As a college student, Rebecca Kuhns slept outside in fifteen-degree weather as a protest against sweatshop conditions. Then she finished med school.

She says that, as a black woman, she was raised to seek a prestigious careermedicine, law, academiato honor the struggles of the people who made civil rights and professional opportunity a reality. So she became a physician, though the fire for social justice she felt as an undergrad still burned. Earlier this year, she gave herself permission to bring it fully into focus. On November 26, she opened Liberation Threads, a boutique that only stocks carefully vetted fair-trade clothing, at 405A East Chapel Hill Street in Durham.

“I’m still that radical college kid at heart,” Kuhns says. “It’s just that now I have resources to channel my passions into generative endeavors and not just protest.”

At Liberation Threads, Kuhns works with brands that honor the humanity of their workers. One, Global Mamas, has the name of the woman who sewed the garment on its tag; another, Outland Denim, has a thank-you note from the seamstresses printed on the pocket label of each pair of jeans. The labor force, rather than the consumer, is the focal point, and in the store, Kuhns displays pictures of the women who crafted the collection. She is especially aware of the critical importance of maintaining the labor force’s humanity.

“My ancestors were literally the ‘property’ on which the antebellum South was built,” she says.

Kuhns’s store is just the latest ethically minded fashion entity in North Carolina. Burlington screen-printing company TS Designs aligns itself directly with the local green movement, while Echoview Fiber and Spiritex bring responsible manufacturing to western North Carolina. The Morganton-based Carolina Textile District works to pair designers with local manufacturers. In Charlotte, recycled garment company Recover Brands can make a T-shirt out of eight plastic bottles. In Durham, Spoonflower‘s digital textile printing process allows for small-batch manufacture, enabling designers to order quantities they know they will sell.

And in the Oak City, Redress Raleigh helps designers and consumers understand how to minimize the ecological and human cost of their fashion decisions. From widespread pollution to human rights abuses, the fashion industry has significant problems. The stakes are high: our climate, people’s lives.

“The industry will try to adjust to what the market wants,” says Kuhns. “We need to develop a critical mass of consumers who are willing to pay for ethically sourced goods and unwilling to pay for questionably produced items.”

Citing the Rana Plaza disaster of 2013, she calls the 1,129 workers killed in that Bangladeshi building collapse victims of “fast fashion.” Yet the owner of the building, who forced the largely female workforce back into an obviously compromised structure, wasn’t the only villain, she says; people in developed countries who drove up the desire for cheap and quick fashion are just as complicit.

“Companies that are transparent and tell the story about where their products are coming from are really important to support,” says Bill Johnston, Recover Brands’ cofounder. Redress Raleigh cofounder and executive director Beth Stewart agreesany company that’s concerned about ethics or the environment is transparent about who makes its garments and what they’re made of. Stewart mentions Patagonia as a company that excels in this regard.

Looking for the “Made in USA” tag, Kuhns says, is one way to buy ethically, because at least the U.S. has labor laws and a minimum wage. It can be exhausting, though, to hunt for American-made clothes in Southpoint Mall, and you have to wear something.

“Manufacturing is coming back to a certain extent,” Stewart says. “We don’t have gigantic companies over here for manufacturing that they have overseas, but the gigantic factories are generally not the best for everyone involved.”

Johnston is one of the people working to make fair trade and eco-friendly fashion more accessible. He grew up in Statesville, in a textile family, a textile town, and a historically textile-oriented state, but he never thought he’d go into the industry, even after graduating from N.C. State’s College of Textiles. He guided backpacking and mountaineering trips in his early twenties before realizing there was a junction between his environmentalism and his lifelong knowledge of clothing manufacture. He joined forces with textile industry veteran John Riddle, a family friend, to produce shirts made of factory scraps and recycled plastic bottles.

“People are amazed at the softness of the shirt,” Johnston says. The problem with plastic, he notes, is that it lasts forever. When it’s repurposed into T-shirt form, that problem becomes a benefit, thanks to Riddle’s manufacturing expertise, and it only gets softer with time.

Still, Johnston says he would be thrilled if single-use plastics were eliminated from the marketplace and Recover Brands had to find another material. The fashion industry is rife with unsustainable practices, and recycling is only the start. Shipping fabric from one factory to another, often internationally, increases the carbon footprint. And dyeing a single T-shirt, Johnston says, requires about seventy-five gallons of water. By making shirts out of other manufacturers’ industrial wastethe precolored scraps and clips that would otherwise end up in landfillsRecover Brands avoids dyeing and uses closer to ten gallons of water per shirt.

“Over the last eight years in the Obama administration, we’ve made tremendous strides in regulating big business to meet a lot of environmental standards,” Johnston says. Moving into a Trump administration that denies the reality of climate change concerns him. Kuhns agrees that the stakes are about to be higher in many ways. Everything from empathy and respect for diversity to environmental consciousness are actively under attack, she says, and when something of value is under attack, you need to fight to keep it. You also need to put your money where your ethics are.

“The American people have chosen materialism, ego, environmental destruction, and blatant self-interest to occupy the highest office in the land,” she says. “In times like these, there is no pretending that our choices don’t matter.”

This article appeared in print with the headline “Dress to Redress”