Op-Ed: Abortion Access and Trans Health Care Are Bound Together in Texas

Rosie Jimenez, who following an illegal abortion after the passage of the Hyde Amendment, which banned public funding for the procedure.
Rosie Jimenez, who died in 1978 following an illegal abortion after the passage of the Hyde Amendment, which banned public funding for the procedure.  Jen Reel

In September, we will acknowledge the 40th anniversary of the Hyde Amendment, which has blocked federal funds from covering abortion since 1976. Abortion is the only procedure to ever be blocked from Medicaid. The policy disproportionately harms people of color, immigrants, LGBTQ folks, young people and rural communities. The Hyde Amendment is at least part of the reason that abortion funds, including Texas funds such as the Texas Equal Access Fund, exist across the United States. (And in fact, the first woman known to have died as a result of the Hyde Amendment’s restrictions on abortion access was a Texan, Rosie Jimenez.) Funds like ours attempt to make up for the injustice of the Hyde Amendment.

But now, the Hyde Amendment is on my mind again, this time for a different reason. In late August, the state of Texas, along with Nebraska, Wisconsin, and Kentucky, filed suit against the United States Department of Health and Human Services over a rule change meant to protect trans people from discrimination in health care. These states claim that including gender identity under the definition of “sex,” for purposes of anti-discrimination language, is a redefinition of the word. This, they argue, will force doctors to act contrary to their religious beliefs when providing care such as gender confirmation surgery or hormone replacement therapy for trans people.

What does this have to do with the Hyde Amendment? Federal funding bans on abortion are mentioned multiple times in the suit, and in the suit these existing statutes are used as justification for discrimination in the provision of health care for trans people. It makes sense. The Hyde Amendment is discrimination in health care against low-income people (which means that it also disproportionately impacts people of color, immigrants, and people in rural communities), and it is an example of the government blocking the ability of people to exercise their reproductive rights as granted by the Supreme Court. This lawsuit expressly highlights the ways that the movements for trans and reproductive justice intersect.

When people don’t have the lived experience to understand what it’s like to face barriers to health care, it’s easy to dismiss and misunderstand the harm such obstacles cause. That’s part of why anti-abortion lawmakers put Hyde into place, and why it has persisted. I have had a Texas legislator’s wife ask me, “Who doesn’t have $500 for an abortion?” She possibly hasn’t had the experience of living paycheck-to-paycheck, or the experience of not having private health insurance. It’s easy for her to dismiss the ways economic injustice intersects with reproductive health care access. For those who are not trans, there is a fundamental misunderstanding of what it means to be trans and how barriers to gender-affirming health care are an issue of life and death.

About 100 LGBT Texans, supporters and allies marched outside Rockwall City Hall Monday night to protest the mayor's proposal to criminalize some trans people for using public restrooms. Bathroom ordinance
About 100 LGBT Texans, supporters and allies marched outside Rockwall City Hall in May, in support of trans Texans’ access to public restrooms.  John Wright

Our state isn’t exactly known for providing access to health care generally. But this lawsuit and the continued injustice of Hyde highlight how easily the most marginalized can be pushed out and left behind. Trans people experience discrimination at every turn. A Texas judge recently blocked federal guidelines regarding schools providing access to the right bathrooms for trans students, and another federal court recently ruled that it was legal for a funeral home to fire a transgender employee because of the business owner’s religious beliefs. Meanwhile, Texas argued that it was “protecting women’s health” when it passed the abortion restrictions known as HB 2, leaving low-income, rural people hundreds of miles from the nearest abortion provider. But all the law did was block reproductive justice for low-income Texans and undocumented people. The thousands of calls to the hotlines of Texas abortion funds receive each year prove that. We expect more discriminatory anti-abortion laws to come in the 2017 legislative session.

For those of us fighting for abortion access, it is essential to see how our struggle is tied up with trans people working for justice, just as it is important for everyone whose bodily autonomy is threatened to recognize the ways in which our government has already codified discrimination.

We must support people’s ability to make their own health care decisions. Whether it’s access to abortion, access to the gender confirmation care of our trans siblings’ choosing, or access to health care in general for millions of uninsured Texans, ending Hyde is about pushing back on decades of oppression that we see reflected everywhere around us. We must support true bodily autonomy for all people.

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Nan Little Kirkpatrick is the executive director of the Texas Equal Access Fund, the abortion fund that serves the northern half of Texas.

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