Increasing Indigenous access to sexual health

Natasha Gillezeau explores the implications of structural racism on Indigenous access to sexual health

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Late last year, Professor George Yancy took to The New York Times with a letter titled “Dear White America.” Amongst other things, he stated, “all white people benefit from racism and in their own way are racist.” This made a lot of people very, very uncomfortable, angry, even.

The people who get to define what racism is and how it operates are those affected by it. The people who need to listen to those definitions are those directly or tacitly still benefiting from institutions of white supremacy. Yancy’s definition might be challenging for some because it forces them to consider not just positive acts of racism (taunts, firing someone because they are Indigenous, hate crime), but all the acts of omission, the acts of ignorance allowing white Australians to benefit from systemic racism and Indigenous Australians to be hurt by it – again and again.

One metric by which we can see how Indigenous Australians still suffer from racism and colonialism is sexual health indicators.

In the Kimberley, the rates of gonorrhoea are 40 times higher among Aboriginal people. Rates of chlamydia are five times higher among Aboriginal people. If you thought gonorrhoea wasn’t something people even contracted in the 21st Century, that’s probably because they shouldn’t.

According to data released by Australian Indigenous HealthInfoNet, whilst notification rates for HIV infection and AIDS are similar for the Indigenous population and the non-Indigenous population, in contrast to the total population, for which less than 8% of diagnoses of HIV occurred in females, more than 31% of cases reported among Indigenous people occurred in females. This speaks to how the experience of being Indigenous intersects with gender in relation to sexual health outcomes.

The right to sexual health involves the guarantee of a number of things including availability, accessibility, acceptability and quality. When we analyse how these four factors play out in relation to Indigenous Australians versus non-Indigenous Australians, the reasons behind some of these awful statistics emerge. Healthcare accessibility has multiple facets including both being physically accessible from where a person lives as well as economically accessible. From July, our government is making women pay for their own pap smears. This is a bad enough as a message and as a disincentive for non-Indigenous women, but that $30 (putting aside the need to know about pap smears or how to go about getting to a doctor’s appointment) is not just a deterrent for some Indigenous teens, it’s an utter barrier.

The solution is not as simple as arguing that Indigenous Australians require better sexual education, although of course, that is one way of addressing the problem. For instance, the Alukura young women’s community health program employs two educators who deliver sexual health education to young women aged 12 to 20 years. These community responses are great on a micro level, but we also need a macro level response from our government to implement sustained, intelligent policies and programs that put Indigenous health as a priority.

Yancy challenges the white population to accept the truth about what it means to be white in a society “created for you.” So what’s more uncomfortable? Yancy’s statement that all white people are, in their own way, racist? Or is it these facts? The “truth” of a society created in favour of one race above others is not an outrageous proposition; when we look at the statistics, it’s staring right at us.