The United States Supreme Court recently considered two important cases impacting reproductive rights and health. In Little Sisters of the Poor v. Pennsylvania, the Supreme Court is poised to decide whether employers with religious or moral objections have the right to deny people free birth control coverage under the Affordable Care Act.
Reproductive rights are critical to cisgender sexual minority women and transgender adults assigned female sex at birth. Over 48 million people of reproductive age assigned female sex at birth currently use contraceptives, including up to 3.9 million cisgender sexual minority women and transgender adults.
Research has shown that
- Unplanned pregnancies are more common among bisexual girls and among bisexual women than their heterosexual peers.
- More than one in ten (13.1%) high school girls and 6.2% of women ages 18-49 self-identify as bisexual.
- The odds of pregnancy among sexually active self-identified bisexual girls are 1.72 greater than their heterosexual high school age peers.
- Among women ages 15-44, the odds of an unwanted pregnancy are 1.75 times greater for bisexually identified women than their heterosexual peers.
- Unplanned pregnancies are also experienced by transgender people assigned female sex at birth.
- Many (63%) sexual minority and transgender young adults (ages 18-35) intend to have children, either creating or expanding their families, with over 40% considering using Assisted Reproductive Technology (ART) to do so. ART can be costly, is not covered by insurance in most states, and may only be available to couples who meet infertility criteria in those states that do mandate ART coverage.
- Poverty is more common among bisexual women, transgender people, and LGBT people of color as compared to their cisgender, heterosexual White counterparts.
- In the US, about one in three cisgender bisexual women (29.4%), transgender adults (29.4%), LGBT Black (30.8%), Latino/a (37.3%), and American Indian or Alaska Native (32.4%) adults are living in poverty. Thus, financial barriers to contraceptive access would have a disproportionate impact on these groups within the larger LGBT population and would also limit access to ART.
In June Medical Services LLC. v. Russo, the Supreme Court declared unconstitutional a Louisiana law that would have required doctors who provide abortions to have hospital admissions privileges, despite the fact that abortion is safe, people who have abortions are rarely referred from clinics to hospitals, and when they are, they are easily admitted. Had the Supreme Court decided differently, the number of clinics providing abortions in Louisiana would have decreased from three to one.
Eighty-nine restrictions on abortion have been passed in Louisiana since Roe v. Wade was decided, more than any other state. The Supreme Court’s decision will allow for the minimal provision of these services in Louisiana to continue, allowing in-state access to over one million people of reproductive age assigned female sex at birth (15-49), including an estimated 86,000 cisgender sexual minority women and transgender adults (LGT). The majority (71.2%) of these adults are cisgender bisexual women and are persons of color, including 35% who are Black and 18% who are of other diverse heritages.
More broadly, nearly 34 million people who were assigned female sex at birth and are of reproductive age, including an estimated 2.7 million cisgender sexual minority women and transgender adults, live in the 21 states that require doctors to have admissions privileges at local hospitals (Missouri, North Dakota); have enacted admitting privileges that are not currently in effect (Alabama, Arkansas, Kansas, Louisiana, Mississippi, Oklahoma, Tennessee, Texas, Wisconsin); or live in states with a governor and legislature opposed to abortion (Arizona, Florida, Georgia, Indiana, Iowa, Michigan, Ohio, South Carolina, South Dakota, West Virginia).