Blog Post/ Opinion-Self-Reflection Piece
This is a writing sample from Scripted writer Kirsten Paulus
**For context, this is a post I wrote as a letter to my future self. It was a task given to me to reflect on the research process and where we can learn and improve in how we go about studying other groups of people. I think this could be applied to a multitude of different industries.**
Dear me,
Right now is such an exciting time for you, as you conducted your first global health research project and drafted a first-authored paper. This marks a really important achievement in your Master’s Program training, and you were able to address a topic that you are incredibly passionate about: sexual and reproductive health and rights for a vulnerable and stigmatized populations. You believe yourself to be a proud face of change, of female empowerment and health equity for all—all you want to do is help others, and this project was intended to be a stepping stone of beginning this process for the women you worked with.
However, despite the fact that you live in a time where we (public health professionals) have effectively made large strides in addressing health disparities between men and women and prioritizing women’s health, sometimes we lose site of the fact that all women have not benefitted from these changes in the same way, and some are even doing worse than before. White women dominate the field of public health, and thus the agenda for “women” is being created and pushed forward by white women, like yourself, where we assume that all women have the same wants and needs. The universalism of oppression makes public health work seem more feasible, as you can attack any health problem with an “agreed upon” strategy or method. However, to make a true change it is necessary that we understand the opposite: feminism in public health is multifaceted and complicated, and we cannot base women’s public health interventions on the white, Westernized feminist perspective. There must be a diversity of perspectives included in the study of health, and we must prioritize the “equality of different voices” in the identification of women’s public health needs (Bueter 529). However, you got lost in Western feminism, and missed and/or ignored the intersecting social hierarchies, social stratifiers, and structural processes that result in the unique experiences of sexual health among these women that are much different than my own—as there is no universal female experience.
Audre Lorde was a Black, lesbian writer and activist who shared her concern about how her own words (as a Black woman) were used by Mary Daly, a white woman, in her book Gyn/Ecology. Throughout her letter, she strongly proposes the argument that white women cherry-pick women of color’s words to support their own privileged theories and assumptions—you did the same thing with your work. You conducted interviews and surveys, and chose to analyze and include the results that supported your own hypothesis and argument, rather than using what Lorde advocates for which is the need of close textual analysis and the acknowledgement and clarification of the differences between women’s experiences. Differences between women should be celebrated and be used to motivate change, rather than undermine women of color.
Similarly, Chandra Mohanty, a feminist and women’s studies scholar who has used critical theory to analyze the flaws in current feminist scholarly practices highlights the harm of “methodological universalism,” which in essence refers to the arithmetic approach to women’s oppression, where there is a reduction of “nature:culture::female:male” as an end-all-be-all organization of gender to “find empirical proof of its existence in different cultures” (Mohanty 69). And yet again, your paper highlights a clear use a universal understanding of oppression that is applied to all situations and contexts. An attempt was made to understand oppression and gender dynamics within the local cultural and historical contexts of Cambodia, but you made conclusions and cherry-picked observations to fit the mindset and expectation of a sheltered Western scholar and not for the experiences of non-Western women. You addressed these women’s “needs” in the context of how you understand them as a Westerner: the “third world woman” is someone who needs to be “saved” by western medicine and politics and who suffers from the universalized view of the system of oppression. It is necessary that as a public health professional, you reorient your view of women’s health as something multifaceted and complicated, rather than asserting and operating under the assumption that there is only one universal experience of women in the face of oppression.
How are your proposed next steps going to be successful, based on your research, if they were framed using methodological universalism? It is easy for you to look at this data and make assumptions about the health status of these women, especially because they confirm what you have been taught and come to know as a student of public health and as a white woman. However, through this teaching you have come to “know” that “all” women living in third-world countries suffer from the “same” reproductive and sexual health issues; you “pushed analysis away” from their root causes and instead focused on general universal “health inequalities and inequities” (Adegbulu et al. 2020). The assumptions you make in this paper fall back on what Mohanty deems to be the “universal cross-cultural operation of male dominance and female exploitation,” (Mohanty 66), which she argues is used to make analytic leaps from descriptive generalizations about women, their status, and their experiences without considering the historical and cultural contexts in which they live.
The biggest risk factor for HIV/AIDS, which is the top killer of reproductive-age women worldwide, is unsafe sex. In other words, it is due to the lack of using barrier methods (condoms) during sex. You in turn identified female sex workers as your target group because of the nature of sex work and the unsafe, risky behaviors associated with the profession which puts women at greater risk of contraction and spread compared to the larger population. It is not difficult for you to assume why HIV risk may be higher—not only are they having more sex than the average woman, but they are less likely to use condoms in exchange for higher pay.
Your assumption about the universality of condom use access and HIV prevention was flawed, however, particularly in relation to the cultural and ideological context in which these women lived and worked. There was specific meaning behind why these sex workers were not wearing condoms. It wasn’t about access, which you had assumed, because Cambodia has actually seen a large increase in contraceptive access and use. It also wasn’t about the status and agency of women, which you had also assumed through the simplification of the female experience; there has actually been a dramatic increase in the social status of women. However, the choice to use condoms is in fact more-so rooted in traditional Cambodian beliefs about family honors and socially acceptable behaviors. Even with increasing rates of contraceptive use, there is still an existing reliance on traditional methods, which are not effective at protecting against HIV. Community elders promote Cambodian beliefs about social acceptability of contraception and publicly support or disprove of contraceptive use, especially in rural areas. Therefore, in communities that abide by traditional birth control methods or who have elders that disprove of condoms, it decreases the likelihood of a woman to use condoms (even if she is knowledgeable of its benefits). Not only that, but sex workers also make private decisions within a couple, where women wear condoms with their partners but not their clients, or vice versa; as stated in your manuscript, more HIV infections among Cambodian women occurred through sexual intercourse with unfaithful husbands or long-term partners rather than clients. Without conducting a further context-specific differentiated analysis, like Mohanty advocates for, you made the assumption that these women suffer from the same barriers that many white, American women have to condom use, and your original research proposal does not effectively serve the needs of this particular group.
You also used universal general reduction of the female experience in your work, falling victim to using these generalized concepts to explain why oppression is occurring among a particular group of women, assuming that these are the universal causes of female subordination (Mohanty 67). You used descriptive categories to make assumptions about this entire group of women, without looking at the value within these categories. You interpret their experiences of oppression as identical on a global scale, equating their experiences to experiences of women like you—which, as a result, causes you to miss important and distinct differences in the experience of oppression, which further inserts a flaw into your analyses and your efforts to fight against various forms of gender inequality.
In this paper, you use reproduction as a generalization that turned into an entire assumption about Cambodian women. In the context of contraceptive use and the practice of birth spacing, it is often assumed that female sex workers want to protect themselves from having more children and from contracting any sexually transmitted diseases. As a developing country, the “issue” of “reproduction” is typically described in the context of having little to no education on modern contraceptive use, and often accompanied with poor access to these methods. In other words, referring to the assumption that women have little control over reproduction. However, this is absolutely not the case for this group of women. Data show that Cambodian female sex workers are very aware of modern contraceptive methods, and use a variety of them. Not only that, but there are differences in types of contraceptive methods used between urban and rural women, where urban women use hormonal contraceptives more often than rural, and married women use contraceptives more often than single. The reason behind the contraceptive use patterns among female sex workers has more to do with their general disinterest in using it, rather than educational or access issues. It can also be due to a number of other reasons, such as trust of partners or not wanting to face income losses. Therefore, your general description of inconsistent condom use must be understood within the sociocultural context in which these women live and work, and cannot necessarily be an indicator of oppression; for example, if women are choosing not to use contraceptives when they have them available and are knowledgeable of their benefits, the source of oppression may be elsewhere.
So, as a result, I ask you: how can you be better, knowing you have the intentions to do good but hold a Westernized feminist perspective? The way you made assumptions about these women that you intend to help may be incredibly harmful to the progress of gender and health equality, even without realizing it. I realize I have approached my own work through a privileged first world lens, without taking into account the larger economic, social, cultural, and historical contexts in which oppression takes place, while also ignoring the voices of women of color. Although we truly intend to help women who are dying from pregnancy or abortion complications, suffering from preventable sexually transmitted infections and diseases, and many other health issues, it is crucial that we change our approach to research and interventions. Perhaps you can take on some of the approaches noted by Ollivier et al. (2018), who suggest that applying a feminist post-structural lens to sexual health can help better “understand, question, and challenge how social and institutional beliefs, values, and practices surrounding sexual health… are experienced,” (695). Challenge the assumptions made in Western feminist discourse and public health, and instead do not “view any one person as unable or helpless,” such as the Cambodian women you worked with for this paper (Ollivier et al., 697). Or, as suggested by Dakyin and Naidoo’s (1995) feminist critiques of health promotion, you can also focus on “embrace[ing] diverse strategies,” highlighting the “importance of diversity of practice,” so you can established catered interventions that “offer positive health through support for real choices,” not assumed choices (67).
You cannot change what you have already done, but you can be better moving forward. When you conduct interviews, rather than listening for words that confirm your own biases and hypotheses, you need to ask yourself: “What are they really telling me? What are the actual needs and problems among this group of women, and how can I understand these problems within the context in which they live?” I know you firmly and passionately believe that all women are deserving of good health and quality of life, but you must carry with you the idea that the way we achieve this for every woman may be different due to the complexity, diversity, and multiplicity of all women on a global scale. The paternalistic, orientalist perspective that has been mixed into the feminist approach to public health and has not been effective—it is not the feminist practice I now (or you then) wish to perpetuate. You need to dedicate your work to meeting the needs of women where they are within their own class, ethnic, and racial contexts. I do not think that this perspective must only be used when addressing non-Western women’s health issues, but any women’s health issue, including the women of the Western world. It comes from a place of privilege to make judgements and assumptions about other peoples’ oppression, and I hope you are able to move forward with any future research or intervention with an open mind, no expectations, and the readiness to learn about contextualized needs.
Sincerely,
Future Me
Written by:
Hello there! I am a current third year PhD student in Public Health at Temple University in Philadelphia. I am here to help you in any way that I can. As a published author, I have extensive and diverse experience in academic and research writing, grant writing, technical writing, copywriting, opinion pieces, and blog posts. My content areas of speciality are public health, sociology, global environmental health, health systems, medicine, marketing, and communications. I hope that we will be able to work together to create the perfect product for you!
