This November (or sooner if your state allows voting by mail), individual freedoms and public health protections are on the ballot. Sexual health is no exception. The outcome of the 2020 election will shape sexual health policy in the United States for years to come—and this disproportionately affects women, low-income households, and members of the LGBTQIA+ community.
We are voting for so much more than one old man behind a podium. In addition to the race for the presidency, politicians from the local level up through Congress pose a threat to the future of reproductive and sexual health. When researching candidates, it is important to consider their proposed platforms as well as their prior voting records to gain a sense of where they stand on specific issues.
What exactly is at stake?
First, it is helpful to understand the policy behind some of the healthcare issues at hand. It may be a good idea to further familiarize yourself with some of the policy referenced in this article:
The Affordable Care Act
Roe v. Wade
The Title X Family Planning Program
Now for the specific reproductive health issues to look out for this election:
The Right to an Abortion
Access to Birth Control
STD Testing and Treatment
LGBTQIA+ Health and Protections
These are some of the numerous issues up for grabs. To get a better sense of how each of these issues is at play in the 2020 election, let’s break them down individually.
Few Supreme Court cases studied in high school government class are as memorable and impactful to our lives as Roe v. Wade. The 1973 ruling afforded women the right to choose to have an abortion. Now, nearly five decades later, Roe v. Wade’s landmark ruling is at risk of being severely weakened, if not overturned completely.
Conservative efforts to restrict abortion are continuing despite stark opposition to public opinion. According to 2018 polls, nearly three-quarters of voters support safe and legal access to abortion. If the majority of the American public supports reproductive freedoms, why are many state laws, which facilitate widespread abortion bans, gaining traction?
The Trump-Pence administration has worked to load federal courts with conservative judges whose track records rule in favor of restricting reproductive rights and access to health care. More troubling still is that these are lifetime appointments and Trump has filled a record number of judicial seats in his first term. These appointments outlast a single presidency; they shape the judiciary branch of the US government for generations to come.
If the current administration is eager to limit a woman’s “right to choose” by seeking a ban on abortion (at such an early stage few women are aware of their pregnancy), then they must be in favor of policy for widespread and affordable access to contraception, right? Nope.
In 2019, the Trump-Pence administration undermined the Title X Family Planning Program—which affords equal access to birth control and other reproductive health services including abortion, STD screenings, and cervical cancer screenings—for low-income and otherwise marginalized communities. Two-thirds of people who receive care under Title X are people of color. By placing a “gag order” on funding to organizations that provide education or access to abortion services, the administration has deprived at-risk communities of reproductive healthcare across the board, including contraception a.k.a. “birth control.” This is in direct opposition with wisp’s mission to provide affordable access to birth control and emergency contraception—no matter who you are, where you live, or whether or not you have health coverage.
Title X has been in place for fifty years. Roe v. Wade’s ruling came just three years later. Undoing these crucial protections to women’s reproductive rights sets women’s equality back generations while disrupting the health and wellness of future generations of American women.
Despite COVID-19 illuminating the limitations of our American healthcare system, the Trump-Pence administration has doubled down on forgoing equal access to healthcare for the American public. The primary target of this attack is the Affordable Care Act (ACA) which provides 20 million Americans with health coverage. The ACA has made many strides for equitable healthcare, particularly for women. It has established protections for pre-existing conditions (like pregnancy) and made it unlawful to charge women more than men for health coverage. Since the ACA requires most health insurance plans to cover preventive services, including mammograms and contraception, dismantling the ACA is yet another step towards limiting equal access to birth control.
Like other attacks on reproductive health, targeting equitable healthcare primarily impacts already marginalized communities—people of color, women, immigrants, low-income families, youth, people with disabilities, LGBTQIA+, etc.
The Trump-Pence administration has cut funding from sex education and birth control access in schools by reallocating funds from the Teen Pregnancy Prevention Program (bipartisan legislation passed by Congress in 2010) to abstinence-only programming despite statistical evidence that abstinence-only education is ineffective at preventing pregnancy and the spread of STIs. Forgoing comprehensive sex education in favor of abstinence-only education results in increased rates of unwanted pregnancy and STD transmission.
As someone who was educated in an abstinence-only state, I can personally confirm that opting out of comprehensive sex education does not mitigate the risks of becoming sexually active. Abstinence-only education promotes shame, confusion, and poor communication practices long past adolescence, while completely ignoring the spectrum of sexual identities falling outside heterosexual marriage relations.
When it is time to vote, remember that sex education policy is ultimately determined by state legislators. Pay attention to policy from the state level down to who is running for members of the school board.
STD Testing and Treatment
Since we know a lack of comprehensive sex education leads to the rampant spread of STDs, then surely STD testing and treatment will be a priority to those pushing abstinence-only education! Think again. STD testing is one of the many reproductive health services lost as a result of the Trump administration’s Title X “gag rule” and attempts to repeal the ACA.
The impact of faulty to non-existent sex education paired with slashing reproductive healthcare facility funding and limiting access to health coverage is a recipe for public health disaster.
LGBTQIA+ Health and Protections
Remember those rights we’ve been fighting for—marriage equality, equal protection in the workplace, trans rights? Whoosh, they could be gone too. From Trump’s transgender military ban to Pence’s long history of discriminatory policy during his time as a member of Congress and as the governor of Indiana, the Trump-Pence administration has made their stance clear to the LGBTQIA+ community. We are not wanted, nor protected. To add insult to injury, two supreme court justices have raised an issue with the 2015 ruling in favor of marriage equality, inciting widespread concern that the protection may be in jeopardy of being overturned.
The Solution? Vote.
Many of these issues are interdependent. Banning abortion impacts access to birth control, a crucial component of comprehensive sex education without which people are at higher risk of contracting and transmitting STDs. Once this domino effect is set in motion, sexual health across both the country and the identity spectrum is decimated. Vote as if your life depends on it. Even if your life doesn’t, others’ do. Please, stay informed and vote.