Supreme Court abortion ruling is a win for LGBTQ health care


The Supreme Court handed down a victory for LGBTQ people on Monday when it ruled against a Louisiana abortion restriction.

On Monday, the Supreme Court ruled 5-4 in favor of abortion access by striking down a Louisiana restriction on the procedure. If the Louisiana law had been upheld, it would have threatened to close the state's last three abortion clinics.

The decision is being celebrated as a victory by members of the LGBTQ community, who often rely on the health care providers that were threatened by the law, such as Planned Parenthood, to safely obtain affirming care. 

LGBTQ people are often left out of discussions about reproductive health care, especially abortion access. The Supreme Court's decision, as well as Justice Brett Kavanaugh's dissent, imply that only women are affected by barriers to abortion; however, trans men and nonbinary people also may have unwanted pregnancies. 

Chase Strangio, deputy director for transgender justice with the ACLU's LGBT & HIV Project, stated soon after the ruling came down, "Though it is painful that we still have to have these fights, we are relieved that the law was struck down not only for all women but also for the transgender and nonbinary people who need access to abortion care. In many communities, reproductive health care providers are one of the only sources of trans-affirming health care." 

LGBTQ equality advocates and health care experts say that striking down restrictions such as the Louisiana law helps LGBTQ people continue to access all kinds of LGBTQ-affirming health care. 

Clinics that provide abortions often provide a more welcoming environment for LGBTQ people than other health centers they may find in their area, they say. Many also provide services such hormone therapy for trans people. If abortion restrictions result in fewer clinics, LGBTQ people lose options for health care.

Dr. Bhavik Kumar, medical director of primary and trans care at Planned Parenthood Gulf Coast, which operates health care centers in Louisiana and Texas, said that if the restriction had been allowed to stand, it would have meant that even more LGBTQ people who need abortions, particularly Black and Indigenous people and other people of color, would have been left with no options at all.

Planned Parenthood centers offer a variety of health services that LGBTQ people need, including abortion and gender-affirming hormone therapy. More than 200 health centers in 31 states provide hormone therapy for trans patients, Kumar said. Planned Parenthood also provides LGBTQ health-training programs to its health centers across the United States. Without this kind of training, doctors may, in the case of many queer women, tell patients they don't need cervical cancer screenings, for example, or they may just assume patients are straight or cisgender.

"We are an essential and irreplaceable provider of hormone therapy as well as general care to trans patients, especially in areas outside of major cities where we are often the only provider doing this work," Kumar said.

He added, "For many LGBTQ+ people, especially those who are BIPOC, Planned Parenthood is often their only source of affordable, nonjudgmental, and high-quality care. Attacks on abortion and abortion providers like Planned Parenthood health centers and other clinics threaten our ability to stay open and provide essential health care to trans patients."

LGBTQ people, and particularly transgender people, say they face discrimination in health care and often struggle to find physicians who are well-trained in LGBTQ-inclusive medical care. According to a nationally representative survey conducted in 2017 by the Center for American Progress of lesbian, gay, bisexual, and queer respondents, 8% of those who visited a doctor's office in the preceding year said a doctor had refused to see them because of their actual or perceived sexual orientation, and 29% of transgender people said they had been refused care due to their actual or perceived gender.

A 2017 survey of Boston University School of Medicine students found that students' self-reported knowledge of transgender and intersex health lagged behind their knowledge of health issues affecting lesbian, bisexual, and gay people.

Cazembe Jackson, a 40-year-old Black queer trans man who had an abortion during his college years at a Planned Parenthood in Austin, Texas, welcomed the Supreme Court's ruling. "It's good news. It's the result of a lot of hard work of organizers on the ground in Louisiana," Jackson said. 

Jackson noted that some advocates leave trans men and nonbinary people out of arguments in favor of increased abortion access.

Jackson became pregnant in college after a group of men raped him, an attack he has called a "corrective" rape. Corrective rape can be defined "broadly to refer to the rape of any member of a group that does not conform to gender norms or heterosexuality when the motive of the perpetrator is to 'correct' the individual," according to an article published in the University of California, Hastings Women's Law Journal.

Jackson said that although the people leading fights for reproductive justice on the state level in the South are often queer women, there should be more recognition of the links between fights for LGBTQ equality and fights for health care access.

"We have to be fighting on all fronts. I do. I'm a Black trans man, which means I'm fighting for Black liberation too, and I'm working class, so I'm always thinking about the class analysis of what it means to access abortion as far as costs and travel and being able to get off of work," Jackson said. "I think there needs to be more conversations about abortion access and supporting abortion in the queer community and more conversations in the reproductive health world about queer and trans folks."

Although the Supreme Court's ruling comes at a critical time, as LGBTQ people endure a pandemic and widespread unemployment, the threat to their access to health care, including abortion, remains. Chief Justice John Roberts joined in striking down the Louisiana law, but his concurring opinion made it clear that states could pursue other avenues to shutting down clinics and restricting abortion care. He said in a footnote that the "validity of admitting privileges law depends on numerous factors that may differ from state to state."

"I think there's more work to do because it was a close vote and ultimately it means we can't afford four more years of Trump. We can't afford another conservative Supreme Court justice put on the bench," Jackson said.

Published with permission of The American Independent Foundation.