One of a number of statements that stood out during the recent court hearing regarding the conservatorship of pop star Britney Spears was the singer's testimony that she was being forced to remain on birth control against her will.

"I have (an) IUD inside of (me) right now, so I don't get pregnant. I wanted to take the IUD out, so I can start trying to have another baby, but this so-called team won't let me go to the doctor to take it out because they don't want me to have any more children," she said, according to a story from Variety, which notes that a live audio stream of the hearing was shut down by the judge, after learning that it was being broadcast online.

That revelation was surprising, if not shocking, to many because of the reproductive rights and justice issues it raises, especially for advocates and experts who work to ensure that individuals are able to choose to reproduce and obtain access to reproductive health services.

Rachel Johnson-Farias, executive director of the Center on Reproductive Rights & Justice (CRRJ) at Berkeley Law School; Debra Mollen, professor of counseling psychology at Texas Woman's University and a licensed psychologist and certified sexuality educator with the American Association of Sexuality Educators, Counselors, and Therapists (AASECT); and Sonja Goetsch-Avila, the California state senior organizer at URGE: Unite for Reproductive & Gender Equity (URGE), a national reproductive justice organization that centers the voices and leadership of young people, share some of the history of the reproductive justice movement and their professional perspectives on the violation of reproductive rights that Spears' has testified to experiencing. (This email interview has been edited for length and clarity. )


Q: Multiple news outlets have reported that pop star Britney Spears has said that she's been forced to remain on birth control (through an intrauterine device, or IUD) against her will, as part of her testimony in court proceedings to end the conservatorship she's been under since 2008. What were some of your initial thoughts or concerns when you first learned of this detail in her testimony?

Rachel Johnson-Farias: I entered the reproductive justice movement via my work in California's women's prisons. A common human rights and reproductive abuse that I saw in prisons is incarceration during reproductive years. Even if the state did not intervene to sterilize someone inside, earlier contact with the prison system and longer and longer sentences have normalized such that people are incarcerated at younger ages and long enough to inhibit chances of reproducing upon release. In Britney Spears' case, an IUD can be removed, but the fact that she is not allowed to choose when that happens in combination with the amount of time that the IUD has already been in place (13 years) means that Spears' has been stripped of making reproductive choices, and, the longer it persists, the more her case looks like forced sterilization.

Debra Mollen: My initial reaction was one of concern about the potential for harm, particularly around issues of reproductive coercion, which are common and often associated with other patterns of relationship violence, trauma and abuse.

Sonja Goetsch-Avila: I was disgusted but, sadly, not shocked after reading more about the situation. Forcing anyone to remain on birth control against their will is an explicit form of reproductive coercion. Our country has a dark history of racist, sexist, classist and ableist laws and practices that have targeted people through forced sterilization and coercion of long-acting reversible contraception (LARC) methods, like IUDs and implants, to prevent wanted pregnancy in certain populations. It's unfortunate that many people are only learning more about how forced birth control and sterilization are still legal and in practice today when it happens to someone as famous as Britney Spears.

Q: Can you help us understand a bit about the basics of reproductive rights and how this particular issue fits into that understanding?

Rachel Johnson-Farias: Reproductive justice maintains that all people have the right to have a family, not have a family, and the ability to raise the families we do choose in safety and with dignity and respect. Reproductive rights forms the legal-focused arm of the reproductive justice movement and focuses on challenging laws and policies that impugn someone's human right to choose whether, when, and how to have a family. Because Britney Spears' right to have a child is impugned by the forced use of contraceptives, the current conservatorship case calls her reproductive rights into question. Reproductive justice is intersectional by definition, such that the historic conflation of disability and reproductive oppression should be a factor if the court reviewing Spears' conservatorship employs a reproductive justice lens.

Debra Mollen: Reproductive rights are grounded in ideas that undergird personal and bodily autonomy. In the same way that no one can force you to be an organ donor, reproductive rights activists are committed to allowing each person the ability to access reproductive care and make decisions about our reproductive lives. Reproductive justice, a broader idea that was coined in 1994 by a group of Black women who recognized the need for organizations that centered the rights of indigenous women, women of color and transgender people, asserts that people should have the ability to control how, when, and if they have children and be able to raise their children safely in supportive communities.

Sonja Goetsch-Avila: Reproductive justice is defined as the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities. It was first officially coined by a group of Black women in 1994 in Chicago, right before attending the International Conference on Population and Development in Cairo. The mainstream reproductive rights movement in the U.S. was primarily focused on the needs of middle to upper-class white women and didn't address the intersecting reproductive injustices that Black women, other women of color, queer, trans, low-income, disabled and other marginalized communities had faced for generations.

The reproductive justice framework not only demands access to reproductive health care, birth control, abortion and sex education, but also freedom from abusive and coercive powers preventing one's ability to get pregnant on their own terms. Britney Spears' situation directly links to one of the key tenets of reproductive justice — people deserve the right to determine if, when, and how they want to have children. In her own words, Britney Spears referenced her conservatorship as "abuse." Under this abuse of power and control, it's clear that Spears does not currently have the freedom and autonomy to make her own reproductive decisions.

Q: Can you also talk a bit about the history of forcing birth control or sterilization on people in this country? I understand that there's a 1927 U.S. Supreme Court case that ruled in favor of this practice? How does this relate to what someone like Spears has testified to experiencing?

Rachel Johnson-Farias: "Buck v. Bell" (1927) was a textbook case of reproductive oppression in which the Supreme Court authorized the forced sterilization of Carrie Buck after she was raped by her foster parent's nephew and, subsequently, became pregnant. The foster family, eager to hide their shame, had Carrie Buck committed to a mental institution and sterilized under a state sterilization law rooted in eugenics that legalized sterilization of "feebleminded" people. Several states, including California, had similar laws on the books and, together, these laws reflected a broader societal normalization of eugenics: a White supremacist pseudoscience that holds that humans can be bred to privilege "desirable" traits. These laws were red herrings for genocidal efforts to eliminate all deviations from a White supremacist standard and would inform the Nazi Party's antisemitic efforts.

"Buck v. Bell" provided the legal grounds for the sterilization of thousands of people who did not conform to arbitrary racist, ableist, classist and sexist standards and were deemed mentally and/or physically "unfit." This case also serves as a foundation for much of the ongoing sterilizations that happen in prisons today. Because more than half of Black people with disabilities in the United States will be arrested before their late 20s, our jail and prison system is ground zero for reproductive oppression at the intersection of race, class, gender and ability.

Like Carrie Buck, Spears was deemed "unfit" to make choices for her life as a result of her disability, including reproductive choices. If the court is not careful, it stands to replicate the reproductively oppressive outcomes that eugenics laws like the one that informed "Buck" procure.

Debra Mollen: Forced sterilization became popularized and widely practiced at the beginning of the 20th century. It's linked to ideas rooted in eugenics (which literally means "to be well born") about who should be able and encouraged to reproduce, and who should be prevented from having children. Chillingly, the Nazis borrowed extensively from U.S.-based eugenicists in both their justification and practice of genocide of 6 million Jews. Though it's tempting to see these ideas as antiquated, there have been documented cases of forced sterilization through 2013 in the California prison system.

By her account, Britney Spears is experiencing reproductive coercion, denied the ability to exercise her reproductive rights by being compelled to keep her IUD inserted against her will. Reproductive coercion includes pregnancy coercion, birth control sabotage and abortion coercion. Though it is more common that people are deceived or coerced into pregnancy and to have their birth control use impeded, another example of pregnancy and birth control coercion is to prevent people from getting pregnant and compel them to use contraception against their wishes. While it is most common for men to perpetrate reproductive coercion against women, people of any gender can experience reproductive coercion.

Sonja Goetsch-Avila: Forced sterilization has been going on in this country for centuries and has particularly harmed Black, Indigenous, and other people of color, immigrant communities, poor and disabled folks.

Yes, the "Buck v. Bell" case you mentioned set a precedent for the continued targeted sterilization of people in U.S. institutions, and Spears' experience is certainly connected to that legacy, particularly for those with mental health conditions.

State-supported control of reproductive decisions is still widespread. Dorothy Roberts writes at length about the forced sterilization of poor and incarcerated Black women in her book, "Killing the Black Body," and refers to horrific trends of requiring specific birth control to reduce sentences or even to qualify for certain benefits. And most recently, we have seen forced hysterectomies in ICE facilities in the United States.

While California is known for its progressive policies toward advancing reproductive freedom and access to health care, it's also important to recognize California's own egregious history with forced sterilization and reproductive coercion. California was the most aggressive state in the country throughout its 70-plus years of eugenics laws, sterilizing over 20,000 people in our state-regulated institutions.

Q: In some of the discourse around this story, there have been arguments made that the choice to have, or not have, children is a fundamental right. Why is this so? What makes this a fundamental right?

Debra Mollen: Having or not having children is a fundamental right as it allows us the ability to make our own decisions about vital aspects of our health and reproductive lives. Interfering with and violating these rights has profound implications for our inalienable rights to life, liberty, and the pursuit of happiness. Historically and currently, White, middle and upper-class cisgender heterosexual women have been encouraged to have, and celebrated for having, children; while those from marginalized groups (women of color, poor women, people with disabilities, transgender people, incarcerated people) have been discouraged, prevented from, and shamed for exercising their reproductive decisions across the spectrum. Consider, for example, the ability to access treatment for infertility and the distinct lack of controversy or obstacles to those who most commonly pursue fertility treatments, generally class-privileged White people, that regularly result in the abandonment or destruction of hundreds of thousands of embryos. On the other hand, marginalized people, especially women of color, poor women, and trans people, have been systematically denied access to abortion, forcibly sterilized, and experienced reproductive coercion with much greater frequency.

In the case of Britney Spears, we are reminded that no amount of fame, celebrity or wealth is adequate protection against reproductive coercion.

Sonja Goetsch-Avila: Everyone should be able to determine if, when, and how to parent on their own terms. Over the years, the Supreme Court has recognized reproductive rights as fundamental human rights including having children, contraception, abortion, family relationships and child-rearing. Reproductive justice allows us the freedom to make decisions about our own bodies without interference from politicians and to decide what is best for ourselves and how to best build our families and communities.

Q: What is the denial of this right — of allowing people to make their own choice about having children or not having children — typically rooted in? What is it historically rooted in?

Rachel Johnson-Farias: As to historical roots in the United States, reproductive oppression has deep roots in slavery. As an institution, slavery was legal at the country's founding and repeatedly codified in law. Slavery mandated the separation of African families and necessarily required the removal of any reproductive rights for an entire class of enslaved people. This disregard for human rights based on race and class provided a broad foundation for the legal denial of basic human rights based on identity. It is not a coincidence that prisons continue to be hotbeds of reproductive oppression as the 13th Amendment outlawed slavery except in cases of conviction for a crime. If slavery can persist via jails and prisons, so too do attacks on reproductive choice and freedom.

The law is nothing else if not an iterative instrument that holds legal precedent in the highest regard. The precedent established during slavery, and later during "Buck v. Bell" when the eugenics movement was even more mainstream, continues to inform our reproductive rights today. "Buck v. Bell" was never overturned and cases like Britney Spears' highlight the ways that precedent rooted in human rights abuses echoes throughout our legal systems.

Debra Mollen: The denial is rooted in eugenics, Nazism, ableism, sexism, classism, antisemitism and racism. Of course, there are powerful implications for the intersection of these systems, which lead not only to oppressive practices but, exercised to their logical, albeit terrifying conclusion, to genocide. When the government makes decisions about who is deemed worthy and fit to reproduce, the results undermine our individual rights about one of the most vital decisions we ought to be able to make freely and with informed consent.

Sonja Goetsch-Avila: Policies that seek to control whether and how people give birth are rooted in White supremacy and forced upon our communities to maintain power and control.

Policies requiring forced birth control and sterilization very often go hand in hand with anti-abortion legislation and attempts to restrict access to birth control, with these laws usually pushed by the same elected officials and political movements. All of these laws have racist, sexist, classist and ablest roots and are intended to strip away the dignity and autonomy of poor people, people of color, immigrants, LGBTQ people, disabled people and young people who already face the greatest barriers to accessing care, and more stigma when they seek support as survivors of violence. Everyone should have access to reproductive health care in their own communities and on their own terms. This includes survivors of violence and those who have experienced domestic or family violence.

Q: What kind of mental, emotional and physical impact do you think the denial of this right to have an IUD removed/discontinue birth control can have on a person?

Rachel Johnson-Farias: Immense. People are quick to look to the "third world" for the impact of human rights abuses, but what we are witnessing in the Spears case, and the many cases like hers, is nothing short of abusive and inhumane. Unfortunately, what is happening to Britney Spears is legal and it highlights a central failing in our legal system: that which is morally bankrupt, abusive and inhumane is not necessarily illegal.

Debra Mollen: There is an established relationship between reproductive coercion and intimate partner violence. Women of color, poor women, single women and women younger than 30 are at higher risk of interpersonal violence, reproductive coercion and unintended pregnancy. Interpersonal violence and reproductive coercion are associated with increased risk for adverse psychological, physical and reproductive outcomes such as depression, anxiety, inconsistent condom use, sexually transmitted infections, impaired physical health and substance use. Unplanned pregnancy is associated with a range of adverse outcomes, including increased rates of depression and anxiety, delayed prenatal care, poorer relationship quality and less social support.

Sonja Goetsch-Avila: The reality is people should not have the right to decide if they want to be on birth control and the type of birth control they use taken away from them, as Spears has. Taking away someone's right to discontinue birth control, or any personal decision about their own health care and body, for that matter, has serious emotional, mental and physical impacts. When bodily autonomy and reproductive control is compromised, other aspects of one's life, sense of safety, stability, freedom and self-determination are impacted.

We can never undo the harm survivors of reproductive coercion have faced, but there are a few ways we can acknowledge them. In particular, URGE is supporting state legislation that would establish a Forced Sterilization Compensation Program to provide reparations to survivors of forced sterilization under California's eugenics law from 1909 to 1979, or who were subjected to coerced or involuntary sterilizations in women's state prisons after 1979. People can follow California Latinas for Reproductive Justice (CLRJ), California Coalition for Women Prisoners (CCWP), Back to the Basics Community Empowerment (B2B) and the Disability Rights Education and Defense Fund (DREDF) for updates and advocacy opportunities.


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