Latina mother
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Implications of Repeal of the ACA for American Fertility

In considering the potential impact of the repeal of the Affordable Care Act, efforts to defund Planned Parenthood, and other actions that may affect women’s health, most of the discussion has appropriately been on the impact on individual women. Indeed, Texas demonstrates the risks. The state had operated a Medicaid financed family planning system that included funds for Planned Parenthood. In 2011, the state legislation cut family planning grants by 66%, and tried to redirect federal funds from Planned Parenthood to more general county-based programs. Although litigation initially prevented the switch, Texas eventually succeeded in replacing the federal funds with state money, and moving such funding away from family planning providers.

The result produced a shift in contraceptive use, and an increase in Medicaid funded childbirths.  Between 2010 and 2012, as these results were taking effect, the state’s maternal death rate doubled, though no thorough study has yet to determine the causes.

Less examined is the potential impact on overall American fertility. The United States is unusual among developed nations both in its high birth rate and its correspondingly high rate of unintended pregnancies. Until the Great Recession, overall American fertility had been at 2.1, that is, an average of 2.1 children per woman, just above replacement levels. Since the Great Recession, however, that rate has fallen to 1.86, a rate that resembles Northern Europe. The potential implications are complex and potentially far-reaching. On the one hand, lower overall fertility, particularly in developed countries, can lead to lower economic growth.  On the other hand, if the decline comes primarily from fewer unplanned births, it can lead to greater investment in children, and a narrowing of class-based disparities in the timing and number of children.  The decline in unplanned pregnancies also tends to increase women’s autonomy and to reduce the incidence and importance of abortion.

 

 

Three big stories underlie the change in overall fertility. First, is the bifurcated nature of American fertility. Between 1990 and 2008, the best off Americans saw their unintended pregnancy rates fall by half, while they increased substantially for poorer women; those trends reversed after 2008. Second, the effect has been particularly marked among Latinas. They have had the higher fertility rates than any other segment of the American population leading into the Great Recession. Since 2008, however, Latina fertility, particularly in what had been the peak childbearing years between the late teens and early twenties has fallen off a cliff, explaining half of the overall American fertility drop. Third, the consensus among the few studies to date is that the increased efficacy of contraception has played an important role in the drop in fertility. While rigorous studies have yet to be undertaken, the evidence suggests that increased access through the Affordable Care Act, which mandates contraceptive coverage as part of private health insurance coverage and expands access through Medicaid, is an important part of the explanation.

The Bifurcated Nature of American Fertility

According to the Guttmacher Institute, between 1981 and 2008, unintended pregnancy became a product of class. For the wealthiest part of the population, unplanned births fell in half at the same time they increased substantially for the poorest part of the population.  For the better off, the steady drop in unplanned pregnancies almost certainly reflected systematic use of contraception together with a small drop in sexual activity in the mid-teens. Better off teens have become more likely to use contraception before they begin sexual activity, and doctors (including Web M.D.) emphasize the advantages of the pill in controlling acne, regularizing menstrual periods, and alleviating cramps. Indeed, more than half of women who use the pill do so for reasons other than the prevention of pregnancy.  During that same period, poorer women received less (and often no) information about contraception compared to the better off, and restrictions on immigrant women’s access to contraceptive services increased.   Women without health insurance are thirty percent less likely to use prescription methods, which are more effective than the alternatives.

The Decline in the Latino Birth Rate

Since 2008, however, unintended pregnancies have declined for all groups, with the largest declines occurring among poorer women and Latinas.  “Between 2006 and 2013, the Hispanic birth rate plummeted 25 percent. By comparison, the rate for non-Hispanics declined just 5 percent—though the latter was already much lower.” For Americans generally, the biggest decline in births has been among younger women, and that has been particularly true for Latinas. During the 2006—13 period, Latina birth rates declined by 45 percent among 15- to 19-year-olds and by 34 percent in the 20-24 year-old age range. Together with the decline in immigration, this has slowed the growth in the Latino percentage of the overall population.

The Factors Producing the Declines

The precipitous decline in births, with Latinas accounting for 50% of the total American decline and even more for teens, reflects a combination of factors.  First, the decline in construction jobs, which have been particularly important for Latino men and which boomed during the housing bubble in the early 2000s, almost certainly played a role. Latinos constitute about a quarter of construction workers and were particularly hard hit during Great Recession.  Partly as a result, Latina women have been staying in school longer and delaying pregnancy. Second, foreign-born Hispanics indicate greater support for teen births than do those born in the United States. In 2009, a Pew Research Center study found, for instance, that while 69 percent of first-generation Hispanic teens called teen pregnancy a bad thing for society, 86 percent of Hispanic teens who are third-generation and higher gave that response. As immigration declines, a higher percentage of Latinos are American born, which may contribute to changing attitudes.

 

While the recession and changing immigration patterns accounts for some of the drop in fertility, however, it is not the entire story.  Since the onset of the Great Recession, poorer women have experienced the greatest drops in unplanned pregnancies – a reversal of the trends of the last quarter century. Colorado provides a particularly dramatic example.  Between 2009 and 2013, the state provided free access to IUDs and long acting hormonal implants to teens and poor women.  Birth rates for the group dropped by 40% (and abortion rates dropped by even more). Looking just at teen pregnancies between the ages of 15 and 19, which is the group with the greatest declines among Latinas, the largest factor appears to be a change in contraceptive use, with an increase in hormonal contraceptive use from 37% in 2006–2008 to 47% in 2008–2010 of sexually active teens nationally. There has been a similar change in increase in the use of long acting contraceptives generally, with large increases after adoption of the ACA, though the causal factors have not been established. What has been documented is the decline in costs: for women with private health insurance, the proportion who paid nothing out of pocket for birth control pills rose from 15% in 2012 — before the federal requirement took effect — to 67% in 2014 — after it was implemented.

In addition, while the Great Recession appears to have triggered the changing fertility patterns, the recovery has not produced more births to young women – the first three months of 2016 saw overall U.S. fertility rates fall to their lowest levels in recorded history, and between 2014 and 2016, the births to women under the age of twenty-five continued to fall.

Conclusion

Overall, greater use of contraception accounts for a large portion of the drops in unintended pregnancy, though individual state rates continue to vary substantially.  The Guttmacher Institute concludes that both more use of contraception and greater use of more effective forms of contraception contribute to the changes; Pew, looking at just teen births, attributes a greater role to more effective forms of contraception. The most effective forms of contraception require a prescription and can be expensive.  ACA mandates for their coverage make them accessible to a larger group of women, and Guttmacher ties at least some of the regional variations to insurance and Medicaid coverage.  The declines in unplanned pregnancies have had beneficial effects on families, including increasing the percentage of births within marriage for the first time in decades and reducing the percentage of births to teens.  Changes to the ACA mandate may reverse the recent trends, which have finally seen poorer women adopt some of the techniques that have long been available to better off women.

June Carbone, Professor and Robina Chair in Law, Science and Technology, University of Minnesota, School of Law

Defending Human Rights in an Era of Retrogression

Monitoring international human rights protections for gender equality

Given the misogynistic tenor of the discourse used by the President throughout his campaign, as well as the trend toward repudiating established supranational spaces, many of us are justifiably concerned about the roll-back of the legal and policy advances that we have won in the global arena over the past three decades in terms of women’s human rights and gender equality.

In this section of the Report we will be watching how U.S. federal laws, policy, and diplomacy under the Trump administration will interact with various international systems related to the protection and promotion of human rights and gender equality and the direct and indirect impact on human rights on the ground.

Working with a diverse set of collaborators, we will seek to document and analyze how the actions of the administration of the 45th President and the 115th Congress directly and indirectly impact the human rights protections for particular groups and individuals, with a focus on gender. In the face of anticipated challenges, we will also explore how advocates might leverage the international law, fora, and mechanisms to resist rollbacks in U.S. policy and practice, to uphold human rights in challenging circumstances, and to further gender equality at home and abroad.

The international human rights framework is cross-cutting and relevant for monitoring the developments at home and abroad for each one of the policy areas of the Gender Policy Report. We will make a special effort to highlight the connections between international human rights and the monitoring and analysis in other parts of the Gender Policy Report.

Beijing as a benchmark

To measure the United States’ potential regressions in terms of international protections for women’s human rights and gender equality, we propose to use the Beijing Platform for Action as a set of benchmarks.

This agenda was the hard-fought outcome of the 1995 United Nations Fourth World Conference on Women and remains a relevant, forward-looking global policy consensus about the importance of gender equality and the barriers which must be overcome to realize women’s human rights. It is an agreed-upon set of standards and commitments against which we have been measuring the actions of all governments for the past 20 years.

The Beijing Platform is a useful analytical and organizing tool because  it organizes a review grounded in the international human rights framework and covering a broad range of areas key to gender equality—including peace and security, the environment, poverty and economics, and empowerment.

The twelve critical areas of the Beijing Platform are:

  • Women and the environment
  • Women in power and decision-making
  • The girl child
  • Women and the economy
  • Women and poverty
  • Violence against women
  • Human rights of women
  • Education and training of women
  • Institutional mechanisms for the advancement of women
  • Women and health
  • Women and the media
  • Women and armed conflict

In 2015 the U.S. government submitted an extensive summary and self-assessment report of its implementation of the Beijing Platform, including its domestic efforts to guarantee women’s rights (useful to many of the other sections of the Gender Policy Report), as well as its efforts to promote women’s human rights and gender equality abroad—our focus in this Section. This document, as well as activist and academic complements, serve as a useful starting point with which to monitor advances and retreats in U.S. law, policy, and practice.

Inquiries driving this human-rights monitoring initiative

The central questions that rise to the fore for the curators of this Human Rights Section of the Report are to what lengths will this new Administration go in trying to negate women’s international human rights, and what will be the durability of existing human rights laws and procedures in pushing back against those efforts? We will pay close attention to the diplomatic dance (or struggle) that shapes the Administration’s human rights policies before international institutions, especially regarding gender. So, for instance, if the most powerful government in the world seeks to roll back reproductive rights or gender equality in the global arena, what will be the efficacy of international legal and advocacy tools in pushing back?

Institutionally, we will monitor any key changes in U.S. institutions and personnel that would signal the undermining of international protections for women’s human rights and gender equality around the world: for instance, will the current office of the Ambassador for Global Women’s Issues be eliminated? Who will assume the diplomatic appointments to key United Nations human rights fora?  Will the new Administration cooperate with UN human rights mechanisms, including treaty body reviews and invitations to U.N. special procedures? What will be the discourse promoted by the Trump Administration on the twelve critical areas of concern? How will the U.S. engage with the Women, Peace, and Security (WPS) agenda at the UN, including Security Council Resolution 1325 and the six subsequent WPS resolutions?

We will aim to flesh out the direct and indirect impacts of potentially retrogressive U.S. foreign policies on the security and human rights of women and LGBT persons, near and far. And finally, we will convey inspiring and innovative approaches leveraging the international systems to defend human rights and security, and to promote gender equality in the coming years.

We welcome guest observers, practitioners, and researchers to share their stories and insights. Through the lens of our collective experiences, we will monitor US policy in relation to the diverse international systems and fora dedicated to the protection and promotion of global human rights.

We look forward to your stories and collaboration to defend and promote internationally guaranteed human rights, including dignity, fairness and equality for all persons, regardless of their gender.

Barbara A. Frey, J.D., Director, Human Rights Program
Amanda Lyons, J.D., Executive Director, Human Rights Center

Photo by Milton Grant

What’s to come for more gender-responsive climate policy?

Climate change and gender equality are fundamentally linked. The effects of climate change are, and will continue to be, disproportionately experienced by women. Climate vulnerability is not gender-neutral because women have higher levels of poverty, greater reliance on climate-vulnerable natural resources, fewer legal rights, less access to international institutions and finance, and often face more restrictive cultural norms.

But women also hold critical capacity to make the response to climate change more effective in agricultural production, household energy use, community management, natural-resource and biodiversity management, and education of children, among other channels (UNDP).

In recognition of this disproportionate impact and the important role of women in addressing climate change adaptation and mitigation, the United Nations Framework Convention on Climate Change (UNFCCC) and other international bodies that engage in climate policy have begun processes to mainstream gender in their work. At the 20th UNFCCC conference in Lima, Peru, in 2015, the Lima Work Programme on Gender was established to increase both gender-responsive and gender-inclusive climate change policies.

Gender equality was also highlighted in the historic Paris Agreement ratified in November 2016, which acknowledged that countries “should, when taking action to address climate change, respect, promote and consider their respective obligations on … gender equality, empowerment of women and intergenerational equity.”

The increasing recognition of the relationship between gender and climate change is reflected in the development of gender policies in many—but not all—multilateral climate funds. These funds represent a critical mechanism for developed countries to make the global response to climate change more equitable and are a critical component of developed country pledges to mobilize $100 billion to finance climate change mitigation and adaptation in developing countries.

Multilateral climate funds, including the Green Climate Fund, the Adaptation Fund, the Clean Technology Fund, and the Global Environment Facility, have created requirements such as gender representation or the reporting of gender “co-benefits” in project proposals. These requirements help make multilateral climate funds an important intermediary step in translating gender-responsive climate policies into action.

Over the last eight years, the United States has become a leader in drawing attention to the linkages between gender equality and climate change through its international development policies and engagement with international bodies. The United States has deposited around USD 5.7 billion since 2003 to the multilateral climate funds (and has pledged to increase its support). Its historic support and future pledges makes the United States one of the largest donor countries (behind the UK and Norway) to the funds referenced above, and this commitment provides considerable support to climate projects under multilateral funds with specific gender policies.

Further, the United States has initiated gender-responsive climate policies through the State Department and USAID through new programs such as the Gender Equality for Climate Change Opportunities, Women in African Power, and the Partnership on Women’s Entrepreneurship in Renewables.

In light of this progress in integrating gender equality and climate change response efforts, the incoming Trump Administration has denied the connection between human activity and climate change and has promised to withdraw the United States from international climate agreements. The incoming administration also appears likely to renege on the United States’ pledges for climate finance, which could decrease the global availability of finance under multilateral climate funds by 25%. In stepping back from engagement on climate change both politically and financially, the United States will be weakening many domestic and international institutions that work to address gender disparities in the context of climate change.

It remains to be seen whether President Trump will choose to be an active obstructionist or simply a passive isolationist when it comes to international climate policy. It is even more difficult to know exactly how the Trump Administration’s promises to renege on the United States’ climate change commitments will determine how these actions will affect gender-responsive climate action. However, if the United States pulls out of all United Nations climate agreements and fails to fulfill its financial pledges, the bodies currently working to address gender disparities in the context of climate change will lose one of their most effective advocates for making the linkage of gender and climate issues stronger.

Many questions remain to determine how actions of the Trump Administration will affect women around the world. Through the course of this initiative, we will monitor the new administration’s engagement with the international community in the hopes to better understand the complex relationships between gender-responsive climate policies at the level of international bodies, financial flows, and ultimate gender and climate outcomes at the local level.

—Peder Garnaas-Halvorson, MS-STEP Student, Humphrey School of Public Affairs, University of Minnesota

—Gabriel Chan, Assistant Professor, Humphrey School of Public Affairs, University of Minnesota

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Understanding the specific gendered implications of US immigration and refugee policies.

School Discipline: Perspectives and Policies in Flux

In spite of the largely local control of U.S. education policy, there are many ways that federal and state governments impact school policies and practices, from what’s taught in the classroom to what’s served in the lunchroom. Given the Republican control of both Congress and the White House, we may see departures from the Obama Administration’s practices that will impact not only federal, but also state-and local education policy. Whether or not Republicans implement proposals to change current policies, they will send strong signals to local school districts about what’s possible and permissible over the next four years.

As the curators for the Education section, we’ll be looking at a host of issues using an intersectional lens, where we examine gender, race, indigeneity, gender and sexuality when attending to policy issues. We invite guest contributors to shed light through their research on a wide range of topics.  Here’s a glimpse at one of the topics we’ll be looking at to start:

School Discipline
On its face, school discipline might not seem like an obvious gender/sexuality issue, especially when most data is conveyed to the public in terms of “racial gaps” without attention to gender. But an intersectional breakdown of suspension rates reveals that while black students overall are suspended three times as often as their white peers, black girls are suspended at higher rates than girls of any other racial group, and most boys. This difference in degree suggests there is a specific gender/race dynamic driving these disparities. We also know that GLBT and gender non-conforming students are more likely to face more harsh discipline than their cis-gender peers.

The Obama Administration highlighted the need for research and urged action to reduce disparities in suspensions in an exit memo published January 15, 2016 and framed this as a civil rights issue. The Trump campaign, in contrast, said nothing about these issues and ran on a “law and order” platform. Relatedly, the incoming president and many of his surrogates have scoffed at science-based evidence. What will that mean for federal programs like the School Climate Transformation Grants, launched by the Department of Education to implement evidence-based interventions to reform school discipline policies and reduce racial disparities? A growing body of research finds that teachers scrutinize students of color more and show implicit bias against students of color of all ages, disciplining them for behaviors that do not elicit punishment for white peers.

Recent overviews of research on discipline practices show that zero-tolerance discipline policies don’t improve behavior, but other interventions can.  These studies provide compelling evidence that racial biases and disciplinary disparities can be decreased with targeted policy changes, particularly teacher training in constructive discipline policies and restorative justice.  These relationship and skill-building strategies support student development and increase teacher capacity. Replacing zero-tolerance policies with staff training and coaching in these practices, combined with hiring sufficient classroom aides and counselors to support students, leads to significant reductions in suspensions, violent incidents, and student arrests. A growing number of individual schools and districts are adopting these reforms, and are showing real progress. In a program started in Virginia, for example, teachers who had restorative justice training not only reduced the number of times they sent students out of class, they also eliminated racial disparities in the practice compared to teachers without training.

But in the wake of high-profile media cases of attacks on teachers, some legislators are proposing bills that would allow teachers to have students expelled if they assault a teacher or make the teacher feel fearful of an assault. Will the new leader of the Department of Education continue the Obama Administration’s agenda on evidence-based interventions, or will the law-and-order rhetoric of the Trump Administration spur an increased police presence in schools, which leads to increased exposure of GLBT students, boys and girls of color to the criminal justice system?

We’ll update information on these questions, as well as examine issues surrounding Title IX enforcement, curriculum design, sex education, and guns in schools, after the new leader of the Department of Education takes over in Washington.

—Catherine R. Squires & Keith Mayes

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Whither Gender in U.S. Trade and Development?

With the exception of Ivanka Trump’s focus on paid maternity leave for working mothers, the Trump campaign gave little explicit attention to women’s issues or to the impact of his proposed policies on gender equality or equity. Within the new administration’s policy rhetoric on international development and trade, discussion of gender has continued to remain largely absent. Yet there are important reasons to pay attention to the gender dimensions of U.S. trade and development policies.

This section of the Global Policy Report will devote itself to identifying, unpacking, and analyzing these dimensions.

Trade issues represented a central pillar of Trump’s campaign promises, which emphasized re-negotiating multilateral and bilateral trade agreements and increasing tariffs on imported goods from specific countries (China, Mexico) as well as across the board. These promises appealed to voters who saw globalization generally and free trade deals in particular as detrimental to American jobs and workers. However, the new administration’s trade policy rhetoric rarely exhibits a gender focus and there has been little discussion of how proposed policies might impact women or gender relations more broadly, at home or abroad. This dearth of gender-based discussions of U.S. trade policy is alarming, as many of the new administration’s proposals could have differential gender-related effects.

Take, for example, the tariff on imported goods recently discussed by Trump’s transition team. Rates as high as 10% have been suggested, with the purported goal of spurring U.S. manufacturing. While such a tariff would encourage consumption of more American-made goods to the benefit of the manufacturing industry, it may not translate into many jobs, given the high-tech, automated nature of modern manufacturing. More importantly from a gender equity perspective, research demonstrates that tariffs tend to place a heavier burden on certain categories of consumers–namely single parents–and many goods that women overwhelmingly purchase (such as women’s clothing) have historically faced higher tariffs than goods typically consumed by men.

In addition, there is the risk that the imposition of country-specific tariffs (such as those proposed for China and Mexico) could lead to trade retaliation or a full-blown trade war. In evaluating the impact of such a scenario on the U.S. economy, one study found that while sectors that produce capital goods are likely to be the most intensely affected, the largest absolute number of job losses would occur in non-trade service sectors. These sectors include wholesale and retail distribution and sales, restaurants, healthcare, and temporary employment agencies, sectors that tend to disproportionately employ women.

Similarly but more indirectly, Trump’s proposed renegotiation of trade agreements has the potential to differentially impact women in developing countries. Although his cabinet picks have differing views on some of these agreements, any renegotiation that decreases trade flows or integration risks affecting women differently from men in developing countries, in ways that are not entirely apparent. For example, many developing countries have a comparative advantage in the apparel sector, which typically relies heavily on female labor for the production (although not management) side. Trade liberalization will typically lead to resources flowing into such sectors, thereby expanding employment or income gains for women. However, entrenched gender discrimination can often blunt the potentially positive impacts of increased demand for women’s labor,” suggesting that much more research is needed to understand the global gender dimensions of U.S. trade policy.

As for international development policies, in December Trump’s transition team requested the State Department to turn over all information about “gender-related staffing, programming, and funding.” This request raised concerns of potential rollbacks of such programming, although the new administration further indicated that it had inquired about these programs for the purpose of “finding ways to improve them, along with hundreds of other requests.”

During his Senate confirmation hearing for Secretary of State, Rex Tillerson committed to continuing those programs, noting studies finding “that when you empower women in these developing parts of the world, you change the future of the country because you change the cycle within that family.” Although continued support for these programs is promising, we must see whether Tillerson’s words will lead to action. Moreover, we know much less about how such programs might be impacted by changing levels of trade with the U.S. that could occur as a result of the more protectionist policies suggested by the new administration.

In the months to come, the International Development and Trade section of the Global Policy Report will keep track of these and other proposed and implemented trade and development policies, with a focus on their implications for women and gender issues in the U.S. and globally.

—Karen Brown and Cosette Creamer

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Call for Submissions in the Criminal Justice Area

The Criminal Justice Area of the Gender Policy Report seeks to clarify how gender works intersectionally to shape the creation, operations, and consequences of criminal justice policies. Contributions to the area might offer a gender-based analysis of criminal codes, law enforcement practices, dynamics of judicial action, or incarceration, for example. Why are women of color the fastest growing population of prisoners in the U.S.? How do developments such as  prison privatization matter differently for groups defined by gender, and distinctively for transgender populations? How does the rise of mass incarceration, centered on American Indian, Black, and Chicanx/Latinx males, transform gender relations and affect women and families?

On these and many related questions, we hope our area of the GPR will offer a distinctive voice in public discussions of criminal justice policy.

Call for Collaborators: We are actively seeking Research Collaborators to join the work of the Criminal Justice area and shape its trajectory going forward. We encourage potential collaborators to set their own pace, and we expect a lot of variation in terms of individual involvement. Please contact us at the email addresses below if you are interested.

Call for Submissions: The criminal justice area of the GPR will seek to publish original content at least twice per month. We are eager to receive submissions and proposals from diverse perspectives across a broad spectrum of relevant issues. We are also committed to publishing work in a wide range of formats and communications styles.

Examples of Content include but are not limited to:

  • Policy Analysis Blog Posts (500-1200 words): Short essays that weighs in on how serious attention to gender research and/or community experience may inform a criminal justice proposal or policy development. Ideally, the essay would clarify gender implications of a criminal justice policy that otherwise may not be evident.
  • Research Summary Blogs (500-1200 words): Accessible, engaging summaries or reviews of existing research on gender and criminal justice policy. This public-friendly translation of a recent research article or book might use a current criminal justice policy debate or development as its “hook”.
  • Data posts on Criminal Justice Policy (3-4 figures with explanatory text): Posts that focus on drawing attention to illuminating data visualizations in the form of charts, graphs, etc. Contributors would provide a short written introduction and a few lines to help readers interpret each data visual.
  • Multimedia Contributions: Video presentations, powerpoint slide decks, audio podcasts, recordings of panel discussions…You name it, we’re interested. Send us your ideas and teach us some new tricks!

We hope you’ll join us in this exciting and timely new project. If you have any questions about the criminal justice area of the GPR, would like to become a Research Collaborator, or have ideas for contributing content, please contact us via e-mail.

Lena Palacios and Joe Soss

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