Keywords

abortion, gender-affirming care, human rights, social justice

 

Authors

  1. Relf, Michael V. PhD, RN, AACRN, ANEF, FAAN

Article Content

Over the last couple of years, I have watched what is going on the United States with a sense of disbelief, a sense of confusion, and a sense of anger. And even sometimes, a sense of embarrassment.

 

For me, my sense of disbelief began in earnest on January 6, 2021. I was working at home that day like so many because of the COVID-19 pandemic. I planned my lunch at the time the US Congress was scheduled to count the electoral votes. As someone who loves politics, to the best of my recollection, never in my lifetime had the counting of the electoral college votes been aired live on one of the major news channels. Instead of watching an orderly process unfold in the US Congress, I watched chaos and insurrection unfold. I was in utter disbelief watching people fight with the US Capitol Police, scale the walls of the Capitol building, break windows, and enter the building illegally. My initial disbelief grew into anger and embarrassment. How could this happen in the United States? What kind of country had we become?

 

When Roe versus Wade was overturned in June 2022, I was again in disbelief. In this situation, I was angered because this was about political ideology and not individual choice, reproductive freedom, women's rights, and human rights. Instead, this ideological warfare has focused on the right to birth and not the right to life-a full life where there is equal distribution of harm, equal opportunity, and the right for self-determination. A society where there is both social justice and equity. To me, if we as a society truly cared about the right to life, we would fully invest in preschool education, high-quality public education, and school lunch programs. We would restore home visits by public health nurses to every newborn and their family. We would guarantee that every citizen and resident of the United States has access to primary health care, fulfilling the 1978 Declaration of Alma-Ata. We would stop squabbling about Medicaid expansion and guarantee access to universal health care for all.

 

In the 2 years since Texas' abortion restrictions have been in place, there has been a loss of rights for women, and their partners, to self-determine their own decisions related to reproductive health. Instead, women are being forced to carry nonviable pregnancies unless they have financial resources to travel to another state. Women who are raped and learn they are pregnant are barred from an abortion in Texas after 6 weeks. After this time frame, they, too, must travel to another state for an abortion if they have the resources to do so. For those who have financial resources, a social determinant of health, they can obtain the care they need in another state. For those who do not, they must carry the pregnancy to term. For those with nonviable pregnancies, they are forced to continue the pregnancy and deliver the fetus that is destined to die in the hours or days after birth. As reported by Isabelle Chapman of CNN, "Texas' abortion restrictions-some of the strictest in the country-may be fueling a sudden spike in infant mortality as women are forced to carry nonviable pregnancies to term" (Chapman, 2023, first paragraph). It seems that this is a violation of Article 5 of the Universal Declaration of Human Rights which states that "no one shall be subjected to torture or to cruel, inhuman or degrading treatment" (United Nations, n.d.). To me, being forced to continue a pregnancy of a nonviable fetus or a pregnancy originating from rape seems cruel, inhuman, and degrading.

 

During the last 2 years, 20 states have enacted laws banning gender-affirming care. Transgender youths experience inequalities in violence victimization, substance use, suicide risk, mental health, and sexual risk compared with their cisgender peers (Johns et al., 2019). For this population, gender-affirming care is a path to well-being, to identity, and to life. I was in disbelief when congressperson Zooey Zephyr-a transgender lawmaker in Montana-was barred from the State House floor "a week after saying those who voted to support a ban on gender-affirming care would have blood on their hands" (Weber & Hanson, 2023). In denying youth access to gender-affirming care, it seems that politicians are yet again establishing a situation where there is cruel, inhuman, and degrading treatment. These laws are contrary to statements from the American Nurses Association, American Academy of Nursing, American Medical Association, American Academy of Pediatrics, American Psychological Association, American Psychiatric Association, and others that recognize the medical necessity and appropriateness of gender-affirming care for youth and the harmful effects of denying access to these services (Dawson et al., 2022).

 

Many who read this editorial will probably call me just another lefty liberal. Well, that is a true statement. But I am also a nurse who is committed to social justice and equity. I recognize that I have privilege as a White person and as an individual with a college education. As such, I must use my position to call out inequities and injustices. As Martin Luther King stated, "The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy." For me, we are in challenging and controversial times; times that require me to speak out and to advocate for social justice, equity, and human rights.

 

Disclosures

The authors report no real or perceived vested interests related to this article that could be construed as a conflict of interest.

 

Author Contributions

Michael V. Relf was involved with the conceptualization, writing the original draft, and review and editing.

 

References

 

Chapman I. (2023). Nearly two years after Texas' six-week abortion ban, more infants are dying. CNN Investigates. https://www.cnn.com/2023/07/20/health/texas-abortion-ban-infant-mortality-invs/i[Context Link]

 

Dawson L., Kates J., Musumeci M. (2022). Youth Access to Gender Affirming Care: The Federal and State Policy Landscape. Kaiser Family Foundation. https://www.kff.org/other/issue-brief/youth-access-to-gender-affirming-care-the-[Context Link]

 

Johns M. M., Lowry R., Andrzejewski J., Barrios L. C., Demissie Z. (2019). Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school students-19 states and large urban school districts, 2017. MMWR, 68(3), 67-71. https://doi.org/10.15585/mmwr.mm6803a3[Context Link]

 

United Nations. (n.d.). Universal Declaration of Human Rights. https://www.un.org/en/about-us/universal-declaration-of-human-rights.

 

Weber P. J., Hanson A. B. (2023). "Blood on your hands": Montana lawmaker's words not unusual. APNews. https://apnews.com/article/montana-transgender-lawmaker-zooey-zephyr-e44017dee7b[Context Link]