The U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization decimated federally protected abortion rights. Writing for the majority in Dobbs, Justice Clarence Thomas also called on SCOTUS to reconsider constitutional protections for contraceptive access, same-sex marriage, and same-sex intimacy.
Like abortion, gender nonconformity subverts patriarchal control over bodies.
His opinion has prompted many to ask whether queer rights are next. Such inquiries omit the fact that trans rights already face an historic moment of backlash. During the 2022 legislative session, more than forty bills were introduced across a dozen states to restrict, prohibit, and criminalize gender-affirming care (GAC). Alabama attempted to ban hormone replacement therapy (HRT) outright. Texas ruled that child welfare agencies could investigate parents and doctors providing trans youth GAC for “child abuse.” The passage of transphobic laws governing bathrooms and participation in sports have ostracized trans youth from full participation in society. These and other extreme policies are compounding the disproportionately high levels of suicide and mental health crises among trans youth.
The state of reproductive freedom and trans rights demands upheaval. A core tenet of reproductive justice is the right to raise children in a safe and healthy environment. Bringing children into a world where their gender is both violently policed and potentially criminalized is, simply put, not safe.
Though both types of care involve separate restrictions and stigma, there is far more overlap than meets the eye. Black feminist author Audre Lorde told students in 1982 that “there is no such thing as a single-issue struggle because we do not live single-issue lives.” These words should guide advocates’ action in fighting for reproductive justice and trans liberation. By realizing the similarities between reproductive and gender-affirming health care, advocates can more effectively address the underlying issues that threaten to destabilize both.
Abortion and trans health care challenge deeply held, hegemonic beliefs about what constitutes supposedly innate gender identities and gender roles. Though many religions hold varying views on abortion and gender mutability, lawmakers have weaponized Christian rhetoric and texts to undermine both.
Despite the fact that abortion is not mentioned in the Bible (and that many Christians receive abortions and support abortion access), Christian beliefs have become synonymous with fetal personhood and the inaccurate framing of abortion as murder. Religious justifications of harsh anti-abortion laws are the product of a decades-long and concerted legislative push to demonize and outlaw abortion. This movement posits abortion as an imminent threat to the structure of the nuclear family, to the nation, and to gender conformity. Children, specifically, are invoked to enact state violence on pregnant people.
Without federal protections, access to abortion care heightens racial and income inequity.
Transgender folks, too, have long been subject to conservative Christian ire. Like abortion, gender nonconformity subverts patriarchal control over bodies. The notion that someone can determine their own gender, rather than abiding by a state and/or religious mandate, is so destabilizing that trans people’s very existence becomes interpreted as deviant. Similar to the sexual aberrance ascribed to queer people through the 1970s, gender deviancy is pathologized to foment moral panic.
Two central fears underlie this moral panic. First, there is a fear that trans people are inherently violent and will attack and/or corrupt children. This assumption rears its ugly head in many arguments against gender-neutral bathrooms and trans visibility, labeling trans adults as “pedophiles” and “groomers.”
The second iteration of transphobic panic is the belief that the very existence of trans people is violent. Children are thus understood to be corruptible to “gender ideology,” whether it be at a “drag queen story hour” or by encountering books written by queer authors.
The profit-driven U.S. health care system is ill-equipped to provide abortion and gender-affirming care (GAC). As long as the United States maintains employer-based health insurance, necessary but politicized health care is at risk. As a result, abortion and GAC face considerable access issues.
An abundance of research has shown that prior to Dobbs, Roe had symbolically—or at least functionally—fallen. Increasingly, restrictive abortions laws have forced people seeking abortions to travel long distances to access care, rendering abortion inaccessible for those who cannot take time off of work or pay for transportation and lodging.
Without federal protections, access to abortion care heightens racial and income inequity.
Corporate attempts to rectify these health care disparities fall cravenly short. Amazon is one of many companies that recently pledged up to $4,000 in travel expenses to allow employees to access abortion care. The catch? The policy only applies to employees enrolled in the company-sponsored health plan. Notably lacking from this policy are the scores of contractors, gig workers, and part-time workers who keep Amazon running. Medicaid recipients, too, are ineligible. Questions about how these benefits can be accessed remain: Could individuals face liability for disclosing their intent to terminate a pregnancy?
Amazon’s announcement does nothing to change the material conditions that restrict abortion access and perpetuate inequity. In fact, the policy escalates inequality by denying care to those who might benefit from financial support the most. Of course, Amazon and its affiliates contribute generously to anti-abortion politicians. Other companies, such as Walmart—the country’s largest private employer—fail to extend any coverage for abortion-related costs.
Employee-sponsored health care is similarly ill-equipped to deliver care to trans people seeking GAC. For example, Starbucks’s extended coverage for gender-reassignment surgery in 2012. But, corporations can easily exploit trans employee’s unique vulnerability.
A recent filing with the National Labor Relations Board reveals that Starbucks weaponized health care coverage for trans employees as a part of its anti-union crusade. The complaint alleges that Starbucks “threaten[ed] employees with loss of benefits,” including access to gender-affirming healthcare. Access to lifesaving care should not be hampered by employers, and employers should not be able to brandish health care as a labor disciplining tool.
There are multiple deliberate and well-financed campaigns to spread misinformation about abortion and gender-affirming health care, which are amplified by a digital ecosystem that is ill-equipped to counter disinformation. Consequently, both types of care are deeply misunderstood.
Rightwing Christian activists have long framed abortion as a gory, dangerous procedure. Images of bloody fetuses abound at the March for Life and on billboards across the country. Former President Donald Trump threw gas on this fire by describing abortion as a plot between “the doctor and the mother [to] determine whether or not they will execute the baby.”
Bolstering these false and misleading claims about abortion is a well-financed, nationwide, and taxpayer-supported campaign to deceive pregnant people. In 2020, anti-abortion crisis pregnancy centers—designed to mimic abortion clinics—received $4.6 million from the federal government.
GAC, too, has been unfairly maligned and deeply misunderstood, further stigmatizing care for trans youth. Media attempts to frame trans health care as a “culture war” produce the same effect. Despite being associated with widely positive outcomes, conservative lawmakers baselessly portray HRT as an entirely irreversible treatment which youth are unqualified to pursue. Particularly concerning are the misconceptions surrounding reproductive capability, which again prioritize potential life over the quality of a current one.
The overlap between abortion and trans health care is clear, and restrictions against both disproportionately impact people of color. Trans people, of course, get abortions. Wealth, ability, and citizenship mediate access to both types of care.
A world in which the state mandates strict gender conformity and controls reproductive capacity is not sustainable. Adopting a reproductive justice lens can enable advocates to build better systems of care outside of current oppressive structures.