Reports continue to grow worldwide about population and family planning organisations demonstrating their preference for administering women long-acting, provider-controlled contraceptives in the form of injections and implants that cannot be removed by the woman herself.
These methods seem to be especially promoted for use amongst marginalised groups in developed countries and poor women in developing countries, causing women’s groups on the ground to raise questions about health impacts and lack of consent. Disenfranchised groups such as native peoples living on Indian reservations in the United States have been targeted.
Now, it seems, it is Australia’s turn. Aboriginal girls living in third world conditions in a supposedly rich country are the latest target. Queensland Health recently admitted implanting contraceptive rods in girls as young as 12 after the practice was discovered in two Indigenous communities - Aurukun on Cape York and Woorabinda, west of Rockhampton. It has since emerged that girls in the Northern Territory are also being given the hormones.
The practice raises profound questions about the health and safety of very vulnerable girls living on society’s margins. No one in authority can say exactly how many girls have been fitted with the implant, which has significant side effects including prolonged bleeding - the main reason women abandon its use. Indigenous women suffer rates of anaemia far higher than their white sisters. Who is monitoring the girls to check on their health status?
Long-lasting contraceptive methods have a controversial history. Depo Provera is the stand-out example, its manufacturer Pfizer, facing a class action lawsuit by users who developed osteoporosis. Norplant was used for a decade in the United States but was withdrawn after lawsuits involving 50,000 women who had suffered side-effects including headaches, irregular bleeding and depression. Its successor, Jadelle, is not yet marketed in the US. Implanon has yet to generate a lawsuit. It has not been clinically tested on girls under 18.
Queensland Health acting chief health officer Linda Selvey said the implants were necessary where a girl’s decision-making process was impaired and they couldn’t make informed decisions about their sexual behaviour. However, if they can’t make informed decisions about their sexual behaviour then they are at even greater risk of coerced sex. A quick contraceptive fix does nothing to stop men who see an opportunity for easy sex with pre-teen girls who don’t comprehend the meaning of consent. In fact, it may serve to encourage them.
In January, a 52-year-old Aboriginal health worker was sentenced to three years in prison for sexually abusing two girls aged 14 and 15 in the Northern Territory. He’d taken the youngest to the local clinic to have Implanon inserted before he started sexually using her. Despite the claims of Northern Territory chief health officer Steven Skov that contraception would only be given to a girl of 12 or 13 after an in-depth interview with the girl and her family, “as well as looking at the relationship she is involved in”, that didn’t happen in this case. I doubt this is a one off.
In January, it was also reported that Queensland welfare workers were unable to find a 13-year-old Indigenous multiple-rape victim who was deaf and suffered cerebral palsy. The girl, who had three sexually transmitted infections, had been given contraceptive injections from the age of 12. She was then raped with impunity.
Of course, no one thinks pregnancy in young girls is a good thing. But this approach sets girls up to be repeatedly raped and abused because not enough is done to address the cause. Health authorities are inadvertently clearing the way for girls' bodies to be invaded by men's abuse - and by sexually transmitted infections which Implanon does not prevent.
Queensland Child Safety Minister Margaret Keech said that accessing contraception was “not always an indication that a child is being harmed or at risk of harm”. But how many 12-year-old daughters of government officials are walking around with Implanon in their arms? Do they view their own pre-teen daughters as informed sexual agents?
This is not about freedom of sexual expression. It’s about branding girls for sex.
Some have argued that Indigenous girls mature earlier. It’s more likely that, living in dysfunctional communities riddled with pornography, alcohol and violence, they are primed for sex at ages considered unacceptable in the white community. And signs of puberty are hardly an indication that a girl is emotionally ready for sex.
Early sexual activity is often a sign of sexual abuse. The first person who interfered with one of these girls set her up further abuse because of the interruption of normal healthy sexual development. Yet Queensland Health has admitted that it doesn’t report all cases of sexual abuse. Where is the duty of care to these children? A synthetic progesterone rod in shoved in their arms and that’s it? One wonders what the Child Safety Department is actually for.
Getting girls fixed up so they don’t get pregnant can actually make them more vulnerable to sexual abuse.
Justice Stephen Southwood in the Northern Territory case, commented that the abuse of young girls was prevalent in remote communities and needed to be stopped. "Young girls … are entitled to be safe and to live with their mental integrity and dignity unharmed," he said. Temporarily sterilising girls without addressing exploitation is hardly dignified.
Why are girls left so unprotected? Why aren’t they removed? Are we so inured to unrelenting reports of the sexual abuse of young Indigenous girls that we have stopped caring? Sexual victimisation has to be stopped. There needs to be an inquiry, now.
Melinda Tankard Reist is a Canberra-based writer and researcher and the author of two books: Giving Sorrow Words: Women's Stories of Grief after Abortion, and Defiant Birth: Women Who Resist Medical Eugenics (Spinifex Press). She is also a director of Women’s Forum Australia. An earlier version of this article appeared in On Line Opinion.
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