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LGBTQ Policy Journal

Topic / Gender, Race and Identity

Reproductive Justice Is an LGBTQ Issue

In fall 2012, my colleague and I interviewed more than a dozen law students for summer clerkships at our organization, the  National Center for Lesbian Rights. When a student learned that I was a Reproductive Justice Fellow at a LGBTQ organization, she asked for my advice on a situation at her law school. She was trying to start a chapter of Law Students for Reproductive Justice, and her efforts were being blocked by the administration. Seeking support from the campus LGBTQ student organization, she was rebuffed by one of the leaders who told her, “These are not our issues.”

The emergence of the reproductive justice movement over the past fifteen to twenty years has both challenged and revitalized reproductive rights advocacy and activism in the United States. Emphasizing the needs of low-income women and women of color, the movement was developed to address the abortion-centric framework of traditional reproductive rights advocacy. This traditional framework was sorely inadequate in understanding the intersection of race, class, and sexuality in reproduction and access to health care. The new conceptual framework — reproductive justice — answered this inadequacy by calling for multi-issue analysis and organizing across the thread of reproduction: from contraceptive equity to abortion access to eugenics of welfare family caps to racial disparities that target poor women of color in the child welfare system.  Reproductive justice can be described in shorthand as considering all the factors that affect the right to have children, to not have children, and to parent the children we have.

Despite the emergence of the reproductive justice movement, much of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) movement has not embraced this framework to become strong advocates for reproductive rights and health. The lack of a strong alliance is reflected in the two movements’ starkly divergent trends in their legislative successes and policy achievements. For example, in 2011 and into 2012, the reproductive rights movement faced an  unprecedented number of state legislative attacks (Guttmacher Institute 2013) while the LGBTQ movement started to see success on some previously intractable issues, such as marriage equality (New York Times 2012) and legal protections for transgender people (Quinones 2012).  These divergent trends are underscored by how little organizational collaboration exists between the LGBTQ rights movement and the reproductive health and rights movement. This is despite the fact that the movements’ legal histories are intertwined and reinforcing and more puzzling in light of the considerable number of lesbians and bisexual women who have led as advocates in the reproductive health, rights, and justice movements. Standout exceptions include organizations like the National Latina Institute for Reproductive Health and Forward Together, which have integrated reproductive health issues affecting LGBTQ people into their advocacy and organizing for several years. However, the majority of the mainstream LGBTQ organizations have neglected to advocate on reproductive justice issues as stakeholders as opposed to as allies.

There are compelling reasons for the LGBTQ movement to better integrate reproductive rights and health issues into its sphere of advocacy. A true reproductive justice agenda for LGBTQ organizations should: incorporate advocacy on contraceptive equity and abortion access into LBGTQ advocacy and understand and address the specific reproductive health and rights issues facing transgender people. LGBTQ people should not have to look to another movement for advocacy on some of the most critical and sensitive issues in our lives. Instead, the LGBTQ movement should embrace those issues as an integral part of its agenda. Below are two of the main reasons why.

I.  Contraceptive Equity and Abortion Access Impact the LGBTQ Community

Lesbian and bisexual women are significantly impacted by battles over contraceptive equity and abortion access, and they also lead as advocates on these issues. Reproductive health issues for lesbians and bisexual women extend beyond achieving parenthood through access to adoption, second-parent adoptions, and affordable reproductive technologies. In fact, though it may seem counterintuitive, several studies have documented that young lesbians are significantly more likely to experience an unintended pregnancy than their heterosexual peers (Robson 2011). This is because LGBTQ youth are particularly vulnerable to the inadequacies of abstinence-only sex education, sexual abuse, substance abuse, and homelessness and are disproportionately both victims of sex trafficking and involved in sex work. Researchers have also suggested that heterosexist surveillance and harassment may lead young lesbians and bisexual girls to have unprotected heterosexual sex to mask their sexuality. An unintended pregnancy rate so disproportionately high places access to contraception, emergency contraception, and abortion care directly within the orbit of reproductive rights and health issues facing lesbian and bisexual women.

Moreover, for women in the LGBTQ community, the connection between these two movements is not simply theoretical. Lesbians and bisexual women are leaders and staff in major reproductive rights organizations, organizers of clinic defense against anti-abortion protesters, and volunteers for abortion funds. What accounts for the considerable number of lesbians and bisexual women leading on these controversial issues? This may have grown from the professional opportunities for social justice advocacy available to white lesbians and bisexual women in the 1970s and 1980s when the women’s rights movement was well developed and the LGBTQ movement was not. In addition, advocates like myself view lesbians and women exercising their abortion rights as parallel forces of resistance to rigid feminine gender roles. As legal scholar Ruthann Robson pointed out:

Lesbians and women who have abortions share the mantle of women-who-would-be-independent-from-men: they have their rhetorical culmination in the lesbian as “man-hater” and the selfish “mother” aborting “male fetuses.” Such rhetoric contributes to sexual rights advocates and reproductive rights advocates distancing ourselves from the most radical implications of our theorizing. In such theorizing, lesbians have a stake in the reproductive rights of all women. (Robson 2010)

This has been more fully embraced in the reproductive justice movement than in the LGBTQ movement. The reproductive justice movement has affirmatively provided professional opportunities and organizing space for lesbian and bisexual women of color, as demonstrated most recently by the powerful campaign campaign by Strong Families, centering the voices of LGBTQ people of color, and celebrating and making visible their histories of resistance on the recent fortieth anniversary of Roe v. Wade.

II.  Reproductive Health Needs of Transgender People Must Be Addressed

Transgender people face unique barriers to reproductive justice,  as set forth in this fact sheet by the National Center for Transgender Equality (National Center for Transgender Equality 2012). Alarmingly, many transgender people report being denied health care by providers outright. In national surveys, such as by the National Gay and Lesbian Task Force (2011), somewhere between 19 to 27 percent of transgender people report having this experience. With regard to reproductive health, some transgender men who have sex with men report being more concerned about unintended pregnancy than sexually transmitted infections (National Center for Transgender Equality 2012). Moreover, surveys have revealed that as many as half of trans men respondents did not obtain an annual pelvic exam for reasons ranging from past experiences with (or anticipation of) mistreatment, misinformation, discomfort with the gendered nature of this care, or lack of financial resources (National Center for Transgender Equality 2012). For these reasons, our LGBTQ and reproductive movements should be working together to rethink how reproductive health care is conceptualized. This includes everything from questioning the inclusiveness of the phrase “war on women” to ensuring that women’s health centers are — in name and in fact — welcoming to transgender people.

Lastly, requirements that people undergo sex reassignment surgery before being allowed to change the gender marker on driver’s licenses or birth certificates essentially requires that they be sterilized in order to obtain accurate identification documents (Spade 2008; WPATH 2011). While fertility may not be at the forefront of someone’s mind when seeking to obtain sex reassignment surgery or accurate identification documents, the consequences of sterilization requirements are far-reaching and may be irreversible. Given that such consequences may only be circumvented by expensive fertility preservation measures, this is an issue that significantly impacts low-income transgender people who are disproportionately people of color. Given the history of how states have carried out coerced sterilization against marginalized women of color and people with disabilities, this situation should be a profound reproductive justice concern for LGBTQ advocates (Mustufa 2011).

Reproductive justice issues are “our issues.” We cannot abandon our vulnerable LGBTQ community members in this peak climate of attacks on reproductive freedom. LGBTQ people have reproductive health needs and rights outside the scope of securing parenthood. Many of these reproductive health issues disproportionately impact young people, low-income people, and people of color. Therefore, it is no surprise that organizations with a strong race and class analysis in their work, like the National Latina Institute for Reproductive Health and Forward Together, have embraced this intersectionality. The LGBTQ movement would greatly benefit from following their lead.

Thank you to my colleagues Maya Rupert, Connie Utada, Ashland Johnson, and Elizabeth Chen for discussions and feedback that contributed to this commentary.

Asian Communities for Reproductive Justice. n.d. What is reproductive justice? Web page.
Guttmacher Institute. 2013. 2012 saw second-highest number of abortion restrictions ever, 2 January.
Mustufa, Asraa. 2011. North Carolina confronts the ugly past of its eugenics law. Color Lines, 15 June.
National Center for Transgender Equality. 2012. Transgender sexual and reproductive health: Unmet needs and barriers to care. Fact sheet, Washington, DC.
National Gay and Lesbian Task Force. 2011. Injustice at every turn: A report of the National Transgender Discrimination Survey.
New York Times. 2012. A big leap for marriage equality. New York Times Opinion Pages, 7 November. n.d. Racism at the root of racial imbalance in child welfare. Beyond Foster Care Web page.
Quinones, Sam. 2012. EEOC rules job protections also apply to transgender people. Los Angeles Times, 25 April.
Robson, Ruthann. 2010. From page to practice: Theorizing lesbians and abortion. Law Students for Reproductive Justice RepoRepro blog, 4 February.
———. 2011. Abortion rights are lesbian rights: Op-ed. She Wired, 19 May.
Romero, Diana, and Liza Fuentes. 2010. The welfare family cap policy: Fertility restriction as poverty prevention. Population and Development Program, Hampshire College.
Spade, Dean. 2008. Documenting gender. Hastings Law Journal 59:731.
World Professional Association for Transgender Health (WPATH). 2011. Standards of care for the health of transsexual, transgender, and gender nonconforming people. Seventh version.