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LGBTQ+ Healthcare Issues

The Dobbs decision, otherwise known as the court case that overturned Roe v. Wade, has resulted in confusing medical situations for many patients. On top of affecting access to abortions for straight, cisgender women, it presents heightened risks for LGBTQ+ healthcare as a whole. Flipping the switch on reproductive rights and privacy rights is a far-reaching act that makes quality care harder to find for an already underserved community.

As the fight against the Dobbs decision continues, it’s important to shed light on the full breadth of its impact. We’ll discuss specific ways that the decision can affect LGBTQ+ healthcare and offer strategies for overcoming these challenges.

How the Right to Bodily Privacy Affects LGBTQ+ Healthcare

When the original Roe v. Wade decision was made, the bodily privacy of people across the United States was protected. Now that bodily autonomy is no longer guaranteed, the LGBTQ+ community must brace itself for a potential loss of healthcare rights beyond abortions. This includes services like feminizing and masculinizing hormone therapy (particularly for transgender youth) that conservative lawmakers have been fighting against this year, as well as transition-related procedures. Without privacy, gender-affirming care may be difficult to access without documentation of sex as “proof” of gender.

As essential services for the LGBTQ+ community become more difficult to access, perhaps the most immediate effect we’ll see is eroding trust between healthcare providers and LGBTQ+ patients. When providers aren’t working in the best interest of patients — just like in cases of children and rape victims denied abortions — patients may further avoid preventative care in a community that already faces discrimination in doctor’s offices.

The Dobbs Decision Isn’t Just a Women’s Issue

While the Dobbs decision is often framed as a women's issue — specifically, one that affects cisgender women — it impacts the transgender and non-binary community just as much. All people who are capable of carrying a pregnancy to term have lost at least some ability to choose whether or not to give birth in the U.S.

For transgender and non-binary individuals, this decision comes with the added complexity of body dysmorphia. Without abortion rights, pregnant trans men and some non-binary people may be forced to see their bodies change, and be treated as women by healthcare providers and society as a result.

The Dobbs decision also opens up the possibility for government bodies to determine when life begins — and perhaps even to add legal protections for zygotes and embryos. This puts contraceptives at risk, which could make it more difficult to access gender-affirming care while getting the right contraceptives based on sex for LGBTQ+ individuals.

Overturning Reproductive Rights Puts IVF at Risk

Queer couples that dream of having their own children often have limited options beyond adoption. One such option is in vitro fertilization, or IVF, which involves implanting a fertilized egg into a uterus.

While IVF isn’t directly affected by the Dobbs decision, it could fall into a legal gray area depending on when states determine that life begins. Texas, for example, is already barring abortions as early as six weeks. To reduce embryo destruction, which often occurs when patients no longer want more children, limits could be placed on the number of eggs that can be frozen at once.

Any restrictions on IVF will also affect the availability of surrogacy as an option for building a family.

How Can LGBTQ+ Individuals Overcome Healthcare Barriers?

While the Dobbs decision may primarily impact abortion rights today, its potential to worsen LGBTQ+ healthcare as a whole is jarring. So how can the community be prepared?

If you’re struggling to find LGBTQ+-friendly providers near you, using telemedicine now can be an incredibly effective way to start developing strong relationships with far-away healthcare professionals. Telemedicine eliminates the barrier of geography and can be especially helpful for accessing inclusive primary care and therapy. Be sure to check if your insurance provider covers telemedicine.

If you’re seriously concerned about healthcare access in your area — especially if the Dobbs decision affects your whole state or you need regular in-person services that may be at risk — it may be time to consider moving now. While not everyone has the privilege to do so, relocating gives you the ability to settle in areas where lawmakers better serve your needs. However, this decision shouldn’t be taken lightly, so preparing and making progress on a moving checklist now can help you avoid issues later.

The Dobbs Decision Isn’t LGBTQ+-Friendly

The Supreme Court of the United States has proven the power of its conservative majority with the overturning of Roe v. Wade. However, the effects of the Dobbs decision don’t stop at affecting cisgender women’s abortion rights. In states with bans, it also leads to forced birth for trans men and non-binary individuals. Plus, the Dobbs decision increases the risk of other rights, like hormone therapy and IVF, being taken away.

Taking steps now, whether it’s choosing a virtual provider or considering a move, can help you improve your healthcare situation in the future.

In response to a lawsuit filed by a foster youth and alumni group as well as LGBTQ service and advocacy organizations, a court has remanded and vacated a Trump-era policy permitting taxpayer-funded discrimination against people who receive services from HHS grant programs.

A federal district court on Wednesday rescinded a discriminatory Trump-era rule that prohibited the U.S. Department of Health and Human Services (HHS) from requiring that service providers in its $500 billion federal grants program not discriminate based on sex, sexual orientation, gender identity, religion, and other characteristics when providing HHS grant-funded services. Democracy Forward and Lambda Legal, along with pro bono co-counsel Cravath, Swaine, and Moore, LLP, filed a lawsuit challenging the rule in February 2021 on behalf of Facing Foster Care in Alaska, Family Equality, True Colors United, and SAGE. Wednesday’s order rescinds the rule completely and restores protections in the 2016 Rule.

Just over a week before it left power, the Trump administration finalized an unlawful rule that scrapped nondiscrimination protections, including an important clarification recognizing the Supreme Court’s marriage equality decisions. The Trump administration’s rollback of these protections left beneficiaries of and participants in federally funded programs vulnerable to discrimination on the basis of sexual orientation, gender identity, and religion. In February of 2021, HHS agreed to a court order that immediately stayed the effective date of the rule.

Vulnerable and traditionally marginalized populations — such as children in foster care, older adults, youth experiencing homelessness, and families navigating the child welfare system — have been and, under this Rule, would have been subject to discriminatory practices from taxpayer-funded service providers and programs. Such discrimination harms beneficiaries, imposes additional barriers to service, causes significant economic costs, undermines HHS’s mission to enhance the health and well-being of all Americans, and will lead to worse outcomes in HHS programs.

​“We are thrilled that the court has removed the continuing threat the presence of the discriminatory Trump-era rule posed to some of the most vulnerable members of society, including LGBTQ+ children, seniors, and people with low income, who rely on federally funded programs to meet their basic needs. Beneficiaries and participants in HHS-funded programs should have the basic expectation that they can access all services and care and do so without facing harm.” said Currey Cook, Senior Counsel and Youth in Out-Of-Home Care Project Director at Lambda Legal. “This week, the court took an important step on the heels of HHS’s acknowledgment of a flawed process that violated important procedural safeguards ensuring that comment by the public is meaningfully considered.”

“There was simply no excuse for the Trump administration’s unlawful policy sanctioning taxpayer-funded discrimination against people who receive services from HHS grant programs, including youth and families in the child welfare system, youth experiencing homelessness and older adults, among other vulnerable populations,” said Kristen Miller, Senior Counsel at Democracy Forward. “While today's victory is a step in the right direction, the Trump-era decision not to enforce the lawful 2016 rule has not yet been reversed. Lambda Legal and Democracy Forward will continue to challenge the non-enforcement policy until all persons receive the protections of the law."

Read more about the case: Facing Foster Care in Alaska v. HHS

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