Amidst a global pandemic that has already claimed the lives of over 165,000 Americans and left more than 20 million unemployed, GOP politicians are still shamelessly focused on curtailing access to safe, legal, affordable abortion care. In Nebraska, Republicans have introduced a bill that would ban an abortion method that is proven to be safe. In Iowa, GOP lawmakers passed a law requiring abortion patients to make an additional, medically unnecessary appointment with an abortion provider then wait 24 hours to receive abortion care. In Tennessee, lawmakers successfully banned abortion as early as six weeks, which is before most people even know they’re pregnant (the law was blocked by a federal court 45 minutes after it was signed).
These blatant attempts to control pregnant people’s bodies and demonize a common reproductive outcome are nothing new. The United States is the only industrialized nation with a maternal mortality rate on the rise: Black mothers are three times more likely to die in childbirth, yet Republicans have paid little mind to the health care outcome of children and parents. These attacks on pregnant people are often framed as a “women’s rights” issue—and, more specifically, straight women’s rights—even though straight women are not the only people who get pregnant and have abortions. Those within the LGBTQ2 community are also systematically harmed by the continued attempts to dismantle abortion access, and, in fact, stand to face additional barriers to care as a result of their gender identity and sexuality.
“I find it hard to seek out health care in general. I’m afraid of going into these spaces where doctors hold all the power,” Nik, who is non-binary and a We Testify abortion storyteller living in Houston, Texas, tells me. During the pandemic, there was an attempt to ban abortion procedures under the guise of COVID-19 protection and preserving PPE, which was blocked, then reinstated, then blocked again. Right now, abortion access is how it was pre-COVID-19—which is to say it isn’t great, but people can still legally access abortion care. “I’ve had to sit and listen to a doctor misgender me and deadname me because she was the one who controlled my access to medication,” Nik says. “I was really afraid that I would have to tolerate mistreatment in order to get the abortion I so desperately needed.”
A study published in 2017 found that financial barriers, discrimination, lack of cultural competence by providers, as well as health systems and socioeconomic barriers keep trans people from accessing the health care they need. And a survey of 6,450 trans and non-binary people conducted by the National Gay and Lesbian Task Force and the National Center for Transgender Equality found that nearly one in five respondents have been refused health care due to their gender identity. “While no studies currently document the number of transgender men who have had a pregnancy, 22 suggest numbers of transgender individuals who are seeking family planning, fertility and pregnancy services could certainly be quite large.”
For trans and non-binary people, it isn’t just abortion bans and other anti-abortion laws that hinder their ability to seek comprehensive, compassionate, affordable reproductive health care: it’s also stigma, bigotry and ignorance.
“I cried when I scheduled my appointment [for my abortion] because I was so afraid of going into this space where I knew I was going to be misgendered,” Nik says. “It went much better than expected. No one was hostile towards me, but I could tell that not everyone was well educated on transgender issues. I had an amazing advocate in the woman who was my abortion counsellor. She tried to make sure that everyone would respect my gender.”
In addition to the anti-LGBTQ2 sentiments, another factor hindering a pregnant person’s ability to seek abortion care is the inaccurate belief (in many instances held by health-care providers) that straight women are the only people who can experience an unwanted pregnancy.
Yet a 2017 meta-analysis found that adolescent lesbian and bisexual women had higher rates of pregnancy than their heterosexual counterparts, putting them at greater risk of unwanted pregnancies than straight women. Another study found that LGBTQ2-identified youth are twice as likely to get pregnant or get somebody else pregnant as those who do not identify as queer or trans.
“I knew in my heart that continuing the pregnancy would not work for me,” Caitlin Sample, who lives in Ottawa, Ontario, and had an abortion in April of this year, tells me. “With my marriage still struggling through the hurdles of having a miscarriage, a successful pregnancy and [me] coming out as bi, there was no way we would be able to do it.”
Sample called her doctor to discuss her abortion options and was “devastated” when she was told her doctor doesn’t provide abortion care, including medication abortion (the “abortion pill”)—she would have to travel to a clinic in the midst of a global pandemic. “I then had to drive across town to a hospital to pick up a RhoGam shot because of my blood type,” Sample says. “So being processed through the hospital’s pandemic protocols was an additional stress.”
After Sample’s successful medication abortion, she says she then had to go back to the clinic for a two week follow-up, which she assumed was to check on her physical health. “But it was merely to try to get me to start taking birth control.” (Even though Mifegymiso, the abortion pill, is covered under most Canadian provincial and territorial health plans, pregnant people still struggle to access it, and there have been numerous and unnecessary barriers, including requiring an ultrasound, to getting the pill.)
These additional and often medically unnecessary trips to clinics that provide abortions are especially difficult for the 28 percent of lesbian and bisexual women who live at or below the poverty line. (Studies have shown medication abortion delivered via telehealth is extremely safe.) According to the Kaiser Family Foundation, poverty rates are higher among lesbian and bisexual women, and a reported 40 percent of the homeless youth population identify as LGBTQ+, per the Trevor Project.
Given that federal funds, such as Medicaid and Medicare, are banned from covering the cost of an abortion, the majority of abortion patients in the U.S. pay for their care out-of-pocket (in Canada, most territories and provinces cover it). In 2014, the average cost of a surgical or medication abortion at 10 weeks gestation was over USD $500. At 20 weeks, the cost was USD $1,195. And this does not include additional money spent on things, such as travel, lodging, childcare and lost wages.
The continued attacks on access to abortion care is not just a “woman’s” issue, and they do not just impact straight women. It is the LGBTQ2 community, especially Black and brown LGBTQ2 people who endure additional disparities in health and reproductive care, who are also harmed by these blatantly unconstitutional laws that aim to control a pregnant person’s body with impunity. Fighting for and standing steadfast in support of the LGBTQ2 community is to fight for abortion rights and reproductive justice; fighting for and standing steadfast in support of abortion rights and reproductive justice is to fight for the LGBTQ2 community.
“I came out later in life and only to people I really trusted to support and not invalidate me. So with them, I had no problem sharing my abortion,” Sample says. “But I guess the fact I feel I can’t share both my abortion experience and my identity as a bisexual/queer person with the majority of people in my life says something. Both are things I’m proud of, in a way. I’m proud of who I am and that I wasn’t too afraid to do what was best for me. But I’m afraid of judgement and shame from most everyone I know.”