In 2024, thousands of transgender adolescents and pregnant people across the United States are navigating an increasingly hostile landscape when it comes to accessing the health care they need. Many have been forced out of their homes and communities to embark on harrowing journeys to obtain access to care.
When the Supreme Court overturned Roe v. Wade in 2022, states across the country quickly got to work banning access to abortion. These same states have also moved swiftly in the past two years to ban medical care for transgender adolescents. The result is that doctor-recommended medical care is out of reach for thousands of people who have become internally displaced—some temporarily, some permanently—across the country.
Instead of accessing medical care from local, trusted doctors, pregnant women and families with transgender adolescents have had their lives uprooted and their health imperiled. Politicians claiming religious and moral objections to abortion and transgender health care have placed the government between doctors and patients and the consequences are predictably dire. Since the overturning of Roe with the Dobbs decision, maternal health outcomes have worsened. In September, ProPublica reported that the deaths of at least two women in Georgia were tied directly to that state’s abortion ban.
Meanwhile, a recent study found that anti-trans laws have been associated with a 72% rise in suicide rates among trans and nonbinary youth. For many families with trans kids, the stakes are just too high to stay in their homes when the government is threatening to not only ban their children’s health care but also to potentially remove trans children from affirming homes. As one mother of a transgender daughter told USA Today in 2022, “This is a crisis…We have political refugees in the U.S., leaving with whatever they can fit in their car.” Another mom recalled deciding to leave her family’s home in Oklahoma after that state’s Republican governor was re-elected and vowed to ban medical care for transgender adolescents. For that mom, it was simple: “We were in a fight or flight situation…And we chose flight.”
Read More: Why Abortion and Trans Rights Activists Have Found Common Cause
In some sense, those who can safely flee are the lucky ones. Many people don’t have the ability to move away from home, whether temporarily or permanently, to obtain the medical care they need, which leaves trans youth suffering and pregnant people forced to carry unwanted pregnancies to term. For others, the process of fleeing home for care can itself increase the risk of catastrophic harm, as in the case of Amber Nicole Thurman, who died in her home state of Georgia after suffering rare complications from a medical abortion she began in North Carolina.
Every day, new horror stories emerge from the ever-expanding map of care restrictions. And this is just the beginning. The Supreme Court’s decision in Dobbs, overturning 50 years of precedent, claimed its reasoning was limited to the context of abortion. But in the two years since, Dobbs has been used to justify bans on health care for transgender adolescents across the country. And now, the Supreme Court is set to consider the constitutionality of these trans health care bans in the first test of Dobbs’ reach. The states defending bans on health care for trans youth claim that Dobbs grants states greater latitude to discriminate when it comes to sex-based restrictions on health care. If the Supreme Court agrees, it could open the door to even more restrictions on care—on health care for trans adults, on contraception, on IVF.
The right to self-determine our identities and control our bodies and reproductive choices is on the line. We must understand that the fight for trans justice and the fight for reproductive justice is one fight. And it is a life-or-death fight for bodily autonomy, health care, and freedom.
Chase Strangio is co-director of the ACLU’s LGBTQ & HIV Project.
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