Once I started providing hormone therapy for transgender adults, my patients began sharing their nonbinary identities and pronouns. This shift was a first step in claiming their LGBTQ+ rights. It reminded me that those who seek reproductive care form a beautiful tapestry of identities.
People who identify as LGBTQ need healthcare that sees, hears, and respects them for who they are. This is especially true when it comes to reproductive healthcare, an area where they face significant barriers.
We hear a lot about being “pro-choice,” but that framework doesn’t cut it anymore. It’s time to go beyond choice and embrace a more inclusive, radical vision: reproductive justice.
Centering LGBTQ Rights in Abortion
The language of pro-choice often assumes abortion is a woman’s issue. But what about transgender men? What about nonbinary people?
The reality is that anyone who can become pregnant can also need an abortion. Reducing this issue to a simplistic binary ignores the lived experiences of so many—particularly those in the LGBTQ+ community.
Even the highest court in the land falls into this trap. In the Dobbs v. Jackson Women’s Health Organization decision that overturned Roe v. Wade, the majority opinion consistently uses language centering on “mothers”—a perspective that erases the realities of trans and nonbinary individuals. Justice Alito’s argument that “modern developments” like paid leave have lessened the burdens of motherhood fails to consider the profound distress and dysphoria that pregnancy can cause for some.
Imagine being a transgender man forced to carry a pregnancy to term, an experience that fundamentally conflicts with your sense of self. That’s not “choice”—that’s medical trauma.
Progress and Challenges in Inclusive Care
The medical community is slowly catching up. The American Society for Reproductive Medicine issued an Ethics Committee opinion emphasizing that transgender and nonbinary individuals have the same interests in accessing fertility services as other people. While this is progress, we’re far from achieving truly inclusive reproductive healthcare.
One of the most basic steps we can take is to change our language. Instead of defaulting to “women” when talking about pregnancy and abortion, we can use terms like “pregnant people” or “birthing people.” This simple shift acknowledges that transgender men and nonbinary people can and do get pregnant, and they deserve to be seen and supported in the reproductive healthcare system.
The Ripple Effect on LGBTQ Rights
The overturning of Roe raises serious concerns about the future of other hard-won rights, including those of the LGBTQ+ community. In his concurring opinion, Justice Thomas explicitly stated that the court should reconsider its stance on contraception and same-sex marriage. This chilling reminder highlights how attacks on one group’s rights can snowball into broader erosions of freedom.
The history of the LGBTQ+ rights movement underscores this interconnectedness. From the criminalization of homosexuality to the fight for marriage equality, systemic discrimination has consistently targeted those already vulnerable. When reproductive rights are under attack, the LGBTQ+ community often bears the brunt of it.
Discrimination in Healthcare
Discrimination against LGBTQ+ people in healthcare remains alarmingly common. A Harvard study found that nearly a sixth of LGBTQ adults have experienced discrimination in healthcare settings, and a fifth have avoided seeking care out of fear of bias.
The Dobbs decision has only intensified these anxieties, creating a climate of fear and uncertainty.
Taking Action for Inclusive Healthcare
So, what can we do to fight back and build a future where reproductive healthcare is truly just and equitable for all? Here are a few steps:
- Speak Out: Challenge harmful rhetoric in personal conversations and public spheres. Use inclusive language that reflects the diversity of experiences in the LGBTQ+ community.
- Support Organizations: Back groups like the ACLU and Human Rights Campaign that are fighting tirelessly for LGBTQ rights and reproductive access.
- Volunteer Locally: Engage with LGBTQ+ centers and reproductive health clinics to provide direct support.
- Educate Yourself and Others: Learn about the reproductive justice framework and share its principles widely.
We must show up for each other. This includes supporting independent abortion providers like me who are on the front lines, especially in states where access is most under threat. It also means having difficult conversations with friends, family, and colleagues who may not fully understand the stakes or urgency of this moment.
A Shared Vision for Justice
We won’t have true reproductive justice until we dismantle the systems of oppression that have historically silenced LGBTQ+ individuals, people of color, people with disabilities, and other vulnerable communities.
Reproductive healthcare, especially for LGBTQ+ individuals, should be grounded in compassion, inclusivity, and respect. We can create a world where everyone feels safe and supported in making the right choices for their bodies and lives.
The end of Roe v. Wade has been a devastating setback, but it has also ignited a new wave of activism and solidarity. We are seeing people from all walks of life coming together to demand a future where everyone can make decisions about their bodies, lives, and families.
We can create this world, but it will take our commitment to courage, compassion, and a relentless commitment to justice.
Are you in?
