Department of Theology Spring Term 2015
Master's Thesis in Human Rights 30 ECTS
Still unequal?
The impact of social identities on girls’ access to sexual and reproductive health and rights in South Africa
Author: Katharina Stark
Supervisor: Professor Elena Namli
Abstract
Sexual and reproductive health and rights (SRHR) are human rights, thus they should be universally accessible. Young women and girls are often considered a disadvantaged group with low access to human rights. Various feminist scholars have highlighted gender inequality as the cause of this marginalisation. Intersectionality scholars instead argue the marginalisation of women to be more complex. The approach emphasises that oppressed women and girls are not only discriminated because of their gender but that the prevalence of intragroup discrimination hampers them from accessing their rights. This thesis aims to study if and how social identities, more specifically class and ethnicity, affect adolescent girls’
access to sexual and reproductive health and rights within the South African school realm. A case study is conducted on the south coast of KwaZulu-Natal, focusing on secondary- and high school teachers and on how the subject Life Orientation is implemented to create access to SRHR.
Empirical results of the study indicate that class- and ethnic belonging impacts the access of female students to their rights in various ways. Monetary resources, information and knowledge influence social identities and access to SRHR in Life Orientation. As well as overall school conditions, including level of school violence and harassment. Finally, this thesis illustrates that privileged girls are also impeded from accessing their SRHR, due to the implementation of school fees. This system allows guardians to gain substantial influence and constrain school teachings of controversial topics.
Keywords: Gender, Class, Ethnicity, Sexual and reproductive health and rights, Human rights, Intersectionality, South Africa, Education, Inequality, Life Orientation
Acknowledgments
I would like to express my deepest gratitude to Guhlshera Khan, my South African supervisor, who opened her home and heart to tirelessly help me throughout my stay in the country. The following members of Port Shepstone Twinning Association Judy Mkhize, Silvy Ragoobar, Margaret Nqoko, Dell Pendock and Pauline Duncan have graciously assisted me to reach out to various schools. I am grateful to all principals and teachers who welcomed me to their schools, made me feel at home and contributed with their time and invaluable knowledge. Due to confidentiality reasons they will remain anonymous, however, without their help this thesis could not have been completed. Linnea Burke Rolfhamre’s assistance has been of great value and has improved the quality of this work. Lastly, I would like to thank my Swedish supervisor, Professor Elena Namli, for her wise and patient guidance and advice.
This thesis is dedicated to all South African adolescent girls. May they be acknowledged as capable agents and full individuals, never to be considered a problem but the country’s bright presence and future.
With gratitude
Katharina Stark
Stockholm, 24 October 2015
Table of contents
1.0 Introduction ... 5
1.1 Thesis aim ... 6
1.1.1 Research question ... 7
1.2 Delimitations ... 7
1.3 Methodology ... 7
1.4 Case selection ... 11
1.4.1 Hibiscus Coast municipality & Umzumbe municipality ... 11
1.4.2 School selection ... 12
1.5 Theory -‐ the capabilities approach & intersectionality ... 14
1.6 Disposition ... 14
2.0 Capability & intersectionality ... 16
2.1 The capabilities approach ... 16
2.1.1 Amartya Sen ... 16
2.1.2 Martha Nussbaum ... 19
2.1.2.a Nussbaum’s response to critique of the capabilities approach ... 22
2.2 Intersectionality ... 23
2.2.1 The intersectional approach ... 23
2.2.2 Consequences of ignoring intragroup differences ... 28
2.2.3 Critique of intersectionality ... 29
2.3 Discussion – capabilities & intersectionality ... 32
3.0 Sexual and reproductive health and rights ... 35
3.1 SRHR and the international human rights system ... 35
3.2 SRHR and gender in South Africa ... 36
4.0 The case study ... 42
4.1 Part 1 – Thematic issues ... 42
4.1.1 Contraceptive methods & HIV/AIDS ... 42
4.1.2 Teenage pregnancy ... 43
4.1.3 Abortion ... 45
4.1.4 Gender-‐based violence ... 46
4.2 Part 2 – Rights, access & school conditions ... 48
4.2.1 Right or responsibility? ... 48
4.2.2 Resources & access ... 49
4.2.3 Obstacles & coping mechanisms ... 52
5.0 Analysis ... 54
5.1 Class, ethnicity and SRHR ... 54
5.2 The intersectionality of different identities ... 57
5.3 The role of the teacher ... 58
5.4 Not a neutral set of rights ... 58
5.5 A minimum level ... 60
5.6 Individualistic universalism ... 61
6.0 Concluding remarks ... 64
6.1 Future research ... 65
7.0 References ... 67
8.0 Appendix ... 71
1.0 Introduction
Sexual and reproductive health and rights (SRHR) are fundamental for the wellbeing of adolescent girls in all countries, including South Africa. According to Martha Nussbaum, certain capabilities enable humans to become dignified and free beings who shape their own lives, instead of passively being shaped by others. Such human capabilities include access to reproductive health and being secure from sexual assault and violence.1 However, like other human rights SRHR face different challenges within different contexts. South Africa is a heterogeneous, multicultural country with great ethnic, gender and socioeconomic inequalities affecting all levels of society. Therefore, adolescent girls face different obstacles concerning access to SRHR depending on which class- and ethnic identity they have. This leads to adolescent girls with different socioeconomic backgrounds gaining unequal access to various rights.
Sexual and gender-based violence, teenage pregnancy, HIV/AIDS and limited access to contraceptive methods as well as safe abortion indicate that achieving full access to SRHR remains a great challenge in the country. The number of rape cases in South Africa has steadily increased since the 1990s and has now reached the highest level of any country not at war.2 Since the 1990s HIV/AIDS has been a social, health, demographic and cultural catastrophe for the South African people and women in particular, since the epidemic disproportionally affects females.3 Teenage pregnancy is another pressing issue. A survey conducted in four of South Africa’s nine provinces found that 19,2 per cent of all girls between 12 and 19 years have undergone at least one pregnancy. A vast majority of these pregnancies were unplanned and unwanted.4 The South African constitution highlights SRHR in three separate places, e.g. it stipulates that everyone has the right to health care, including reproductive health care. Nevertheless, there is a wide gap between girls’ constitutional rights and their experience of health care service delivery, which often is of poor quality, unprofessional and inaccessible. Finally, female patients often are not consulted correctly about their options concerning medical tests and procedures, which could prevent or treat sexually transmitted infections (STIs).5
Life Orientation (LO) is one way in which South African schools work with SRHR related problems. The curriculum includes information about e.g. HIV/AIDS and
1 Nussbaum, 1999, pp. 233-235
2 du Toit, 2014, p. 101
3 Rispel & Popay, 2009, p. 90
4 Beksinska et. al, 2014, p. 676
5 Mbali & Mthembu, 2012, p. 5
positive self-image.6 However, due to widespread segregation and inequality within the South African society one specific right may be easily accessible to girls in one school, while it remains inaccessible to girls enrolled in another school.
1.1 Thesis aim
This thesis aims to research difficulties adolescent girls in Port Shepstone and its surroundings face regarding access to SRHR. South Africans lack access to many SRHR, however, evidence suggests that different groups face different challenges. E.g. adult males may not hesitate to visit a clinic out of fear to be treated with disrespect by the clinic staff, an obstacle many adolescent girls face.7
Just like all individuals, adolescent girls hold many different group identities, not all of them related to age or gender. Ethnicity, sexuality, religion, culture, class, ability and nationality are a few examples of such. If some characteristics, in this case gender and age, are important for access to SRHR, other identities should also influence a person’s access to these rights. Research on intersectionality, i.e. the interconnection of different social identities or power axes, confirms that social position, including discrimination or access to power and resources, is not a single dimension. Instead different social divisions interact and together create an individual’s social position. Therefore, this thesis focuses on varying access to SRHR within the category adolescent girls.
Schools play an important role in regards to making SRHR available to adolescent female students. They should inform students about their rights, function as active rights promoters and bridges of rights implementation. Of course many actors have to contribute for SRHR to become accessible to all adolescent girls. The state has to ensure that there are clinics working with reproductive and sexual health, the legal system has to protect girls against sexual violence, coercion and so forth. Nonetheless, schools remain an important promoter of SRHR. Schools normally are segregated institutions, i.e. students enrolled in the same school often come from similar socioeconomic and ethnic backgrounds. This makes schools a suitable institution to study difference in accessibility to SRHR within the group adolescent girls.
This thesis therefore aims to study if and how social divisions other than age and gender influences adolescent schoolgirls’ access to SRHR in South Africa, KwaZulu- Natal, more specifically Port Shepstone and its surroundings. Variation in access to SRHR
6 Prinsloo, 2007, p. 158
7 Thokoane, 2014, pp. 1-19
between adolescent girls should be understood in a broad sense. It is not limited to one group having greater access to SRHR than another but also includes the possibility that one group of girls has access to right A but lacks access to right B. Another group may have limited access to right A but full access to right B, etc.
1.1.1 Research question
If and how does social inequality affect the access of South African adolescent girls to SRHR within the school context?
1.2 Delimitations
Intersectionality is not locked to any particular social categories. This thesis focuses on the four different parameters class, gender, ethnicity and age. Gender and age are fixed categories, i.e. the focus group is socially defined as adolescent females, meaning young, not yet adult women. The remaining two categories, class and ethnicity, vary within the studied group. In reality other factors also impact access to SRHR for adolescent girls. The field study is conducted in Port Shepstone and its surroundings, a city located on the south coast of South Africa, in the province KwaZulu-Natal.
SRHR are a specific set of rights and this thesis does not aim to draw generalising conclusions on how intersectional categories influence human rights in general.
SRHR is a broad category, covering a variety of topics and rights. This work cannot cover the entire range of rights but focuses on the following topics: teen pregnancy, HIV/AIDS, abortion, contraceptive methods and sexual violence or coercion. These issues are defined more thoroughly in section 3.2 SRHR and gender in South Africa. Furthermore, this study does not have any generalisation objectives for intersectionality regarding other groups than adolescent girls, enrolled in secondary schools in KwaZulu-Natal in the surroundings of Port Shepstone. I.e. how males, pre-adolescent girls, adolescent girls not enrolled in school and adult women are affected by intersectionality in their access to SRHR is not studied. Finally, how schools work with SRHR can vary greatly and teachers may work with SRHR in many different subjects. However, the interviews focus on LO teachers, therefore other aspects of how SRHR are taught or implemented within the school realm are not included.
1.3 Methodology
Just like Martha Nussbaum, this thesis applies the 1994 International Conference on Population and Development’s (ICPD) definition of SRHR. ICPD defines reproductive health as complete, physical, social and mental wellb an overview of intersectionality eing, exceeding the absence of disease or infirmity for all matters connected to the reproductive
system, its functions and processes. Individuals should be able to have a satisfying and safe sex life, the capability to reproduce as well as the freedom to decide if, when and how often to do so. Therefore, women and men have the right to information about effective, affordable and acceptable family planning methods of their choice as well as access to such methods.
They should further have access to safe contraceptive methods and fertility regulations, which are not against the law. Women have the right to safe healthcare during pregnancy and childbirth. Adequate reproductive health care must include methods, techniques and services, which contribute to reproductive health and wellbeing, not only solving but also preventing reproductive health problems. The definition includes the right of individuals to make decisions regarding reproduction free from discrimination, coercion and violence in accordance with human rights documents. Mutually respectful and equitable gender relations should be sought, especially concerning educational and service support for adolescents, to enable positive and responsive attitudes towards their own sexuality.8 The normative starting point for this thesis is that women and men should have access to safe contraceptive methods and fertility regulations and that the law should not oppose this.
Class is used to define an individual’s social origin, including the cultural resources of education and profession as well as social and network resources. Power relations within the category often derive from income and wealth inequality. These inequalities influence a person’s resources. Class not only influences economics and politics but all levels of society, including family, living conditions, voluntary work and housework.
Gender is used to describe the naturalised and binary male-female differentiation as well as the heteronormativisation phenomenon. Heteronormativity defines the hierarchy based on gender relations, the unquestioned assumptions that heterosexuality is the norm and that gender is binary. While classism is legitimised by performance the legitimisation of gender is conducted through naturalism. The same applies to racism, which is based on the power asymmetry between human groups, socially constructed into races. This creates a difference between them and us, leading to structural discrimination deriving from a majority in society in regards to e.g. nationality, skin colour or religion. Racism is built on the differentiation between the centre and the periphery.9 However, according to science there only exists one human race and referring to the term race upholds the illusion that there are different genetic human races. Therefore, this thesis refers to ethnicity instead of race. Countless individuals are racialized, particularly non-whites, hence the way ethnicity is used refers to how racism is
8 United Nations, 1994
9 Winker & Degele, 2011, p. 55
defined above. Age is often used to discriminate both young and old individuals. Ageism often is not taken as serious as other forms of discrimination. However, it can have the same economical, psychological and social impact as any other form of discrimination.10
The South African school system can be divided into three different categories.
Primary school includes reception to grade 6, secondary school covers grade 7 to 12 and higher education refers to all university education. School is compulsory up to grade 9, after which students may continue to senior secondary school for grade 10 to 12. In secondary school LO is a compulsory subject.11 According to the law schools have to charge school fees or provide a required amount through fundraising and donations. However, some schools have the right not to charge fees. Schools located in poor communities or with few economic assets are granted the right not to charge fees. Furthermore, parents struggling financially may be exempted from school fees.12 LO is part of national curriculum and applies religious, socialisation and self-development programmes as well as life and survival skill training.13 It is the study of the self in relation to others and society and aims to apply a holistic approach.
It includes topics such as sexuality, teen pregnancy, STIs including HIV/AIDS as well as personal and community health. Racism, gender and discrimination are other topics covered.14
The theoretical part of the thesis is derived from Martha Nussbaum and Amartya Sen’s work on the capabilities approach as well as the work of intersectionality scholars.
Furthermore, articles on SRHR and gender in South Africa and the international human rights system are studied. The empirical study applies qualitative participatory method to collect primary source data. Semi-structured interviews are conducted with LO teachers in seven secondary schools. All questions are open-ended to allow a follow-up of unexpected and relevant issues. Interview results are then analysed through the two variables: class and ethnicity. SRHR are combined capabilities, as they require a combination of internal and external physical and social conditions to become truly available to a person.15 The influence of different social identities on adolescent girls’ access to these combined capabilities will thus be analysed.
10 Ontario Human Rights Commission, Ageism and age discrimination
11 United States Embassy to South Africa, The Educational System of South Africa
12 Department of Basic Education, Republic of South Africa, No Fee Schools
13 Prinsloo, 2007, pp. 156-158
14 Department of Education, 2003, pp. 9-13
15 Nussbaum, 2010, pp. 120- 129
The school environment is suitable for this study as schools generally attract girls from limited geographic areas. Individuals sharing similar ethnic and/or socioeconomic backgrounds tend to live close to one another, i.e. schools are often highly homogenous environments. The differences between students from the seven schools make the research on the impact of social differences on SRHR within the school context possible.
The case study includes a number of validity and reliability problems. Semi- structured interviews may lower the reliability of the empirical results, as asking open-ended questions does not generate identical interviews, making it impossible to replicate the study.
As the interviewer and the respondents grew up in different countries and cultures, the usage and understanding of language and the meaning of specific words differs. E.g. several respondents claimed that there are no obstacles when teaching LO but referred to great difficulties in other parts of the interviews. Some teachers expressed a willingness to discuss anything related to SRHR in the classroom, after expressing an unwillingness to discuss abortion with their students. Communication is a two-way street and respondents’ replies are interpreted by me, a young, middle class, white, European woman. Hence, some aspects of the replies will be lost or wrongly interpreted. To increase the validity of the study, topics are rephrased and repeated in several questions. Cultural differences may influence the study in several ways, due to the underlying parameters of a young, white, European woman interviewing mainly African teachers. The power imbalance between white Europeans and non-white Africans creates a risk of respondents providing the replies they believe I want to hear and excluding certain aspects they believe I may disapprove of or am unable to understand.
Loyalty and disloyalty towards the own school can influence the reliability of the interviews, as teachers may be biased, glorify or demean reality. To minimise this risk, at least two LO teachers from each school are interviewed. The interviews are conducted individually to avoid peer pressure and respondents influencing each other’s responses.
Knowledge about the actual situation of female students may vary among different teachers, leading to false information being presented in the interviews. Furthermore, the thesis aims to study the situation of female students, not their teachers’ conditions. Interviewing teachers could thus be considered a secondary information-source, lowering the case study’s validity.
Due to ethical considerations concerning the sensitivity and private nature of SRHR no students will be interviewed for the case study. Teachers may have a broader understanding of the overall situation concerning SRHR in the school realm, as they have studied LO and work with numerous female students.
LO is taught in mixed-gender classes, hence, sometimes teachers refer to both boys and girls when they discuss their students’ situation. Therefore, teachers were explicitly reminded, both before and during the interviews, of the target group being solely female students. Finally, although schools are highly segregated they are not entirely homogenous environments. Hence, a working class school may enrol some middle class students, etc.
1.4 Case selection
1.4.1 Hibiscus Coast municipality & Umzumbe municipality
Six of seven schools included in the case study belong to Hibiscus Coast municipality, located in Ugu district, KwaZulu-Natal. The province, with an estimated population of 10 267 300, is divided into ten districts. Hibiscus Coast is one of Ugu district’s six municipalities, located in the southern part of KwaZulu-Natal, on the Indian Ocean coastline. Hibiscus Coast municipality holds the biggest population of Ugu district and is its most urbanised municipality, with Port Shepstone being the commercial and financial centre. Crime levels in urban districts are high and due to a housing shortage, a number of informal settlements have sprung up. In 2011 the municipality’s population was estimated at 256 135. The area experiences a high population growth with the African, mainly Zulu, community being largest, followed by the white community, the Indian community and lastly the coloured community. The municipality is the economic centre of Ugu district, however, unemployment, especially youth unemployment, crime rates, poverty and inequality remain widespread.16
In 2011 unemployment was estimated at 28 per cent, with youth unemployment rates being as high as 37,3 per cent. More females than males have no income and income distribution between different ethnicities is uneven. More than 72 000 households are living under the Minimum Living Level and the poverty head count ratio is 1:5. Rural areas suffer from a school shortage, especially primary schools, and some schools lack access to clean water and sanitation. Teenage pregnancy is estimated at 9,6 per cent and 40 per cent of the population of Ugu district is HIV infected.17
One case study school is located in Umzumbe municipality, a largely rural area with only 1 per cent of the region being semi-urban. The municipality is also part of Ugu district and high poverty levels, a lack of basic services and an economic base mark the municipality. The population of Umzumbe is estimated at 179 638, with a vast majority, 178
16 Hibiscus Coast Municipality, 2015, pp 34-48
17 Hibiscus Coast Municipality, 2015, pp 68-93
975 individuals, belonging to the African community. The second largest group is the coloured community, 491, followed by the white community, 109, and a small Asian community, 62. Umzumbe is the poorest municipality within Ugu district, with agriculture being its main income source. However, the number of people living in (extreme) poverty has declined in recent years. Official unemployment rates were 72 per cent in 2007 and the informal sector far exceeds the formal. The annual HIV growth rate is 13,7 per cent and 32,3 per cent of all deaths are AIDS related.18
1.4.2 School selection
For confidentiality reasons no teacher or school names or exact school locations are included in this thesis. Instead, the relevant information about each school is explained below. The seven schools cater to different demographic groups, hence, they are not randomly chosen but fulfil specific criteria. Included categories for the school selection are location, urban or rural, guardian employment and wealth, guardian level of education and student ethnicity. The interviewed teachers teach grade 8 to 12 and of the 17 interviewed teachers 3 are male, 3 are Indian, 3 are white and 11 are African. All but one of the interviews were conducted individually. Upon the request of two teachers from the semi-rural school, one group interview was conducted.
School 1 is located in a semi-rural environment outside of Port Shepstone. The community attracts individuals who want to live close to the city but cannot afford expensive housing. Students enrolled in the school belong to the African, mainly Zulu and some Xhosa, community. Unemployment is widespread among students’ guardians, a majority of whom did not complete secondary school. The school is exempt from charging school fees.
School 2 is a no fee school located in the rural areas of Hibiscus Coast municipality and all enrolled students are African, predominantly Zulu and some Xhosa. The poverty-stricken area offers few work opportunities and many guardians are unemployed.
Those who are working have to travel far, often by foot, to work and typically work in low skilled sectors.
School 3 is a no fee school located in an even deeper rural environment, farther from any city or town than school 2. It is part of Umzumbe municipality and students belong to the Zulu community. The level of education among guardians is low and few have completed secondary school. Unemployment is a great problem with most families depending
18 Umzumbe Municipality, 2012, pp 19-22
on social grants. Guardians who are working are mainly domestic workers or self-employed, e.g. selling vegetables.
School 4 is one of Port Shepstone’s suburban schools and a majority of its students come from middle class backgrounds. The largest student group is African, followed by Indians and coloureds. Some years a few white students enrol in the school. Many students do not live in the surrounding community but enrol in the school due to its positive reputation.
Most guardians are employed, typically as police officers, nurses or teachers. They generally hold a college or university degree. The school charges a fee, currently amounting to R1 400 per year and student, nonetheless, some students in each class are exempted from the fee.
School 5 is also located in the suburbs of Port Shepstone. However, a vast majority of the enrolled students come from disadvantaged, working class homes. Most students are African and some belong to the coloured community. An informal settlement is located close to the school and many learners live in the settlement. Unemployment rates among guardians are high and few have any form of higher education. The school does not charge fees but students can choose to pay a voluntary fee.
School 6, located in central Port Shepstone, is an ethnical mixed school, with the largest student group belonging to the African community. The second largest group is white students, followed by a small group of Indians, coloureds and others, including Chinese students. Unemployment is a problem among guardians, some students are orphans and some are raised by single unemployed mothers. The level of education among guardians is relatively high and many work as lawyers, teachers, doctors, nurses, are business owners, shopkeepers and accountants. The school charges a school fee of R14 680 per year for grade 8 students and R13 680 for grade 9 to 12 students. However, a relatively large group of students is partially or fully exempted from the fees.
School 7, located in one of Port Shepstone’s affluent suburbs, is the only private school included in the case study. The Christian based school is an ethnical mixed institution, with white students being the largest group followed by Africans, Indians and a small group of coloured students. Guardians are typically affluent, well-educated farmers or business owners. School fees amount from ca. R60 000 to R62 000 annually per student, however, some students are exempted from the fees. Such students are financed through academic or sport scholarships.
1.5 Theory – the capabilities approach & intersectionality
Amartya Sen and Martha Nussbaum, the scholars behind the capabilities approach, emphasise that states should ensure citizens access to certain capabilities. These capabilities are considered a precondition for dignified human life, as they describe what the individual actually can do and become. Hence, they are tools rather than functionings. They should be available to everybody, however, whether or not the individual uses them should be her/his own decision. Nussbaum argues that there is a set list of capabilities, which every society must provide. She further emphasises that this list is universal, i.e. everyone everywhere should have access to it. The capabilities approach is meant to function as an overlapping consensus. Finally, every capability has a value in itself and the lack of one capability cannot be compensated by another.19
Intersectionality scholars study how different social divisions, e.g. gender, class and ethnicity, are interconnected and together create a different kind of oppression than each factor individually. The different categories cannot simply be added on top of each other and are not reducible to one another. In other words, a coloured woman is discriminated because of her gender and ethnicity, which is different from the discrimination a white female or coloured male experiences. Through an intersectional approach different power axes of socially constructed categories are studied. The approach can be used to examine oppression on the individual level as well as the institutional and system level.20
1.6 Disposition
The introductory chapter discusses the background, research question and aim of this work. It further outlines the methodology for its empirical and theoretical part and provides background information about the case study. Delimitations and an introduction to the theoretical part, focusing on the capabilities approach and intersectionality are also included in the chapter. The two approaches function as the theoretical backbone of this thesis.
Chapter 2, theory, studies the capabilities approach through Amartya Sen and Martha Nussbaum’s work. It further includes an overview of intersectionality, Kimberlé Crenshaw’s work on Afro-American women and intersectionality as well as common critique of the approach. Thereafter follows a discussion of the capabilities approach and intersectionality.
Chapter 3, SRHR, includes a section about SRHR within the international human rights realm as well as in the South African context. Here, the emergence of SRHR in the international legal context and research about the overall situation for women and girls concerning SRHR
19 Sen, 2005 & Nussbaum, 2010
20 Lykke, 2003
in South Africa is outlined. The chapter highlights teen pregnancy, HIV/AIDS, abortion, contraceptive methods as well as gender-based and sexual violence in South Africa.
The case study and its empirical findings are presented in chapter 4. They are divided into two different parts and the thematic results are presented in part 1, followed by an outline of overall teaching- and school conditions as well as teachers’ reflections about rights and responsibilities related to SRHR in part 2. Chapter 5, analysis, includes a discussion about different aspects of the empirical results, such as the role of the teachers, the intersectionality of different social identities, a common minimum level as well as universalism and individualism. The final part of the thesis, chapter 6, outlines concluding remarks concerning the thesis question, reflections about how to move forward and increase equality between girls as well as suggestions for future research.
2.0 Capability & intersectionality 2.1 The capabilities approach 2.1.1 Amartya Sen
In his work, Development as freedom, Amartya Sen emphasises five different kinds of instrumental freedoms: political freedoms, economical facilities, social opportunities, transparency guarantees and protective security. These freedoms each increase human capacity and are not only the primary aim of development but also its greatest tools. Sen’s approach to freedom includes processes enabling human capacity as well as real opportunities, which individuals hold in their personal social context. Even in comparably wealthy countries, marginalised groups suffer from the lack of freedoms, such as basic health care, education and economic and social security. Gender inequality hampers women’s freedoms, showing why poverty should be considered the deprivation of basic capabilities.
This is illustrated through e.g. shorter life expectancy, chronic illness and illiteracy. Inequality between women and men therefore needs to be studied through demographic, medical and social data, as income data often provides limited information about inequality between the sexes.
Class is another important factor. When life expectancy is compared between Afro-Americans in the US and the population of Kerala India, Sri Lanka, Jamaica or Costa Rica, data shows that it is lower for Afro-Americans than the much poorer population of the latter examples. This is impacted by societal implementations such as health care, law and order, education and violence.21 Studies show that GDP growth is not the main drive behind increasing life expectancy. Instead the way in which the gained wealth is used, in this case how much is spent on public health measures, is of greater importance. Hence, countries such as Sri Lanka and Costa Rica successfully decreased mortality rates without an economic boom. Countries including South Africa and Brazil have, despite their significantly higher GDP per capita, lower life expectancy rates than Sri Lanka. The two decades during the 20th century when life expectancy increased the most in the U.K. occurred during World War I and II, due to the increase in social services, e.g. health care and food aid.22
Sen highlights that Rawls primary goods provide a broader base, than GDP per capita, for the understanding of which resources individuals need, no matter which goals they may have. He further argues that everyone has to take responsibility for his/her own
21 Sen, 2005, pp. 24-38
22 Sen, 2005, pp. 64-72
preferences. Primary goods are first and foremost common resources and should be used to create capabilities for the individual to do whatever she/he finds valuable. However, just like Martha Nussbaum, Sen does not focus on utility or primary goods but real freedoms; the capabilities an individual has to create a desirable life. Individual capabilities are the alternative combinations of functionings, feasible for a person to achieve. Hence capabilities are a special kind of freedoms.23
Capability poverty defines poverty as the loss of capabilities rather than just low income. This approach does not deny that low income is one of the main factors behind poverty, as it is one of the main reasons for capability deprivation. Nonetheless, poverty often includes other factors than low income, including social roles, epidemic diseases, gender, etc.
The way a family’s income is divided between its members is also of importance. Girls often receive limited proportions of the family income. Hence, even if a family’s income is relatively high, girls may not gain access to health care, etc. Relative poverty is of further importance, as a higher income is needed in high income countries in order to reach the same level of social functioning as in less wealthy countries. Education, health care, etc. should not be considered just a way to decrease income poverty. They are not only tools but goals in themselves, as they create freedoms. Inequality has different dimensions and an individual who has a relative high income can still lack access to some freedoms, e.g. political participation.
In Western Europe the unemployed normally receives compensation for her/his income loss. Nevertheless, unemployment brings with it consequences other than monetary loss, including mental problems, chronic illness and social exclusion. This implies that inequality created by unemployment exceeds income inequality by far. Inequality in life expectancy between Afro-Americans and white Americans is large and prevails when income differences are taken into account. Once the understanding of inequality is broadened it becomes clear that many Afro-Americans lack access to social services including basic health care and qualitative educational institutions. India and Sub-Saharan Africa have comparably low life expectancy but in India malnutrition is far more widespread than in Sub-Saharan Africa, where infant mortality is greater than in India. In both areas illiteracy remains a substantive problem. This illustrates that all capabilities are important and that the lack of one freedom cannot be compensated by another freedom.
23 Sen, 2005, pp. 101-108
Sen emphasises that the main issue within the field of economics is not a lack of interest in inequality but that income inequality is used as a synonym for inequality. At the same time evidence suggests that differences in mortality between the sexes, societal classes and ethnicities can be explained by other factors than income difference. Therefore inequality should be considered capability deprivation.24 Inequality becomes even more prevailing through a focus-shift from income inequality to inequality of the distribution of freedoms and capabilities. A person with a disability often not only experiences greater difficulties accessing the job market but also experiences greater difficulties when it comes to transforming her/his income to capabilities. Therefore, both sides should be considered simultaneously, i.e. both access to the labour market and income as well as social measures, e.g. health care, enabling individuals to live fulfilled lives.25
One of Sen’s greatest contributions is that he broadens the understanding of poverty, which often is narrowly defined by economic scholars. His writings connect human rights and development and he applies a rights based understanding of development and poverty reduction. However, he treats discrimination against different groups as isolated factors and fails to emphasise the interaction of different kinds of oppression. E.g. classism and sexism are approached as two separated systems. Furthermore, even though his understanding of poverty is broader than that of mainstream economic scholars his approach is based on economic arguments. Two important aspects within the field of economics are international relations and global trade. It is widely acknowledged that global inequality hampers the development of low- and middle-income states. Sen focuses on the responsibility of the government towards its own citizens. This is a very important aspect, however, it can be argued that it is impossible for governments of low- and middle-income states to provide all freedoms or capabilities to their citizens if global status quo remains. It can be argued that a state’s government should spend its resources on making capabilities available to all its citizens. However, for an economic approach to fairness to entirely ignore global inequality can be contested.
Sen’s approach is highly individualistic, which can be problematic in cultures and among groups that value collectivism over individualism. Basing a theory on collectivism can be equally criticised as it implies that the individual can and sometimes should be sacrificed for the common good. Collectivism emphasises that the group-interest should outweigh the interest of the individual. The capabilities approach instead emphasises that the
24 Sen, 2005, pp. 127-158
25 Sen, 2005, pp. 173-175
individual should have access to all capabilities but that she/he has the choice to decide whether or not to implement or use the capability. It can thus be argued that this approach is more culture-sensitive than many other human rights approaches, which often are accused of forcing rights upon individuals who do not claim them. Ultimately, whether a scholar emphasises individualism or collectivism the approach can and will be criticised by various groups and individuals. Nonetheless, most important may be analysing the consequences, both positive and negative, of individualism and collectivism.
2.1.2 Martha Nussbaum
Martha Nussbaum defines principles or capabilities for each country to follow to reach a minimum level of human dignity. There is a threshold for each capability and if this threshold is not reached, citizens cannot live truly human and dignified lives. It is the responsibility of every society to ensure that its citizens can reach this threshold. According to the philosopher, human capabilities, i.e. what people actually can do and become are based on an intuitive idea of what defines dignified human life. The capabilities are not based on any metaphysical motivation, however, in a liberal political context they become clear political goals. The list of capabilities can create an overlapping consensus between individuals who otherwise have very different opinions on what is good and desirable. Every individual is a sovereign goal in her-/himself and can never be considered a tool for another person’s end. As women frequently have been used as tools instead of goals, this is of utmost importance for females. The capabilities approach is a universal approach and the defined capabilities are important for every citizen in every country.26
The approach aims to focus on the actual conditions for women’s social and physical realities. The central question for the approach thus is not how happy is Maria? Or which resources can she access? But what is Maria really capable of doing and what can she become? Central to the approach is which freedoms and possibilities the individual has, exceeding the question of which resources are available and how they are used and distributed. The approach enables comparisons of life quality between different regions, classes or within one nation. Furthermore, it is built on the fairness argument that politics must enable citizens to function within the key areas of life. The fact that certain citizens always remain under the threshold within certain key areas should be considered tragic and unfair. This requires immediate attention and actions, regardless of whether development in other key areas is satisfactory or not. This is due to some functionings being fundamental to
26 Nussbaum, 2010, pp. 23-31
human life, i.e. their presence is an indicator for the presence of real human life and their absent is an indicator for the absent of real human life. Just like Marx and Aristotle, Nussbaum claims that there is a human way to practice those functionings, which is different from the animalistic way of practicing them. Simply put, life described as unfit for human beings often describes an existence without any possibility to practice ones human capacity.
Every human being is considered a free and dignified being who shapes her/his life in interaction with other humans. True human life is thus created through the capability to reason and socialise with other humans. Nussbaum’s list of capabilities aims to be cross- cultural and provides an overlapping consensus in the sense that some human losses are considered a tragedy all over the world, despite the fact that metaphysical believes vary widely. The list contains preconditions instead of functionings and provides the space for individuals to practice other functionings they value. Central capabilities are not only a tool but goals in themselves as they make life truly human. They enable different ways of life, hence, they are important for political goals within a plural society.
The capabilities approach is not a complete theory of justice as it solely provides the base that enables us to define a social minimum within different areas.27 The different capabilities are designed to be applicable within varying contexts and can be realised within widely different realities. As of now the list includes the following central capabilities:
1. Life
2. Bodily health 3. Bodily integrity
4. Senses, imagination and thought 5. Emotions
6. Practical Reason 7. Affiliation 8. Other Species 9. Play
10. Control over one’s environment
Shortcomings in one capability cannot be compensated for by other capabilities, as each capability is central and has value in itself. Simultaneously, different capabilities are
27 Nussbaum, 2010, pp. 100-105
interconnected, e.g. enhancing reproductive health can enhance physical integrity and practical reasoning. Central to the listed capabilities is that humans, with the right education and physical support, have the ability to exercise those functionings. 28
The following three different capability categories are vital for human dignity.
Basic capabilities are the internal tools of an individual, vital for the development of more advanced capabilities as well as a base for moral consideration. Examples of such capabilities include the ability to love, practically reason and work. Internal capabilities are the sufficient conditions to practice fundamental functionings. Most internal capabilities, such as making political choices and learning to play with other humans, require the support of one’s surroundings and other human beings in order to develop. Nussbaum emphasises that women who are not victims of genital mutilation often have the internal capability for sexual pleasure. However, once the individual has developed internal capabilities she/he can be hampered from functioning in accordance with them. Combined capabilities are internal capabilities in combination with external conditions, enabling the practice of functionings. A widow who has not been subjected to genital mutilation but is not allowed to remarry does not posses the combined capability to express her sexuality. The difference between internal and combined capabilities is thus that the latter requires external, physical and social, conditions.29 The capabilities approach does not hamper the freedom of individuals to choose the way they want to live. Therefore, capabilities instead of functionings are listed. The state has the responsibility to ensure that citizens have access to different capabilities but whether or not they use those capabilities and turn them into functionings is for the individual to decide.
Nussbaum’s capabilities list is inspired by Rawls primary goods, however, she also includes topics, which Rawls categorized as natural primary goods.30 Human rights should be considered combined capabilities. This explains why individuals cannot access some rights and freedoms, such as freedom of religion, as long as they only exist on paper.
The right or freedom first becomes real once actions are implemented, which make individuals capable of exercising those rights. E.g. in many countries women have the formal right to take part in political processes but become targets of violence as soon as they become part of the public space.31
28 Nussbaum, 2010, pp. 106-110
29 Nussbaum, 2010, pp. 113-115
30 Nussbaum, 2010, pp. 116-119
31 Nussbaum, 2010, pp. 127- 129
Nussbaum’s feminist approach is based on cross-cultural norms concerning justice, equality and human rights. At the same time it aims to be sensitive to local particularities, to include individual preferences and perceptions. Universal feminism need not be insensitive to cultural differences.32 The capabilities approach aims to achieve cross- national comparisons and to develop cross-cultural categories. Any theory with its origins in one culture, used to describe and classify the reality of another culture, is problematic, particularly if the described culture has been colonised and repressed by the describing culture. Nevertheless, individuals, typically female feminists, from low- and middle-income countries are often accused of running errands for the West and betraying their own culture if they promote democracy and human rights. Questioning why feminists are being accused of this and who gains from defining them as traitors is important.33 This argument holds legitimacy, however, there is another side to the story as well. Feminists from the global south frequently criticise white and Western feminists for not including them in the portrayal of womanhood. This phenomenon is explained more thoroughly in 2.2 intersectionality.
Moreover, Nussbaum does not elaborate on the possibility that other factors than gender can have equal and sometimes greater impact on women’s lives. Just like governments should take gender inequality into consideration, they must tackle intragroup inequality. The scholar, however, pays very limited attention to this issue.
Nussbaum argues that the capabilities approach creates an overlapping consensus and that individuals with otherwise widely opposing values can agree that everyone should have access to her specific list of capabilities. When examining the list more thoroughly this argument can be contested. Nussbaum supports women’s reproductive health including, e.g. the right of every woman to decide when and with whom to have sexual relations. This is one of the many topics included in the definition of reproductive health, constantly questioned and fought from various directions. It cannot be argued that there is an overlapping consensus regarding these kinds of capabilities. The universality of the approach can thus be contested.
2.1.2.a Nussbaum’s response to critique of the capabilities approach
The cultural argument emphasises that traditional values should be respected and that the Western way of life does not make women happy. Nussbaum emphasises that the capabilities approach is not contrary to traditional values and women are free to lead such lives as long as
32 Nussbaum, 2010, pp. 23-26
33 Nussbaum, 2010, pp. 58-61
they have the freedom to make particular economical and political choices. As long as women have access to certain capabilities, they are free to choose the kind of life they wish to lead.
Another argument, that of diversity, claims each culture to have its value and beauty and that the fact that there are many unique cultures with a unique set of values enriches our world.
However, cultural aspects often repress individuals and whether or not they should be preserved should be questioned.34 Finally, the paternalistic argument emphasises that individual freedom of action is not fully respected under universal norms. This worldview is based on the belief that individuals know what is good for them and that not letting them act in accordance with their wishes would be equal to treating them like children. Universalism can, nonetheless, be based on respect for individual freedom and choice. Values such as freedom of religion, freedom of associations, etc. are important universal principles, protecting people against individuals who do not wish to let them make their own decisions.
The fact that various contemporary political systems are extremely paternalistic towards women, as they do not treat them as equals to men in regards to e.g. freedom of speech, property rights and the right to work, should be emphasised. Even great critics of paternalism, such as John Stuart Mill, have accepted some state control in order to protect individuals against harmful actions from other individuals. Freedom is more than rights on paper and requires tangible and institutional resources. The demands of females must be considered legitimate in the eyes of the law and citizens. Any state aiming to realise fundamental rights for its citizens must consider how to divide its resources. E.g. higher taxes may be necessary to improve the schooling system. It could be argued that this imposes more paternalism on individuals. At the same time it can hardly be argued that today e.g. poor children in rural communities have the freedom to live as they please.35
2.2 Intersectionality
2.2.1 The intersectional approach
Intersectionality provides a frame to study diversity without loosing sight of gender inequality. The concept originates from the word intersect and describes how different asymmetries of power intersect – are interconnected. Categories often included are gender, ethnicity, class, sexuality and age. However, the different categories of oppression cannot simply be added on top of each other. An additive understanding studies different power axes but neglects the interagency of power relations. Intersectionality instead highlights how
34 Nussbaum, 2010, pp. 65-75
35 Nussbaum, 2010, pp. 77-81
different power relations are intertwined through dynamic interaction, how this leads to a mutual construction of different power axes and creates specific kinds of oppression. E.g.
when Serbian soldiers raped Bosnian women during the Yugoslavian war, the women were raped because of their gender, ethnicity and nationality. The different dimensions cannot be separated, as the women were not violated because of one single identity.36
Social divisions are interconnected but not reducible to each other. Individuals are not scattered randomly on the axis of power, however, being racialized or being a woman is not another way of being working class. As aspects such as gender, ethnicity and class affect more people globally than caste membership or refugee status but the latter generally are crucial to those affected, social power axes rather than social identities should be emphasised. Social divisions influence people in the way they experience their daily lives. It affects how they experience inclusion, exclusion, discrimination, disadvantage and specific identities. Not only does it affect how individuals define themselves and their communities but it also shapes attitudes and prejudices towards others.
Divisions including gender and ethnicity are often considered in a similar manner. They are all classified as natural, originating from biological differences, different gene pools of intelligence and characteristics. These naturalising tendencies can have different characters within different cultures. Nonetheless, naturalisation has a strong tendency to homogenise groups and to attribute certain characteristics to specific groups. Such characteristics are then often used to include or exclude and to create a boundary between them and us in order to emphasise what is normal, who is entitled to certain resources and who is not. In this way social divisions are used to create hierarchies, which determine access to resources, including economic, political and cultural resources.37 Patricia Hill Collins emphasises that intersectionality analyses interconnected macro level systems of oppression.
Hence, structures, power and multiplicity are studied. Patriarchy and white supremacy share the ideology of essential difference, hierarchy and exploitation of labour.38 The social construction of gender is thus interconnected with other social hierarchies on an individual level as well as on a structural and institutional level, where gender, class and ethnicity are an integral part of economic, political and cultural institutions.39
36 Lykke, 2003, p. 48
37 Berger & Guidroz, 2010, pp. 44-55
38 Berger & Guidroz, 2010, pp. 100-105
39 Berger & Guidroz, 2010, p. 158
An intersectional analysis should always focus on specific power structures.
Therefore, instead of focusing on what intersectionality is attention should be paid to what intersectionality does. This approach to intersectionality is a work-in-progress understanding, which does not only provide an understanding of where the approach is already working but also visualises which other structures and power relations intersectionality could be applied to. Hence, intersectionality is not locked to any particular social divisions.40
The concept of intersectionality rose from a disappointment among feminists of colour with dominant feminism, which they considered an ethnocentric and homogenising way of describing women and their lives. This, they argue, makes the power asymmetry within the category women invisible and marginalises the experiences of some women. These non-white and non-Western feminist scholars, including Chandra Talpade Mohanty, Patricia Hill Collins and Kimberlé Crenshaw, emphasise that the identity of womanhood is not always the strongest identity for women who lack e.g. class privileges or the privilege of whiteness.
Mohanty highlights that non-white and non-Western women often are defined as a homogenous group of victims or the other.41 The concept of intersectionality was defined in the late 1980s. Nonetheless, the awareness of interacting oppression can be traced back to the women’s movement in the 19th century and their cooperation with the anti-slave movement, focusing on the relation between ethnicity and gender. Socialist feminist movements from the early 20th century focused on the interaction of gender and class. In Europe, socialist and Marxist feminism was dominant during the 1970s, explaining why great attention was paid to gender and class. Finally, during the UN’s World conference against racism, racial discrimination, xenophobia and related intolerance in Durban 2001, several feminist NGO- activists raised the concept of intersectionality.42
Intersectionality is on the line between postmodern feminist theory, postcolonial theory, black feminism and queer-theory. In North America, intersectionality has focused on gender and ethnicity, however, class and sexuality are often included. Crenshaw categorises intersectionality into structural and political intersectionality. She describes structural intersectionality as the way different social division, e.g. gender and ethnicity are intertwined.
Political intersectionality instead describes how these power asymmetries should be fought by using the same multiple principles. Marion Iris Young uses the expression seriality to describe societal collective, sharing some structural conditions without necessarily sharing a
40 Carbado, William Crenshaw, Mays & Tomlinson, 2013, pp. 304-306
41 Gunnarsson, 2011, pp. 25-26
42 Lykke, 2005, pp. 8-9
