This past summer, two federal actions sent a similar menacing message. In Washington, D.C., the National Guard was deployed to remove unhoused people under the guise of “public safety.” Additionally, the U.S. Department of Veterans Affairs announced it will end abortion care for survivors of rape and incest, a rollback erasing even the exceptions anti-abortion lawmakers once used to claim moderation.
In both cases, the targets are punished for living outside accepted norms, and once erased from public view, their rights are stripped away entirely.
Crystal Monds
Across the U.S. and especially in the South, pregnancy is increasingly treated as probable cause. People in various stages of pregnancy or pregnancy loss can be surveilled, denied care or incarcerated. Even providers can face professional penalties.
Criminalization doesn’t only mean investigation or jail time. The system of criminalization begins with who is seen as deserving. It polices identity as much as it withholds care.
It erases people who do not fit the ideal image of motherhood. It punishes nontraditional families. Pregnant bodies are met with suspicion and hostility, especially in Black, poor, immigrant, trans or other marginalized communities.
For trans and queer people, pregnancy can trigger an added layer of surveillance and risk. In the U. S., one in five trans and nonbinary people who’ve been pregnant have attempted to end a pregnancy without clinical supervision — often due to fear of discrimination or because they’d already been turned away.
“For trans and queer people, pregnancy can trigger an added layer of surveillance and risk.”
A trans man on testosterone is significantly more likely to miss early signs of pregnancy and miss the legal window for abortion, especially in states with early abortion bans. If he attempts to manage the abortion on his own, prosecutors can misapply old laws to charge him. They don’t need explicit laws to criminalize pregnancy outcomes.
Nearly one-third of trans adults avoid care due to fear of mistreatment, and about 17% have been denied gender-affirming treatment outright. Many need to act as educators in their own appointments just to receive basic care.
I know firsthand how reproductive control of the most marginalized ripples out to put barriers on us all. I’m a queer woman planning my first pregnancy with my best friend. That path first required me to address my growing fibroids, another under-addressed reproductive issue.
I started without insurance as a lower-income person and eventually found a temporary solution to my everyday complications: Lupron. Two years later, I had to advocate to get this same medication again. Why? Because Lupron also can be used in hormone therapy for trans people. I can’t say my new insurance company knew me as queer, but I can say transphobia plays a part in hormone prescriptions being flagged for investigation.
By the time my new doctor and I pleaded, appealed and made numerous calls, my symptoms were so bad I had to settle for a different treatment, one that would later require minor surgery.
Some people don’t get that chance to fight for their care. There are at least 17 states in the country with fetal personhood laws that can delay or deny care entirely if it is seen as interfering with a pregnancy.
Earlier this year, a Georgia mother and nurse named Adriana Smith visited the emergency room knowing something was wrong. She was nine weeks pregnant, when a fetus is smaller than a grape. Instead of receiving care, she was sent home with Tylenol. The next day, she was declared brain-dead, then kept on machines until her pregnancy could survive without her.
Adriana was denied treatment due to a normalized culture of ignoring Black women’s pain in medical settings. Her story and many others are the deadly result of abortion bans and fetal personhood laws that prioritize embryos and fetuses over the health and life of the pregnant person.
“Public narratives about pregnancy and abortion prioritize a limited image: white, married, middle-class, heterosexual and cisgender.”
Public narratives about pregnancy and abortion prioritize a limited image: white, married, middle-class, heterosexual and cisgender. Our communities are far more complex. Trans men often delay or avoid routine care out of fear. Young people and queer families get sidelined in conversations about family planning. Migrant women frequently face language barriers, lack insurance or risk deportation. When people are made invisible in society and health care, their rights are easier to violate.
Pregnancy-related care remains deeply unequal, racialized and shaped by fear of punishment. Lawmakers and anti-abortion advocates often claim legal oversight of health care that protects women and saves babies. But in reality, the legal ambiguity forces providers to go against their oaths and second-guess necessary care.
As a result, pregnant people pay the price. People who already are targeted by systems of policing become even more vulnerable when pregnant. A teenager seeking an abortion, a queer couple pursuing IVF, or people parenting outside marriage are all treated as deviant and therefore punishable within our current systems.
Just as elected officials built these policies, we can dismantle them. State governments shape how pregnancy is treated in hospitals, jails and immigration facilities. Local officials make daily decisions about funding abortion access, ending medical coercion, expanding protections for queer and migrant families and improving health care standards in and out of jails. That means the solutions also are local and require our voices.
We can choose the policies that govern our communities. We can demand transparency from hospitals and all facilities that offer or claim to offer medical care. We can push for the decriminalization of pregnancy outcomes and insist that every body is free to parent or not, without fear.
Crystal E. Monds is a public voices fellow of the OpEd Project in partnership with the National Latina Institute for Reproductive Justice, the Every Page Foundation. She serves as communications and technology manager at Amplify Georgia Collaborative