The intersection of multiple axes of oppression: Implications for conducting health equity research Manisha Gupte National Seminar on Health Equity: Evidence and Priorities for Research in India AMCHSS, Trivandrum, August 10-12, 2105 MG Trivandrum 2015

Veena’s story* Veena’s husband died of HIV within four years of marriage, leaving Veena HIV positive Her in-law kept Veena at home largely because of the HIV negative grandson, but also treated her well, probably out of guilt and not wanting others to know about HIV Veena had a sexual relationship with her paternal cousin 10 years later and became pregnant because he was drunk at one time, and didn’t use a condom Her paternal aunt denied her son’s involvement in the pregnancy because of a family feud and accused Veena of framing him. Veena was refused as a bride for her paternal cousin even though it is a culturally acceptable alliance in rural Maharashtra. The refusal was also because women cannot marry twice Veena was banished from her in-law’s home because of her pregnancy. Her son was kept behind by them. Veena’s sexual conduct was questioned, but not that of her cousin or her husband who gave her the HIV infection Veena couldn’t access an abortion in time because she was too scared to tell her parents about the pregnancy. She was living in an adoption agency where she was going to give up her baby, in the hope that she could reclaim her older son Her HIV positive status was bound to going against her in the court of law Veena’s older son was growing up thinking his mother abandoned him, and the younger baby was being given up for patriarchal reasons Note the multiple systems of oppression acting in complex ways to disenfranchise Veena *(Name changed – Veena was one of the narrators in my thesis) MG Trivandrum 2015

Dynamic and changing contexts Research on abortion: dynamic and changing needs; use of public and private sector, changing ‘need’ of confidentiality or near-by services How two child norm affects rights of women (maternity benefits, political participation in the PRI, access to subsidised food through the PDS). How this is gendered and located within caste and class How contraception is often, coerced but not available socio-culturally for women outside of marriage The understanding of abortion itself is contextual Campaign related to sex-determination revealed the intersectionality of issues related to reproductive rights MG Trivandrum 2015

Intersectionality (Kimberle Crenshaw, and later added upon by many feminists, especially in the context of race) Study of intersections between different groups of minorities, and specifically that of interactions of multiple systems of oppression or discrimination This multi-dimensional categorisation helps to understand how social hierarchies are created through differentiation at multiple sites “Black woman bleeding to death” at the traffic signal (exclusion by all single-identity movements) Crenshaw: Rape Laws and Race (Black women’s historical experience of rape versus contemporary campaigns led by white women to bring in a law against rape) MG Trivandrum 2015

Complex Matrix of Domination (Patirical Hill Collins) Various intersections of social inequality produce the Matrix of Domination More than addition of all inequalities. The Matrix is an “Interlocking System of Oppression” (Eg: some people having to clear more road blocks than others to reach their destination Internalisation of the oppressors’ view creates further oppression (battered wives, Muslim women, LGBT people, for example) MG Trivandrum 2015

Knowledge comes from lived realities Standpoint theory The unique world view of an individual, based on her / his location, experience and social-cultural condition – this creates a knowledge that is unique The outsider within (Eg Dalit or other subordinated women never feeling ‘insiders’ in our movements) In the early moments, subordinated people need exclusive spaces to formulate and validate their politics, after which they can influence the mainstream (EG: women’s movement now beginning to work with men). This helps to create knowledge free from the domination of the oppressors. In order to avoid victim based identity politics, the exclusive spaces have to guard from becoming exclusionary (Eg: “Men will never understand women’s issues”). The leadership must remain with subordinated groups Struggles have to be collective and must deal with multiple oppressions MG Trivandrum 2015

Conducting public health research from an intersectional feminist standpoint theory and methodology More than context; it is a way of thinking, doing and being Ethics and more are needed to grapple with feminist standpoints. (the ethics of caring, being aware of power, not being discordant in personal or professional life ) Not post-modernist in terms of justifying cultural essentialism / relativism, but understanding nuances. Learning and Unlearning are essential for the researcher Not just giving voices to subordinated groups – giving up spaces appropriated by us all this while. Research itself is contextual, power laden (example of woman jailor) It offers sites of resistance, new ways of thinking, feminist epistemologies and challenging systems of oppression, including patriarchies MG Trivandrum 2015