Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, MD.
Department of Family Medicine and Community Health Mount Sinai Icahn School of Medicine, New York, NY.
Fam Med. 2024 Apr;56(4):222-228. doi: 10.22454/FamMed.2024.973758.
Since European settlement, the United States has controlled the reproduction of communities of color through tactics ranging from forced pregnancies, sterilizations, and abortions to immigration policies and policies that separate children from their families. Lesbian, gay, bisexual, transgender, queer (or questioning), asexual, intersex, and gender diverse people (LGBTQIA+) have been persecuted for sexual behavior and gender expression, and also restricted from having children. In response, women of color and LGBTQIA+ communities have organized for Reproductive Justice (RJ) and liberation. The Reproductive Justice framework, conceived in 1994 by the Women of African Descent for Reproductive Justice, addresses the reproductive health needs of Black women and communities from a broad human rights perspective. Since then, the framework has expanded with an intersectional approach to include all communities of color and LGBTQIA+ communities. Notwithstanding, reproductive injustice negatively impacts the health of already marginalized and oppressed communities, which is reflected in higher rates of maternal mortality, infant mortality, infertility, preterm births, and poorer health outcomes associated with race-based stress. While the impact of racial injustice on disparate health outcomes is increasingly addressed in family medicine, Reproductive Justice has not been universally incorporated into care provision or education. Including the RJ framework in family medicine education is critical to understanding how structural, economic, and political factors influence health outcomes to improve health care delivery from a justice and human rights perspective. This commentary describes how an RJ framework can enhance medical education and care provision, and subsequently identifies strategies for incorporating Reproductive Justice teaching into family medicine education.
自欧洲殖民以来，美国通过各种手段控制有色人种社区的生育，这些手段包括强制怀孕、绝育和堕胎，以及移民政策和将儿童与其家庭分离的政策。性少数群体（包括同性恋、双性恋、跨性别、酷儿或疑问、无性恋、间性人等）一直因其性行为和性别表达而受到迫害，也被限制生育。为此，有色人种女性和性少数群体社区组织起来争取生殖正义（RJ）和解放。生殖正义框架由非洲裔女性于 1994 年构想，从广泛的人权角度出发，解决黑人女性和各有色人种社区的生殖健康需求。自那时以来，该框架通过交叉视角扩展，包括所有有色人种社区和性少数群体社区。然而，生殖不正义仍然对已经边缘化和受压迫的社区的健康产生负面影响，这反映在更高的孕产妇死亡率、婴儿死亡率、不孕、早产率以及与基于种族的压力相关的更差的健康结果。尽管种族不公正对不同健康结果的影响在家庭医学中越来越受到关注，但生殖正义并没有普遍纳入护理提供或教育。将 RJ 框架纳入家庭医学教育对于理解结构、经济和政治因素如何影响健康结果，从正义和人权的角度改善医疗保健服务至关重要。本评论描述了 RJ 框架如何增强医学教育和护理提供，并随后确定了将生殖正义教学纳入家庭医学教育的策略。
