In the United States and around the world, women and girls still face incredible challenges when it comes to being treated equally to men. Here in the United States, we are currently engaged in a cultural shift in which courageous women and men are actively fighting back against misogyny. And when it comes to women's sexual and reproductive health, there is still so many battles to be won. 

In the deep conservative South, many states continue to push for laws that are oppressive and downright sexist towards women's sexual and reproductive health. But women are not standing for this. One particular Southern women's advocacy group - Healthy & Free Tennessee which is based in the The Volunteer State - is working hard to not only change laws, but to change minds. 

We had the incredible opportunity to speak with Anna Carella, who is the co-State Director of Healthy & Free Tennessee to discuss what her organization is doing to fight oppressive laws against women's reproductive and sexual health, and what it's like advocating women's sexual rights in a conservative state such as Tennessee.

Michael Payton: Tell us about healthy and free TN and the work that you are doing.

Anna Carella: Healthy and free Tennessee is a statewide coalition of about 45 groups working to promote health and sexual and reproductive freedom in Tennessee


Can you talk about some of the challenges in terms of sexual and reproductive health care at the policymaking level?


Politically, Tennessee has a conservative supermajority and policymaking is often driven by legislators’ Christian faith and their desire to impose their repressive values around sex, sexuality, and identity. As an example of the climate we’re in -- legislators last year (2016) voted to make the bible the state book, luckily vetoed by the governor.


This plays out as restrictive policies on sexual health, like only permitting abstinence-based sex education, restrictions on abortion, criminalization of HIV status.


In Tennessee we have “choose life” specialty license plates which funnels funding to anti-abortion advocacy groups like crisis pregnancy centers, but the state will not allow a similar specialty license plate for pro-choice groups.


Christians and other faith groups are not inherently anti-choice, but that is the dominant narrative and while progressive people of faith are starting to challenge that narrative (e.g. Religious Coalition for Reproductive Choice, Willie Parker) we are a little behind the curve in this political moment.

Your organization is very deliberate in indicating sexual and reproductive health justice as your main focus. Can you explain why this fight is so important, not only in TN, but for other parts of the country with similar challenges?


Women’s control over their sexual and reproductive capacities is the key element in their access to social and political power, which is why they are shamed and denied access to healthcare by those who hold power, namely men. We can’t have gender equality without women being able to control the conditions of their reproductive and sexual lives.


Many of the transphobic and homophobic policies we see in Tennessee are also rooted in misogyny and a desire to control the sexual lives of Tennesseans for the purposes of imposing harmful and misguided biblical traditions and reinforce the view of sex for reproduction only not for pleasure.


Meanwhile, women of color experience a different type of social control over their reproduction, which is rooted in racist notions of the “welfare queen,” which try to limit or punish their reproduction. “Reproductive justice” is actually something different from reproductive rights, health, or freedom, though it often used interchangeably.


Reproductive justice is a framework that was developed by Black women in the United States in the 1990s to connect other movements for social justice to the movement for reproductive rights. Reproductive justice is the fight against white supremacy and the fight for economic justice for women and parents, this is why it is so important.


And don’t forget, the United States is the only developed country with a rising maternal mortality rate, largely driven by racial disparities. unsafe abortion is one of the leading causes of maternal mortality (13%) globally. Reproductive justice is not just the fight for women’s equality but it’s the fight for women’s lives.


Being situated in a southern/conservative state, does your organization generally receive a lot of blacklash socially?


Not yet, maybe because we have only been around a few years and because we are mostly playing defense right now. Once we begin to have big wins we will be seen as more of a threat, and I’m sure we’ll hit more resistance. It was certainly a strategy to name ourselves “healthy and free” because who can disagree with health and freedom? I think Planned Parenthood absorbs most of the backlash because of their name recognition right now.


Can you talk about some of the battles Healthy and free TN has successfully fought and won?


Our biggest win so far has been defeating the “fetal assault” legislation that was introduced in 2014 which was the first of its kind in the nation. This was a law that criminalized women and pregnant people for substance use during pregnancy, which deterred women from seeking prenatal care and pushed women in labor to try to cross state lines to deliver out of fear of arrest. In Tennessee, we are lacking in treatment options for substance use disorder, especially for women with children or who are pregnant. Rather than provide support and care, the state turned to criminalization. And of course in Tennessee we have the headquarters of the world’s largest private prison company formerly Corrections Corporation of America CCA now CoreCivic, so criminalization of health and social problem is of course profitable. We are still dealing with issues like coercive sterilization of incarcerated people and targeted distribution of contraception to poor people, people of color, and people who are incarcerated, but it was a big win to be able to defeat the fetal assault law in 2016. Though Healthy and free TN was not directly involved in the fight for these, we are also happy about the recent passage of over the counter birth control and a bill that requires the state to track maternal mortality.

Tennessee is often looked at as an irrevocable politically red state, yet your organization advocates on behalf of women’s sexual and reproductive rights, LGBTQ rights, etc. Do you see any indicators on the ground that people in your state are warming to these ideas? Or is the political climate there very polarizing?


I think it’s still very polarizing. One light at the end of the tunnel is that we are seeing gains for transgender people driven by more and more children coming out as trans, even in rural Tennessee. As people’s direct experience with transgender individuals increases, it becomes harder to discriminate since they are our neighbors, friends, family. This is a win for everybody, cisgender and transgender alike, because it helps expand our notions of gender. Although again, with any success comes a backlash, so we have seen anti-transgender bathroom bills at the state level that have thankfully been defeated so far. But the fight is far from over.


As a society we often speak about sexual and reproductive health issues in political terms but we often forget the policies you advocate for affect people’s lives.


Are there any stories you can share that have particularly touched you while doing this work?


One story that sticks out from this year is Hadleigh Tweedall’s. She had a wanted pregnancy but the fetus developed abnormalities and for medical reasons she needed an abortion at 18 and ½ weeks. She had to travel to Illinois to have the procedure done. She likely could have had the procedure done at a different hospital in Tennessee, but she was told erroneously by her OBBYN at a Baptist hospital who was presumably anti-choice that she would have to go to another state and so – as she says in her own words – “On the worst day of her life, she couldn't even sleep in my own bed.” She told her story this year in front of legislators and it had no impact on the bill’s sponsor. Despite hearing her story, and that 99% of abortions occur before 20 weeks when they occur after it is often due to fetal abnormalities like in Hadleigh’s case, he made a speech saying “we need to stop elective late term abortions” and the room, which was full of right to life supporters, cheered as if they hadn’t even heard her testimony.


Do you think men have any place in the conversation regarding women’s reproductive health in terms of creating/advocating policy?


Yes absolutely. Though the conversation must be driven by people who are directly affected, men must get involved. We cannot be limited by only fighting for justice and equality when it impacts us personally. For the same reason, white people must take up the fight for racial justice and straight people must take up the fight for LGBT rights.


How can people support your organization from outside of the state?


By donating. By pushing for the funding and resourcing of southern organizations since the south is often the frontlines of the battle against injustice in this country. By paying attention to what’s happening here and amplifying the stories of people who are affected by these policies in our state. Last year we had a 20 week abortion bill pass in Tennessee and now we are seeing a similar bill in the House and Senate. As we say down here “as goes the south, so goes the nation.” People shouldn’t be asleep to the fights happening down here, because they’ll be in your backyard soon enough.

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Michael J. Payton is the Founder of

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