My Body, My Rules, My Rights!

"Abortion doesn't just impact cisgender heterosexual women. Access to abortion impacts trans men. It impacts cisgender, lesbian and bisexual women. We can all get pregnant. And because of that, we deserve to have access to the full breadth of reproductive health services.”

- Mayra Hidalgo Salazar, Deputy executive director of the National LGBTQ Task Force

People of all genders should be able to make their own decisions about their bodies and the future thanks to the intersectional movements for gender justice and reproductive rights. Reproductive justice includes defending the freedom to choose one's gender identity and maintain one's bodily autonomy.

                              

We are aware that people of all genders require parental support and comprehensive reproductive health care, including access to abortion and contraception. In order to make their own medical decisions about their bodies, futures, especially their reproductive futures, transgenders frequently require access to gender affirming care. A variety of social, psychological, behavioural, and medical services are included in gender affirming care, which aims to support and uphold each person's unique gender identity. This can involve psychotherapy that is both culturally and medically appropriate or treatment like hormone therapy for trans adolescents. All of the main medical groups endorse gender affirming treatment as being medically essential. Youth now have the freedom to express themselves completely. Youth who identify as intersex require the same freedoms as other youth, but far too frequently, when they are too young to make decisions about their own futures, they are needlessly sterilised or forced to have genital surgery as newborns or young toddlers. 

All sexual minority groups who can become pregnant, with the exception of lesbians, are more likely than their straight counterparts to experience an unintended pregnancy, a teen pregnancy, or to have had an abortion, according to a 2019 study (Sexual Orientation Differences in Pregnancy and Abortion across the Lifecourse). Contrary to heterosexuals, bisexual women were three times as likely to have had an abortion. In a separate survey of trans, nonbinary, and gender nonconforming persons, it was shown that 36% of participants thought of trying to stop a pregnancy on their own, without medical assistance. The study concluded that efforts are required to provide trans people with "information on safe and effective methods of self-managed abortion and to dismantle barriers to clinical abortion care." According to the study, this "may reflect the enormous barriers to facility abortion care as well as the strong desire for privacy and autonomy in the abortion process". Furthermore, according to a Guttmacher report, several hundred transgender and nonbinary people had abortions nationwide in 2017, mostly at locations that did not offer transgender-specific medical treatment.Transgender women and men may require fertility preservation treatments, and LGBTQ persons may also require care for infertility and assisted reproductive technology. In addition, LGBTQ persons may require gender-affirming care, screening for intimate partner and sexual assault, HIV and STI testing and treatment, mammograms, Pap smears, and other reproductive cancer services.

Due to the fact that both sexual and reproductive health care and LGBTQ health concerns involve people's liberty in some of their most private decisions, they are intimately intertwined. Due to significant inequities in sexual and reproductive health care and lower health outcomes than the general population, the health care system has traditionally failed and mostly still fails the LGBTQ community.These disparities are caused by a number of obstacles in the healthcare system, including as the fragmentation of healthcare services, prejudice on the part of healthcare professionals, and insurance-related problems. All of these barriers can be compounded by racism and other intertwined oppressions.

                 

Systemic violations of their right to receive healthcare as well as barriers for LGBTQ individuals that are primarily connected to sexual and reproductive health care frequently manifest in the legal and policymaking spheres. A fragmented system, discrimination, a lack of provider training, insurance barriers, and other issues with the healthcare system's structure and operation exist at the individual level and prevent LGBTQ patients, especially those who experience multiple forms of oppression, from accessing care. Services for LGBTQ persons are frequently isolated from sexual and reproductive health care owing to structural and financing barriers as well as damaging heteronormative presumptions, which cause fragmentation throughout the healthcare system. Because clinicians believe LGBTQ persons do not require specific treatments or information, they frequently do not obtain complete sexual health counselling, testing, or care. Unfortunately, there is a lot of anti-LGBTQ prejudice in the healthcare sector. Nearly a quarter of transgender patients report delaying getting medical attention out of concern for being mistreated, and the majority of gay and transgender patients report encountering discrimination from medical staff. By presuming that LGBTQ patients are not at risk for pregnancy or STI transmission, biases jeopardise their access to contraceptive care. LGBTQ people are generally more likely to be uninsured than straight patients. In spite of having health insurance and visiting doctors who deliver adequate treatment, some patients nevertheless experience insurance denials due to gender indicators in their patient profiles. The general health of persons who endure overlapping oppressions is lower than that of those who do not. Due to their systemic marginalisation, LGBTQ persons of colour, immigrants, individuals with disabilities, and those with little income may encounter significant obstacles in accessing sexual and reproductive health care.

The field of sexual and reproductive health still needs to be improved. Innovations in service delivery, such telemedicine or app-based treatment, that have widened and sped up access to gender-affirming services should be maintained by providers. Organisations that provide sexual and reproductive health care should keep using terminology that is gender inclusive to show that they are accepting and have experience caring for LGBTQ patients. Individual healthcare providers should embrace an inclusive philosophy by providing impartial, culturally competent treatment that is grounded in a knowledge of the obstacles that further the health inequalities experienced by LGBTQ individuals.

Sexual and reproductive health care for LGBTQ persons are subject to ongoing ideological scrutiny, criticism, denial, and stigmatisation. While each faces specific difficulties, they are inextricably linked by a shared belief in bodily autonomy. Advocates for sexual and reproductive health must speak out for LGBTQ patients and make sure they get personalised treatment that takes into account their originality and distinctiveness. LGBTQ-inclusive sex education should be implemented, and state legislators and activists should support such legislation and curriculum. Advocates for reproductive justice and health should also connect with LGBTQI+ organisations and individuals to see whether they can work together to grasp shared legal issues and coordinate legal activity.

Written by-

Tannu Shree,

(Content Head, PLNC)