|Elizabeth Dawes Gay|
For a country that puts so much emphasis on the values of individual freedom and self-determination, we sure have a funny way of showing it – especially when it comes to reproductive health. If cognitive dissonance were an illness rather than a theory, I would say that the United States has a really bad case of it.
If we truly believe that all people should have the ability to make the best decisions for themselves and to determine the course of their lives, we should take action to promote individual freedom and facilitate exercising of personal autonomy.
When it comes to reproductive health, we aren’t living our American values and ensuring that people have adequate information, services, and care. Instead, we withhold information and resources that women need to plan for healthy pregnancies and plan their futures. Last year alone, states enacted 42 pieces of legislation intended to restrict access to critical health services, including contraception and abortion. Just last week, House Republicans stripped the “Violence Against Women Act” of protections for LGBT domestic violence victims, Native Americans, and undocumented immigrants.
That’s not okay, but it’s all too common.
The theory of cognitive dissonance holds that people are motivated to reduce any dissonance and often do so by reducing the importance of one of the dissonant elements. For conservatives who value self-determination and small government, but who don’t believe that certain people should have reproductive agency, this is resolved by reducing the importance and worth of those people. This eases their anxiety and allows them to hold the values of individual freedom and personal autonomy in one debate (the right to carry firearms) and not in another (the right to determine if and when you will become a parent).
Historically, poor people and people of color are those whose worth is called into question or dismissed outright. There’s no doubt that this has contributed to inequalities in health and life outcomes and that it still does. For example, free birth control is great, but it’s only great when you can get it. Cost-free insurance coverage of birth control doesn’t mean much unless you actually have insurance (often provided through an employer) or a clinician in your community who can offer culturally relevant counseling on all of your contraceptive options and provide you with the best method for your unique life and health circumstances.
That’s what real self-determination looks like – having the information necessary to make the best decision for yourself and your family and having access to the resources, support, and services to act on that decision.
According to a new poll, 9 out of 10 African American voters agree that personal autonomy is important because we cannot know all of the personal and medical reasons behind a woman’s decision to seek an abortion. Furthermore, 71% agree that at least some health care professionals in their community should provide safe abortion care. Respondents to this poll value personal autonomy and understand that the availability of services is critical to living that value.
For a woman to be able to make a real decision based on what’s best for her own circumstances, she needs to be able to afford it. It’s difficult to exercise personal autonomy if a woman has to choose between paying her rent for the month and obtaining the abortion that she needs. I wonder if the politicians seeking to restrict access to available, affordable care really understand that. The real question is if these politicians care enough about the health and safety of women – poor, ethnic, queer – and about moving this country forward in a way that benefits us all (not just some) to create an environment that supports un-coerced reproductive decision-making.
According to the same poll, 85% of African American voters agree that we should trust women to make the best decision for themselves and their families when it comes to whether to choose adoption, seek abortion, or become a parent. Trusting women means that we have to stop excluding certain people from benefits we know others get easily. We should ensure that people can financially and physically access the full range of sexual and reproductive health care, including abortion, without having to jump through hoops or put their livelihoods on the line. If we don’t, health inequalities and resulting negative health outcomes will continue to harm women and stunt the potential of this country.
It’s time the American people and our elected officials started living up to our own American values. We show our commitment to freedom when we trust individuals to make the best decision for themselves. We demonstrate our commitment to self-determination when we support policies that ensure access to services and information instead of withholding them. We reaffirm our commitment to personal autonomy when we create policies that help all members of society, regardless of orientation, immigration status, color, creed, or class.
We have to get to a place where our actions align with our values. We must understand that protecting and improving the availability of reproductive health care doesn’t conflict with American values - rather, it helps us move this country forward.
Elizabeth Dawes Gay is a Senior Associate for Policy and Programs for the Reproductive Health Technologies Project. She is a guest blogger for Echoing Ida.