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Capitalism, Classism, and Sexual Health

Capitalism, Classism, and Sexual Health

Written and researched by Tomei Kuehl
Accompanying artworks selected in partnership with Talia Cardin, Youth-facilitator to the Youth Sexual Health Program Board


 “Capitalism is defined as an economic system in which a country’s trade, industry, and profits are controlled by private companies, instead of by the people whose time and labor powers those companies.”

–  Definition provided by Teen Vogue


“Classism is the belief that a person’s social or economic station in society determines their value .”

 –  Definition provided by Merriam-Webster


In 1912, JW Williams, a professor of gynecology, published a paper, “Medical education and the midwife problem in the United States” in the Journal of the American Medical Association, recommending the elimination of the practice of midwifery. His motivation was to professionalize the medical field to increase professional standards and increase earning potential. Further the American Medical Association saw midwives as competitors for childbirth, one of the most reliable sources of hospital revenue (Merelli, 2017). This campaign was effective because midwives were largely African American and Native American women, and the United States racist history made it easy to spread suspicions of witchcraft to convince women that they would be better suited with a doctor – likely male and white – to safely deliver their child.

American physicians, who were largely white men, formed the American Medical Association and began lobbying against abortion, in part to neutralize some of the competition from midwives. Within a generation, every state had laws criminalizing abortions (Bruder, 2022).

The United States is the only country in the developed world without universal healthcare. Early attempts at universal healthcare in the United States were met with opposition from doctors, insurance companies, businesses, and some conservative labor unions who considered it unnecessary and beyond the scope of government. In 1944, Clem Whitaker and Leone Baxter – founders of the first political consulting firm – on behalf of the California Medical Association, opposed Governor Warren’s plan for compulsory health insurance in the state, paid for through Social Security (Merelli, 2017). In 1949, on behalf of the American Medical Association, Whitaker and Baxter opposed President Truman’s proposal of a public health plan (Merelli, 2017). Both of their efforts were successful and have resulted in a patchwork healthcare system based on wealth, with the lack of universal healthcare coverage impacting people of color greatest.

Sexual and reproductive health are necessary components of universal health coverage. The United Nations Sustainable Development Goals, which have been adopted by 193 countries though not the United States, includes access to sexual and reproductive health services in the definition of universal access (Guttmacher Institute, 2021). According to the Guttmacher Institute, “every dollar spent on contraceptive services beyond the current level would save $3 in the cost of maternal, newborn and abortion care…bundling sexual and reproductive health service provision offers additional cost savings – such as STI treatment, safe abortion care and safe childbirth services – and can prevent dangerous and expensive complications” (Guttmacher Institute, 2021).


Classism is a symptom of a capitalist society in which different socio and economic classes are created and valued based on those with the most wealth and capital.

During World War I, the United States government fear of sexually transmitted diseases was high because of the impact on soldiers and the war effort (i.e., soldiers would become ill and could not defeat the enemy), which resulted in the government’s involvement in disease prevention programs. Messaging for soldiers was created  that presented abstinence outside of marriage as a vehicle to upward mobility and a sign of patriotism (SIECUS). Further, soldiers were tested for STDs and praised for being venereal disease free or court martialed if found newly infected (Huber & Firmin, 2014).

The Supreme Court’s 1973 landmark decision in Roe v. Wade legalizing abortion inspired the passage of the Hyde Amendment in Congress. The Hyde Amendment blocks federal funds from being used for abortion outside of exceptions for rape, incest, or if the woman’s life is in danger due to the pregnancy, resulting in drastically limited coverage of abortion under Medicaid, Indian Health Service, Medicare, the Children’s’ Health Insurance Program, the military’s TRICARE program, federal prisons, the Peace Corps, and the Federal Employees Health Benefits Program (Salganicoff, A., Sobel, L., & Ramaswamy, A., 2021).

The 1990’s saw the development of new contraceptive methods to enhance reproductive freedom. The Food and Drug Administration approved Norplant as a contraceptive method and quickly judges and legislators attempted to mandate its use by some women. Judges leveraged their power and gave women convicted of child abuse or drug use during pregnancy the “choice” to either use Norplant or go to jail (ACLU). Several bills were introduced, though not passed, that would have offered financial incentives to women on welfare to induce them to use Norplant. Low-income women are harmed by the manipulation of their reproductive health rights within systems of power, like the courts and legislative bodies, because of classist beliefs about which bodies are valued.