This year, we are celebrating the 45th anniversary of the landmark Supreme Court decision Roe v. Wade, which affirmed that the Constitution protects the right to an abortion. Yet, the ability to seek out safe and affordable reproductive healthcare is still not a reality for manyinc luding many LGBTQ people, who are often left out of conversations about abortion altogether.
In the past 45 years, state and federal lawmakers have passed hundreds of new laws severely restricting abortion access. As a result, many are forced to travel long distances, take time off work, and arrange for childcare in order to get an abortion. And, in the past year, things have gotten even worse. Members of the Trump administration have enacted blanket anti-abortion policies in federal agencies and attempted to block abortion access, including for many young immigrants. The Hyde Amendment also remains in placemeaning that Medicaid dollars cannot be used to pay for abortions, and the promise of Roe remains out of reach for many low-income people throughout the country.
In the current landscape of new threats and restrictions on abortion access, LGBTQ people across the country face even more barriers when attempting to access such services. Public conversations and media coverage often frame abortion access issues as something that only affect cisgender heterosexual women. In reality, access to abortion affects individuals and families of all classes, races, religions, and also sexual orientations and gender identities. Framing abortion access too narrowly in our public discourse leads to gaps in access to affirming reproductive healthcare, where LGBTQ people can run into inaccurate assumptions about their relationships, sexual practices, or ability to get pregnant. Many medical schools fail to train their students how to treat LGBTQ patients, so doctors and healthcare systems often lack the knowledge and experience needed to provide truly inclusive and affirming care.
LGBTQ people living in the United States are significantly more likely to be uninsured, experience homelessness, and face discrimination in housing, employment, and places of public accommodation. Transgender individuals are particularly vulnerable to these experiences. At baseline, many LGBTQ individuals report facing discrimination in trying to access basic medical care.
According to a 2016 report from the National Center for Transgender Equality, one-third (33 percent) of transgender people surveyed who had seen a healthcare provider in the last year had at least one negative experience related to being transgender, such as being verbally harassed or refused treatment because of their gender identity. Additionally, nearly one-quarter ( 23 percent ) reported that they did not seek the healthcare they needed due to fear of being mistreated as a transgender person. Given that accessing the most routine healthcare is fraught with obstacles for LGBTQ individuals, it is not surprising that accessing abortionwhich remains difficult even for non-LGBTQ individualscan be nearly impossible.
To compound this, the Trump administration recently announced a new 'conscience and religious freedom' division at the Department of Health and Human Servicespaving the way for more healthcare workers to refuse to provide specific types of care, like birth control and abortion, based on their religious or conscience objections. This new division further threatens access to care for all people and puts the LGBTQ population at an increased intersectional risk, as healthcare providers can object to both a patient's identity and reproductive health requests. It has become all too common for commercial businesses to turn LGBTQ customers away because of who they are; but the consequences can be especially tragic when this discrimination occurs in the medical contextwhen someone is denied healthcare because they are LGBTQ.
In the current climate, it is critical that we all fight together for comprehensive access to reproductive healthcare for all.
Jenna Prochaska works with the ACLU of Illinois Women's and Reproductive Rights Project, which works to protect and expand access to critical healthcare services, including contraception and abortion.
Ghirlandi Guidetti works with the ACLU of Illinois LGBTQ & HIV Project, which works to achieve complete LGBTQ equality and combats discrimination for individuals living with HIV.