved in Jordan, Lebanon, Palestine, and Tunisia.1 Morocco scrapped its version of the law following the suicide of a 16-year-old who was forced to marry her rapist in 2012. In 2016, mass protests led Turkey to withdraw a bill that would pardon men convicted of sex with underage girls if they married them.
The â#MeTooâ campaign against sexual harassment and sexual assault took off in the United States in October 2017 when several womenâmovie stars and former company employeesâclaimed that Harvey Weinstein, the Hollywood movie producer, had sexually abused and assaulted them. #MeToo quickly moved beyond one man, becoming a conversation about menâs behavior toward women, the imbalance of power at the top, and how to hold powerful men accountable for sexual harassment and assault. Then the campaign went global and spread to 85 countries at the last count. In France, the Twitter hashtag is âbalancetonporcâ; in Hispanic circles, it is #YoTambien; and in Arab countries, the hashtags ÙŰŁÙۧ_ÙÙ
ۧÙ# and ÙۧÙۧ_ۧÙ۶ۧ# are prominent.
More women were involved in the peace-building process in Colombia, the Democratic Republic of Congo, and Yemen, and Tawakkol Karman, a Yemeni political activist, won the Nobel Peace Prize in 2011 (https://âwww.âcjpme.âorg/âfs_â170, accessed 22 May 2019). Female heads of state were elected in Croatia, Lithuania, Mauritius, Nepal, and Taiwan. Canada and the Netherlands stepped up to direct more resources to advance womenâs rights. Tens of thousands of women all over the world marched against discrimination, for lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) rights, for reproductive rights, and for the rights of refugees and immigrants.
Despite these victories, women still face many challenges. In mid-2016, only 22.8 percent of all national parliamentarians were women. The gender gap in the labor market prevails, as does the pay gap (globally, in 2016, women earned only 77 cents for every dollar men earned). An estimated one in three women worldwide experiences physical and/or sexual violence during her lifetime; the number of femicides is uncounted. Conflict-related sexualized violence continues in Afghanistan , the Central African Republic, Colombia, the Democratic Republic of Congo, Iraq, Libya, Mali, Myanmar, Somalia, South Sudan, Sudan, Syria, and Yemen. Hundreds of women human rights defenders are murdered every year. In 2017, Russiaâs parliament voted 380â3 to decriminalize domestic violence in cases where it does not cause âsubstantial bodily harmâ and does not occur more than once a year. Early and forced marriage, as well as poverty and gender norms, prevent many girls around the world from attending secondary school. In addition to promoting gender inequity, social customs such as female genital cutting,2 which affects more than 200 million girls and women in 30 countries, impose real health consequences. An estimated 830 women still die every day from preventable, pregnancy-related causes. The expanded global gag rule (formally , âProtecting Life in Global Health Assistanceâ) adopted by the United States in 2017 threatens global health funding, and the Trump administrationâs national efforts to defund International Planned Parenthood undermine womenâs legal and reproductive rights.
Womenâs achievements are numerousâand fragile. Women and girls face new threats and old backlashes; their successes are reversible, even when legislators have made them the law of the land. Women have not yet achieved equality, not even in the most industrially advanced countries of the economic North. Womenâs movements are a necessity.
Social Movements for Progressive Social Change
To situate womenâs movements in the universe of social movements, this section opens with a discussion of social movements, advocacy, and nongovernmental organizations (NGOs). We begin with a definition of social movements and then describe womenâs movements, NGOs, and feminist movements, before focusing on womenâs health movements.
Briefly stated, social movements are collective challenges to power by people with common purposes. Womenâs movements are social movements led by women that mobilize women to make gendered identity claims as the basis for their movement. Feminist social movements are womenâs movements that specifically challenge patriarchyâthe economic, social, and political arrangements of domination and subordination that are gender-based. Womenâs health movements, including feminist health movements, are political movements that seek justice for women around sexual and reproductive issues. Feminist health movements assume both that gender is constructed across biology and social conventions and that gender refers to power relations between women and men. For political and social reasons, many womenâs health movements do not refer to themselves as feminist.3
Social movements arise to redress grievances; they call for collective action and rely on a common purpose to achieve change. Social actors, networks, and organizations come together voluntarily to engage elites, opponents, and authorities in transformative action (Corredor 2019). Peggy Antrobus (2004), a leading Caribbean feminist, believes some womenâs movements lack common objectives, continuity, and unity because they are crosscutting; some focus on gender identity, others on social transformation. What they all have in common is a political purpose and a rejection of patriarchal privilege. Antrobus and Sen are still questioning the feminist social project, its relation to the movement for global economic justice, whether a human rights framework is still a core analytical tool, and the connection between womenâs rights and the rights of others (Sen and Durano 2014). Is the United Nationsâa state-centered space in an era of neoliberal globalization, declining nation-states, and reconfiguration of the geopolitical contextâstill relevant as a multilateral site? Or is a new and people-centered space outside the UN needed?
Womenâs movements are, roughly, of three types: human rights, popular womenâs movements, and feminist movements (UNRISD 2000). Whether reform movements (focused on legal change) or radical movements (focused on changing values and norms), womenâs movements advocate for improvements in womenâs status. They monitor the impact of public and private sector activities on women, and they provide services for women. Body politicsâwhich clusters struggles around gender violence, sexual choice, reproductive rights, and womenâs healthâis the focus that distinguishes womenâs rights movements from other rights movements (Harcourt 2006). Organizations represent the active component of social movements but are not the movements themselves, although the distinction between womenâs organizations and womenâs movements is not clear-cut. A majority of professional activists view themselves as part of womenâs movements, and the organizations that activists belong to vary in their power, resources, ideology, and relations to donors and governments, as well as in the extent and quality of their connections with grassroots movements.
Many organizations that identify themselves as part of the womenâs movement have common characteristics: national in scope, controlled by women, feminist in outlook, led by consumers, and engaged in advocacy, service, and education. Despite these commonalities, the structure of these organizations varies greatly: some are large, centralized, and hierarchical; some are small, decentralized, and participatory; and some combine characteristics of both types. Some groups are nationwide and linked to international networks (e.g., organizationally as chapters); some are community-based and local. Some employ staff and are financially dependent on government or external support, and some are self-financed and run entirely by volunteers. Some start informally as groups of like-minded individuals, and some are the idea of a single person.
The advent of social media has profoundly affected how movements are organized. Internet-fueled social movements have great abilities to mobilize large numbers of protestors very quickly; they also face frequent challenges and have difficulty persisting in their long-term quests for change (Tufekci 2017). In the Arab Spring uprisings, activists used social media to overcome censorship, coordinate protests, organize logistics, and spread dissent, but they had leapfrogged the tedious work of movement building that might have helped them resolve internal conflicts or make collective decisions. For women participating in social movements, social media have proved both advantageousâoffering the ability to hide race and genderâand harmfulâwhen they are targeted for writing about sensitive topics.
When movement members work within the system as researchers, policy planners, and advocates, divided loyalties may result. Advocacy needs explanation and definition. What makes an advocate, according to Sofia Montenegro, a prominent Nicaraguan journalist, feminist, proponent of abortion rights, and critic of Daniel Ortega, is the ability to synthesize and organize academic knowledge and political experience and give it back so that others can use it in their fights; advocates are those women in a third world country who have the pr...