Alturi Project Strategist

Abortion and gender-affirming care are fundamental human rights that provide safe and unrestricted medical care, enabling people to define their families and identities. Denying these rights leads to tragic consequences, curtailing people’s ability to live on their terms. Media debates aside, individual safety and freedom are the real issues at stake, allowing people to live without unnecessary restrictions.

There is an underreported and counterintuitive effect of denying abortion access: When abortion is safe, legal, and accessible, the abortion rate is typically lower. When abortion is unsafe, illegal, and inaccessible, the abortion rate is often higher. The United Nations Office of the High Commissioner for Human Rights (OHCHR) reported conclusively in 2019 that countries with “less restrictive abortion laws generally had lower abortion rates than countries with highly restrictive abortion laws.” Also underreported but perhaps not counterintuitive, in countries that protect transgender health care and the health care of the LGBTI community at large, suicide rates are commonly lower. In countries that restrict LGBTI protections, suicide rates are generally higher. This correlation repeats on a state-by-state basis in the United States: States with restrictions on gender-affirming care harm the transgender population, and CNN reported in 2023 that having “immediate access to gender-affirming hormone therapy can ease distress, depression, and suicidal thoughts for trans adults.”

North America

Within North America, the United States unfortunately leads with the highest rates of abortions and suicide. The World Population Review, 2023, reports that the U.S. has an abortion rate of 20.8 per 100,000 people, while Canada’s rate is 15.2 and Mexico’s is even lower at 0.1. While it seems counterintuitive that the U.S. is experiencing higher rates of abortion now with more significant restrictions, it is in line with what is happening in the world. The last thirty years have shown over 60 countries introducing more access to abortion, with only four countries (the U.S., El Salvador, Nicaragua, and Poland) introducing restrictions. Abortion rates are often higher in nations where abortion is illegal than in nations where it is legal. Our World in Data, 2019, reports the U.S. has a suicide rate of 15.2 per 100,000 people, while Canada’s rate is 10.3 and Mexico’s is only 5.3. Perhaps unsurprisingly, there is also a bleak relationship between restrictions to gender-affirming care and suicide rates. 

In the U.S., abortion and transgender health laws vary by state. While there is a relationship between political parties in control and current regulations, there’s also a correlation between voter participation and existing laws. Examining examples from different ends of the voter participation spectrum can help determine if there is a correlation between restricted abortion access and a lack of protective access to transgender healthcare on a state-by-state basis. Investigating two states that played pivotal roles in the last presidential election by voter participation is logical.

United States

While the general public has differing views on abortion care and transgender rights, their elected officials don’t always reflect those views. According to the Pew Research Center, in 2023, 62% of U.S. adults said abortion care should be legal in most cases, while 36% said it should be illegal in all or most cases. Similarly, regarding transgender discrimination, Pew, 2022, reports that 64% of Americans favor policies protecting transgender individuals from discrimination. On a state-by-state basis, politicians from states with higher voter turnout tend to reflect the views of their constituents more than politicians from states with lower voter turnout. The World Population Review, 2023, puts Minnesota at the highest voter turnout in 2020, with 79.57% of the voting-eligible population participating. On the lower end, Kansas had lower voter turnout, with only 65.86% of the voting-eligible population participating. 

According to The Guttmacher Institute, 2023, Minnesota has “very protective” abortion policies and access, whereas Kansas has “restrictive” abortion policies. According to the Kaiser Family Foundation (KFF), 2020, Minnesota has an abortion rate of 9.5 per 100,000, and Kansas has an abortion rate much higher at 13.4 per 100,000. 

The Movement Advancement Project (MAP), 2023, reports that Minnesota has a “shield law protecting access to transgender health care,” which offers the highest level of protection in gender-affirming care and transgender health. MAP reports that Kansas does not have a shield law protecting access to transgender health care. USA Health Rankings, 2022, says that Minnesota has a suicide rate of 13.9 per 100,000, and Kansas has a suicide rate of 19.4 per 100,000. 

Understanding Trends in the Context of Recent Changes

Drawing conclusions based on data from the U.S. has become challenging due to recent changes such as the overturn of Roe and the rise of anti-trans legislation. It takes time for trends to develop, and while the recent changes have certainly had an effect, they are not diverging from the global trends that have been in place for decades. In fact, except for the U.S. and a few other countries, the global trend is toward liberalization of abortion laws and lower abortion rates, and the movement towards transgender healthcare twists along a parallel path with abortion care.

Wealthier democracies tend to have lower abortion rates due to better access to birth control, sexual education, and reduced sexual crimes. Abortion is an LGBTI issue as it affects those who can get pregnant. Gender-affirming care is also an LGBTI issue as it promotes equal healthcare access.

A protective or restrictive twist?

Abortion and gender-affirming care share a purpose of bodily autonomy and respect and consistently twist together in the same direction of either protective or restrictive. Access to safe and unrestricted medical care is a fundamental human right that enables individuals to define their family and identity. It is crucial to recognize that people deserve the freedom to choose their paths in life without any external interference or coercion and to ensure that they can be safe and free.

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