Almost one year has passed since the Supreme Court of the United States (SCOTUS) overturned both Roe v Wade and Casey v Planned Parenthood which had codified the right of abortion on a national level; thereby sending decisions on the right to abortion back to the states. The right of bodily autonomy is one of the most basic fundamental human rights; if one does not have this right (or the right of property in one’s own body) that means that we are less than human in civil society. The elimination of this right for women combined with the wide-ranging attack against trans people and non-binary people undermines our legal recognition as human beings with basic rights and it is a vicious tool in the hands of people hell bent on ensuring that our traditional dualistic roles are maintained in our societies even as more people reject them. This is a dangerous reactionary resurgence and quite honestly, the divisions and lack of solidarity between oppressed people only facilitates the attacks on all. Solidarity for those under attack and between those facing attack is the least that we can expect.
This year has seen a continued attack on the right to choose in various states controlled by the right, as well as the codification of abortion right in other states controlled by the Democratic Party. As was the case before the overturn of Roe and Casey, where state laws were passed in the hope of overturning Roe, right-wing politicians continue to push restrictions on access either banning abortion completely or rolling it back to the supposed “foetal heartbeat” restrictions (around 6 weeks). However, there has been little done at the national level to protect the right to abortion. The Hyde Amendment which places limits on federal money used for the purposes of abortion still stands as a rider to all government spending legislation and this impacts those that directly receive medical help from the federal government like military personnel, government employees and Native Americans.
The world-wide political shift to the right has led to attacks against the bodily autonomy of women and LGBT+ people alongside of rising racism in many countries, especially against migrants and refugees. The use of hate to enable divide and rule is a powerful focus especially for the far right and its normalisation in mainstream politics on a world-wide level means a general attack against marginalised and oppressed people not only in countries controlled by the far-right but reflects the shift towards the right of mainstream political parties.
Unsurprisingly, the elimination of the right of bodily autonomy for those that can get pregnant has increased attacks on others fighting for recognition of their gender preference like trans people and non-binary people. As such, there are continued attacks on the right to bodily autonomy have spread to wholescale attacks on trans people accessing medical treatment and support; these attacks are often seen in the same states by the same right-wing forces not only attacking marginalised and oppressed people; but also trying to maintain strict dualist gender roles in our societies.
What we need to understand is that attacks on bodily autonomy against women and against trans people and non-binary people are part and parcel of the resurgence of the far right using divide and rule to split us. Whenever, we discuss bodily autonomy, we need to recognise that the right to choose means the right to choose, if, when and how many children we have. The right to choose is constrained by laws, by culture, by incomes and wealth; racism, disablism, homophobia and transphobia, along with misogyny are institutionalised and structural in our societies.
We must be demanding not only reproductive rights, but reproductive justice for all. Both people of colour and disabled people have faced forced sterilisation denying them their right to be parents; poverty undermines security and religion and cultural beliefs impact our choices. This means that there are vast inequalities that impact our choices and with bodily autonomy under wide-spread attack, the only coherent response is to stand in solidarity supporting the right of bodily autonomy of all people and demanding reproductive justice is part and parcel of that due to systemic racism, misogyny, disablism, transphobia and homophobia.
Continued attacks at the state level
The Guttmacher Institute has revised their estimate of the number of states expected to ban abortion from 26 states to 24 following the success of the ballot measure overturning the ban in Michigan in the mid-term elections and challenges to a previous banning attempt in January failing arising from the right to privacy stated in in South Carolina’s Constitution. Currently this leaves the right to abortion legal up 5 and ½ months while the outcome of a revised 6 week “foetal heartbeat” law that is currently awaiting a ruling from South Carolina Supreme Court (expected 27 June, 2023).
These attacks at the state level against the right to choose means that currently there are 14 states with 1.78 women, trans and non-binary people unable to access critical healthcare in their states.
According to the Guttmacher Institute:
“Drivers of inequity such as income and health insurance disparities and health provider bias (including a history of racist attempts to limit childbearing among Black and Indigenous women) are not simply the result of individual acts of discrimination but rather the result of how institutions and public infrastructures function. As a result, people in these groups are systematically denied access to quality health care and safe communities that would help them determine whether and when to become pregnant and to parent children.
Just looking at health insurance by race/ethnicity and income, for example, 23% of Latinas and 13% of Black women aged 15–49 have no health insurance, compared with 8% of White women in the same age-group. Similarly, 22% of women aged 15–49 with incomes below the federal poverty threshold have no health insurance, compared with 11% of those living with incomes above poverty.”
What we need to acknowledge and organise around is that access to health care and reproductive health care under Roe meant that access was far more limited for people of colour and those with less wealth. While many people seeking abortions were already leaving their states prior to the overturn of Roe, this has only increased as accessing surgical abortions is increasingly harder; there is no question that this impacts those that are poorer, or are in jobs that do not allow sick-days or holidays and who have little savings or wealth.
The failure of the Dems to address unequal access to general and reproductive healthcare and to actually enable the right of choice when abortion was legal has meant that the situation has not only continued by has exacerbated by the removal of Roe and Casey and the passage of laws further limiting choice; unsurprisingly those receiving welfare benefits are sometimes pressurised into taking long-term contraceptives rather than ones they would prefer.
The same inequalities that existed when abortion was legal at the federal level still exist and the elimination of Roe will only exacerbate them. As such, there is no question that people of colour are impacted in far greater numbers due to lack of access to health insurance, reproduction healthcare, healthcare discrimination against people of colour, poverty, and lack of social support to raise children such as paid holidays, access to childcare and insufficient welfare benefit levels. All of these issues impact decisions around choice and further restrict options.
There has been a wide attack on trans youth accessing gender affirming care for trans youth, Florida, Idaho, North Dakota, Alabama and Oklahoma have laws complete with felony charges for healthcare providers giving this support. Aiding and abetting includes parental support in many states. According to the Movement Advancement project, only 11 states have shield protection in place for trans youth to get support and care. These state laws specifically target trans youth getting support and assistance (both medical and surgical care), 19 states ban best practice medicine and surgical care for trans youth, and Arizona bans best practice surgical care for trans youth. DeSantis has passed wide-ranging attacks on both on abortion access as well as trans youth gender definition. These include banning access to both medicines (like puberty blockers and hormones) as well as gender affirming surgery, banning children from drag shows, not allowing use of gender preferred toilets and changing rooms in schools, government offices, and universities; laws also force teachers and school staff to not use self-defined gender pronouns. In April, the US House of Representatives passed legislation to prevent trans youth from participating in sports at federally funded schools and institutions; the same bill also banned trans people from participating in women’s sports. While not taken up at the Senate, this bill was a gratuitous attempt at exclusion of trans people and is part of a larger attack against bodily autonomy. A recent law passed in Florida not only impacts trans youth, but also something that is seen as a test case in relation to gender affirming care for trans adults that requires informed consent as well as requiring in-person visits to doctors rather than accessing medical support from nurses or through telehealth.
Despite widespread national support for accessing the right to abortion (an NPR/Marist poll say 61% support the right to abortion), state legislatures and anti-abortion groups have continued to restrict the right to abortion in many states. As such, there are wide swathes of the United States where accessing abortion is extremely difficult; this is the case for many states in the US Southeast and the Midwest where the inability to access abortion care forces those seeking support to travel out of state. While this was already the case prior to the overturn of Roe, there are now laws in place which makes it even harder, this applies not only to surgical abortions but now there are attempts to eliminate the use of Mifepristone.
Finally, since medication abortions are the most common manner that that abortions happen in the US, several states had already tried to limit people’s access to these pills. We have seen a failed attempt to revival the 1873 Comstock Act relating to sending lewd and lascivious material through the mail to prevent shipping abortion pills. This is important as mailing abortion pills within and between states has already been raised in some of the legislation like the Texas anti-abortion bill. So while this has failed at the first attempt, keep an eye out for further attempts to revive the Comstock Act as an attack on sending abortion medicine. If successful, this means that those seeking abortions would have to rely upon surgical abortions which are becoming harder to obtain in many states.
Two recent contradictory rulings have come from federal judges of the states of Texas and Washington in relation to the drug Mifepristone (used in combination withMisoprostol) for medication abortions. The Washington state court case tried to remove FDA control over Mifepristone to ease access to it raising the question whether the judiciary could rule on medicine. The federal judge in Washington state placed an injunction against any restrictions against Mifepristone.
In Texas, the attack came through a lawsuit from a lawsuit filed by the anti-abortion Alliance for Hippocratic Medicine and the Alliance Defending Freedom (whose Freedom you ask?). Trump appointed State Supreme Court Justice Kacsmaryk which upheld the allegations that the Food and Drug Administration (FDA) pushed through the availability of Mifepristone without testing its safety (despite it being used for 23 years safely) questioning the role of the FDA and the federal government in approving medicine for public use. The hope for anti-abortion activists is that this decision will become a national law further constraining abortion access. The Biden administration finally intervened along with the producers of Mifepristone (Danco) and put in an emergency request which called for a stay in stopping the use of Mifepristone which was granted by the SCOTUS. The contradictory decisions means that the SCOTUS will probably hear the cases. Given the hard right (they are not conservatives by any definition) controls the SCOTUS and they have already interfered on medical decisions, this could mean that this case will end poorly. However, if they rule against the use of Mifepristone, while this will further constrain access to abortion, it must be noted that even if the Texas decision wins, Misoprostol on its own can be used for abortion purposes.
Some Gains amidst the Losses
To end on a positive note, in several instances where either the right of privacy has been enshrined in state constitutions or the right of property exists in one’s body (e.g., Kansas) and where direct ballot measures at the mid-term elections either on legalising and strengthening abortion rights (the Michigan ban was overturned, Vermont strengthened its commitment to access), or demanding medical care for aborted foetuses that are “alive” like in Montana’s) and/or changing the state constitution to ban abortion (Kentucky), citizens have voted to reinstate or maintain abortion rights. As raised previously, right-wing controlled legislatures are trying to make it harder for ballot measures to get on the ballot and often ignore the results. The attempt to remove the ability for direct democracy in a situation where there is wide-spread gerrymandering and voter disenfranchisement not only impacts elections at the state and national level, but ensures that a minority political position can completely destroy the possibility of redressing discrimination and oppression passed by right-wing controlled legislatures.
The states that have maintained the right to abortion has not only strengthened access but often have ensured that those from other states travelling to get an abortion will be covered by state funds. On the 9th of June, Maine has not only protected access to abortion which is legal until viability (6 months), but also extended access post-viability if approved by a doctor. Late procedures happen rarely, but literally lives of pregnant people can be endangered in an emergency situation if this is not addressed. Already laws like the one in Ohio which requires attempts to “reimplant ectopic pregnancies” cause doctors worried about the law to wait until the ectopic pregnancy fails, but this clearly endangers the lives of those with an ectopic pregnancy. These laws are incredibly dangerous to the health of pregnant people who show more concern with zygotes rather than living members of their states. Closing loopholes and ensuring access in states where abortion is legal is essential to protect those seeking abortion who can travel.
It is necessary to fight against all laws that attack the right of bodily autonomy using whatever tools are available. This means using lawsuits, when possible, but also grassroots, local and state organising to support the right to choose in an atmosphere of repression and oppression. While the struggle for access continues state by state, covering costs for travel and ensuring access to medication abortions is essential and both the contributions to and support for the National Network for Abortion Funds (or local groups) must be prioritised. However, the reality is that many people cannot afford to travel and cannot take off from work and there are massive inequalities existing in the US accessing general and reproductive healthcare and the anti-abortion laws and bans which means that the burdens against access still far hardest on the most marginalised and oppressed people. Fighting for the right of bodily autonomy and reproduction justice must be a priority for all.