Abstract
Using the case of Sexual and Reproductive Health Strategy in Aotearoa (New Zealand), this article interrogates the dominant risk discourse in sexual and reproductive health policy. It highlights the tensions between risk discourse and broader equity goals, which are increasingly seen as significant within sexual and reproductive health. Working within a poststructuralist perspective, discursive methodology is used to explore the positioning of youth in ten (10) policy documents. The analysis shows how the risk discourse, along with a developmental discourse, creates three common youth subject positions: youth as at risk and vulnerable, as not-yet citizens, and as especially vulnerable relative to other young people. It demonstrates how these positions may be associated with ‘new’ or covert forms of morality and stigmatisation. Detailing the implications for ethnic minorities in particular, it adds to prior analyses of gender- and class-based inequities. The Sexual and Reproductive Justice framework, which encompasses notions of rights and justice, is discussed as an alternative to risk-based policy development that can attend to sexual and reproductive health inequities.
Highlights
The rise of a risk discourse in public health has been well documented (Lupton, 2013; Peterson & Lupton, 2000)
We argue that the naming of specific risks in youth sexual and reproductive health policy is not a morally or ideologically neutral exercise
Our analysis concentrates on risk as the dominant discursive resource within sexual and reproductive health policy
Summary
The rise of a risk discourse in public health has been well documented (Lupton, 2013; Peterson & Lupton, 2000). Of interest within this policy is the concurrent attempt to speak to concerns regarding health inequalities, recognising that these cohere around marginalised social identities This is reflected in the Strategy’s overall vision of “Good sexual and reproductive health for all New Zealanders” In Aotearoa, growing neoliberalism led to a process of health reform that reduced public funding (e.g. of District Health Boards) and regulation of health services, resulting in greater privatisation of healthcare (Ware, Breheny, & Forster, 2016) During this time, public sexual and reproductive health specialist services have been compromised and to a large extent delegated to primary health care provider creating wide variations in availability, quality, and access to services (New Zealand Sexual Health Society, 2011). The influence of neoliberal ideology is, apparent in the policy that we review and can explain the dominance of risk discourse
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