In May, EnCompass and Promundo staff participated in the 2019 Plenary Meeting of the Interagency Gender Working Group (IGWG), discussing strategies and challenges for advancing gender equality and health. The discussion was rich—and honest. In this post, we are pleased to feature a follow-up conversation between two of the participants—EnCompass’ own Priya Dhanani, Gender Equality and Gender-Based Violence Specialist, and Promundo’s Christopher Hook, Business Development Officer—in which they reflect on some of the themes facing our work in sexual and reproductive health.

Q: There were some insightful and uncomfortable discussions at the IGWG plenary event about intersectionality, privilege, and representation and that it must be part of the change processes in the gender and development space. How did that hit home for you?

Chris: Whew. That was … exhausting, but so enlivening. A good friend and colleague stood up and—rightfully—called me out for hogging the microphone, and called the panel out for being (mostly) all white. I was angry, sad, then finally, uncomfortable. And that led to an amazing discussion on stage between us, the moderator, and the audience, about representation. I’ve personally never been more inspired. So, I’m so happy we’re having a little mini-therapy session together on this. How did it feel for you?

Priya: I agree! Honestly, I was simultaneously surprised, frustrated, and hopeful. It’s like the constant elephant in the room that we glaze over. Not only did your colleague and others point it out—we sat in that uncomfortable space and discussed it! I constantly find myself in rooms or panels full of people discussing gender and development, who don’t look like me or identify with my experiences. I think, or I hope, that we are beginning to recognize that there needs to be a shift in the discourse, and we need to center more nuanced stories and experiences that shape the sector.

As a second-generation Indian-American, bisexual woman, there are deep complexities in these competing identities. So there’s that feeling of no one looking like me, but then on the other hand, there is a level of privilege I feel—whether on the basis of colorism, citizenship, or education, which means I need to use that power to fight anti-blackness, promote non-conforming identities, and support inclusivity in the space of sexual and reproductive health and rights. All these are all central to gender and development.

Chris: And for me, a white, hetero, cis-gender Western man, I don’t find my role particularly comforting in any sexual and reproductive health space I’m in. I’ve learned to live in this discomfort. Yet, I know I have something important to say. My lived experience of toxic masculinity informs my work and helps me reach out to others who come from the same world as I do. I like to think of myself as a bridge. I’m still figuring out what this all looks like. Honestly, I’ve only found my voice through engaging with women, diaspora, and queer folk, whose example of resilience and radical vulnerability I continue to try to live into every day.

Priya: I always say, the more uncomfortable the better. Consistently patting ourselves on the back for our work isn’t going to dig deep enough to get to the meat of the problem, nor will it show our deeply rooted biases, which we have as individuals, organizations, and as a sector. We need to get comfortable with calling each other out, and calling out leadership. I appreciated that IGWG was a space where we could do that and point out the unequal representation of men in conversations on sexual and reproductive health, and women in leadership and management positions—and, to a greater degree, people of color.

Chris: As you point out, our field has larger representation issues that also need to be addressed. I’d like to see a broader conversation develop around how can we get more people at this metaphorical table, representing all stakeholders. Not enough of the institutions I have been in in the past have ever questioned things like who is at the decision-making table and how this affects what happens. So, I was pleased that the lack of men in this space was called out. It’s certainly true that at the IGWG, there were no more than five men in attendance. This may be related to the feeling I get all around the world, that sexual and reproductive health is a “woman’s domain.” I think that the more we can project sexual and reproductive health decisions and outcomes as being in everyone’s domain, the more fluent men will become in discussing these topics, being allies with women, and standing up for their own interests. I’m particularly impressed with initiatives doing this well, like Promundo’s Program P and PSI/IDEO.orgs’s Smart Start.

Priya: I would also argue that there are two sides to this coin. Women and girls are not considered “sexual beings,” unless it’s in relationship with reproductive health, the way men and boys can be. And men and boys are largely not seen as having a role in reproductive health, as you mentioned. I think there is work that needs to be done across the board to ensure autonomy of all individuals, informed decision making, and mitigating societal stigma and preconceived notions, which is a big component of the USAID Transform: Primary Health Care project in Ethiopia, which I want to talk more about later.

Q: Better sexual and reproductive health outcomes could be achieved by addressing gender inequality, poverty, and colonialism, which are inextricably linked. What successes have you and/or the organizations you represent had in practically addressing these root causes, knowing that change is a slow, iterative process? How do you practically address this?

Chris: This reminds me of a really important blog post I read by Jennifer Lentfer of How Matters, which poses the question, “Can aid organizations really be part of social movements?” The thesis is that it’s hard to both act as agents of resistance (for equality, for example) and work within institutions and organizations that use rigid results frameworks, work on strict project timelines, prioritize self-interest, and have aims which are, in the final analysis, dictated by Western donor organizations. I think many of us come to our work with an interest in “doing good,” but it gets more complicated pretty quickly. So, I think the first step—and this is parroting thinkers like bell hooks—is getting out of a consciousness, at a personal level, that says the work is easy and you’re what the world needs. And then bringing that awareness to the table in a critical analysis of development.

Priya: Yes! Lentfer’s question here, and the challenges that arise in being “agents of resistance” in development is critical, as we grapple with the ties between “development” and its placement in white supremacy. As trite as the labels “change agent” and “activist” sound, if we accept any part of these roles, then that comes with a responsibility to question and challenge power, which can feel like biting the hand that feeds us. I find that gender conversations are still dominated by Western paradigms, generally leading to an abstract mapping of gender stratification, when instead we need a critical reflection on the institutions that shape those theories. So, how do we go from abstract to the key issue?

Chris: To get concrete, my choice is either to continue working in development and finding a path forward that doesn’t recreate these dynamics, or to get out of the field. I have so far chosen the first option. So, my current path is to prioritize internal work, of course. And, it’s to engage with organizations I find who do “development” the best—finding ways to get money into the hands of local partners, building flexible results frameworks in partnership with those who stand to benefit, and hiring people, particularly at “headquarters”—who represent the communities they are trying to change.

Priya: Right. And, I’d add, having mechanisms in place that hold us accountable, letting go of “development jargon” to make the work accessible to diverse groups, supporting participants to be the decision makers, without always tying their success to funding, and helping organizations feel empowered to push back when donors are not inclusive—all that can move us in the right direction. I think it also helps that we have spaces like IGWG for dialogue that challenges us to identify tangible steps in breaking down power dynamics. EnCompass actually does this, using a participatory approach so communities can be in charge of their narratives, needs, and decisions. We need to arrive at conclusions together and use those partnerships as levers for doing so.

Q: There’s been increased international attention in spaces focused on family planning and gender equality on achieving reproductive rights for all, and including men and boys. What are the tensions inherent to this shift? And, what do you think should be on the agenda for advancing sexual and reproductive health for all?

Chris: Undergirding this concern—understandably felt—is that shifting any attention to men and boys’ sexual and reproductive health needs will take away much-needed funds from women and girls. First, it’s important to say that men and boys are sexual and reproductive beings, with rights to services to help them achieve their goals and relieve their discomforts. But—and this is important—this shouldn’t compromise, in any way, women and girls’ rights to bodily autonomy or safety. Essentially, I think you can have both. Margaret Greene and Andrew Levack, whom I have the unthinkably fortuitous privilege to call colleagues, defined this as a “gender-synchronized” approach. My summation of their take, and this was emphasized in the Guttmacher-Lancet series on this issue, is that you can address the sexual and reproductive needs of people of all gender identities in two ways—by transforming the underlying gender norms, right from an early age, and by approaching sexual and reproductive health in ways that “identify or create shared values among women and men, within the range of roles they play.” I’d like to see this ethic built in the next round of agenda setting. In a paper some colleagues and I did last year, we outline concrete ways this could be done.

Priya: EnCompass has a wide array of projects working on sexual and reproductive health and rights with women, girls, men, and boys, including the Transform: Primary Health Care project. In 2017, our team conducted a gender analysis to better understand how people are receiving and accessing healthcare. We also found a gap in the Ethiopian health system’s understanding and implementation of gender-based violence prevention and response. To fill this gap, the project completed a landscape analysis in 2018 to map existing prevention and response interventions. Now we’re in the midst of a male engagement study to delve into the specific needs and roles of men and boys. We recognize that what is generally missing is the broader awareness of how gender norms are reinforced by everyone in the community. Both men and women shape and perpetuate gender norms, and that affects health outcomes. We hope this analysis can inform “gender-synchronized” interventions and build on the work you and your colleagues have laid out, Chris, while moving the needle forward—for example, by being intentional in considering the health impacts of those who identify as LGBTQI+ or third gender.

Bio: Christopher Hook works with Promundo’s Business Development Team. Chris received his MSPH from Johns Hopkins Bloomberg School of Public Health in 2016. Contact him at c.hook@promundoglobal.org or slide into his DMs at @chook471.

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