LGBTQ+ Advocates and Healthcare Providers Building a Diverse and Accessible Future
Young Activists Share their Efforts in Breaking Barriers and Promoting Reproductive Health Equity
Reproductive health has been a trending topic for years. However, this issue is very real for those experiencing fear and a lack of control over their own reproductive health choices, including those in the LGBTQIAS2+ community. While access to reproductive healthcare continues to be a significant problem across the country, there is hope for the future. Healthcare providers and advocates are working to ensure reproductive healthcare and resources are accessible for everyone.
Reproductive healthcare is one of the few women-dominated STEM fields. Of student doctors matching into OB GYN residency, 82% are women. It hasn’t always been this way, though. As of 1970, women made up only 7% of gynecologists. By 2018, they made up 59% of professionals in this reproductive healthcare sector. There are a wide range of viewpoints regarding how the reproductive healthcare field should look and who patients want to see when they visit the gynecologist. However, with attacks on reproductive freedom across the country, OB GYNs have strong viewpoints about why it’s important to have diverse voices in the field.
Training to Provide Gender-Affirming Care
Samantha Glass is a family medicine doctor in Washington currently participating in a reproductive health fellowship led by Physicians for Reproductive Health. She is also training in reproductive health, which involves providing gender-affirming care, abortion, and more. “Patients are diverse, so patients need to be able to have providers that understand them.” Glass explains that being a healthcare provider goes beyond having knowledge of the medical aspects of the work and involves considering if and how the patient can access care. “You can’t, for example, recommend a medication to a patient…if that patient can’t afford it or doesn’t understand how the medication works.”
For some patients, the importance of seeing themselves in their providers goes beyond gender identity. Mollie Nisen is a queer family medicine doctor and abortion provider. She shares about one memorable experience with a young LGBTQIA2S+ patient.
“I was doing a well child exam for a tween and…I was asking this sweet kid if they had crushes on anyone yet or if they had any feelings, or if they were engaging in any sexual activity.” During the exam, the patient came out to Nisen for the first time.
“I just remember the look on their face when they said, ‘I’m scared to tell my mom I like girls,’ and I said, ‘you know, I like girls too,’” Nisen reflects. “I think just seeing the look on their face when I was able to say that to them… you can see that delight, like there’s some reflection there.”
Limiting Reproductive Rights
It’s no secret that bills limiting reproductive freedom have been being introduced across the country at alarming rates since Roe v. Wade was overturned. Abortion has been banned or restricted in 20 states as of May 2023. With so much legislation limiting reproductive freedom, healthcare professionals play a crucial role in advocating for reproductive health and ensuring patients feel safe at the doctor’s office. However, they aren’t the only ones who feel motivated to take action around this issue.
Emi Gacaj is a young advocate and the sex-ed lead for The Body Org, an organization that focuses on increasing access to sexual health products for young people. Gacaj is also a biology anthropology student and a doula. She was an integral part of founding the organization in 2021 after realizing a barrier to access for students at her school.
“I noticed a lot of students were kind of embarrassed to go into the clinic at school [and were] maybe not super comfortable interacting with an adult, asking for a Plan B or condoms.” Seeing the apprehension among her peers as a barrier to accessing sexual health products, Gacaj started to bridge the gap between students and the clinics offering these products.
“I started kind of picking out the supplies and being like, ‘Hey, you need something? I’ll be in the bathroom at this time, come get some.’” By eliminating the need for students to go into clinics to get these products, Gacaj was able to make these resources more accessible by meeting students where they’re at. “I think of myself as the condom queen,” Gacaj laughs.
Educating People on Sexual Health Products
When the pandemic hit, Gacaj brainstormed new ways to make sexual health products accessible to students and recruited a group of friends to help. “People are still having sex, people are still exploring their bodies and sexualities during the pandemic. How can I support that?” From there, The Body Org became what it is today: a collective of young people who work to increase education and access to reproductive health resources. People can now order products online and get them shipped for free.
The Body Org’s work is an important step forward in making sex education and sexual health resources accessible to young people. Research shows that 80% of college women are sexually active and do not want to become pregnant. Further, Black and Hispanic women disproportionately experience unintended pregnancies.
Peer education can be highly valuable for students who struggle to access sexual health products and education elsewhere. Only 27 states require schools to teach sex education and even more concerning, only 17 states require information taught in sex ed to be medically-accurate. Even in college, there can be barriers to learning about sexual health. For example, research shows that community college students need better education about birth control.
In addition to her work with The Body Org, Gacaj also echoes the value in having a wide range of voices in the reproductive healthcare sector and further diversifying the field. “I might not want to talk to certain people about my sexual health, but somebody that looks like me, that represents me, that shares parts of my identity, that’s super impactful,” Gacaj voices. Making patients feel comfortable at the clinic is a crucial part of healthcare and can influence experiences with the healthcare system. “That can transform the way that people make those health decisions,” Gacaj states.
Having a wide range of voices in reproductive healthcare can also be a part of changing the system for the better. “I have family members that have been affected by medical racism and it was really important to me to be a different kind of provider and practitioner and not perpetuate those systemic harms,” Glass shares.
The Fight for Reproductive Justice
Both Glass and Nisen are reproductive health fellows through Physicians for Reproductive Health (PRH), an organization that helps equip doctors to advocate for reproductive justice by sharing knowledge, advocacy tools, and opportunities to use their voices. The program focuses on helping physicians engage in political and community advocacy. “With PRH, I’ve been able to talk to members of the media, I’ve been able to meet with local political representation,” Glass explains.
Glass and Nisen also say that the fellowship has helped them build community with other physicians across the country. Through the fellowship, physicians are able to share information, provide advice, and speak about their unique experiences with each other. “To be able to provide that support for each other as folks who are all going through a lot of the same stuff has been invaluable to me,” Nisen reflects.
The work of PRH is crucial. As professionals with a firsthand view of the healthcare system, the voices of healthcare providers are crucial not only in their practices and communities, but also in local and national advocacy. “A lot of physicians can feel like our job is just in the clinic or in the hospital, but as I mentioned, patients are whole individuals and they exist outside of the healthcare setting,” Glass voices. “I think it is our job to try and affect patients’ environments and communities for the better.”
As a doula, Gacaj also understands the importance of building connections with patients and understanding them and their identity. Through her training to become a doula, she learned about how to expand on what support really means in the context of patient-provider relationships. “How do you support someone in so many different ways and how do you approach things from a justice perspective? How do you include those lenses in your work so that you can truly support somebody?” Gacaj thinks about her approach as a doula.
While healthcare providers continue to advocate for accessible reproductive healthcare, young people like Gacaj are redefining what it looks like to access care and resources in a safe and comfortable way.
“Sexual health is health,” Gacaj emphasizes. She reminds people that it’s important to realize that sexual health is a crucial part of health and shouldn’t be a taboo topic. “The same way that we invest a lot of time and energy and focus on other pieces of health, sexual health is just as important, if not more important to a young person’s identity.”
Advocate for Reproductive Health Care In Your Own Community
It can feel hopeless, sad, and even violating to see and experience the impacts of limited reproductive healthcare across the country. However, leaning on community and channeling these feelings into activism is a great way to use your voice to push for change, whether you’re a doctor or patient.
For physicians, Glass recommends starting at your own clinic. “Model your personal practice and the clinical practice in which you work to a model of reproductive justice.” Glass gives examples like having a diverse provider pool and making your clinic gender-inclusive as ways to apply this approach. She also reiterates the value of physician advocacy. “Saying as an entire institution of family physicians that we support [something], that has a lot of power when it comes to legislation,” Glass states.
Nisen adds that talking to community members and partnering with local organizations are good ways to get involved. “I talk to folks about providing really good trauma-informed care…[and] being gender-inclusive with their reproductive healthcare and practice,” Nisen shares.
You don’t have to be a physician to get involved with reproductive health advocacy. Community members can start by getting involved with local initiatives and having conversations about accessible reproductive healthcare. For young people, Gacaj reminds that the change starts with you.
“You owe it to yourself to love and honor and respect the body that you live in,” Gajac states.
Gacaj emphasizes that simply learning more about your own body and being aware of community initiatives can be small but impactful ways to support reproductive health access. “For me, the start to my work was in my high school…you too can start projects [and] get involved.”
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Hailey Dickinson (she/her) is a creator passionate about using writing and digital platforms to build community, make connections, and ignite positive social change. She is a Communications Major with a social media emphasis at the University of Minnesota and will graduate in December 2023.
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