Bisexual women are more likely than heterosexual women to have abortions

A lot of reproductive health messaging targets heterosexual women. They are assumed to be the default audience for information about pregnancy issues. However, people belonging to a wide range of gender identities and sexual orientations can and do experience pregnancy, parenting, and abortion. Some studies have even shown that people belonging to sexual minority groups may actually be more likely to need abortion care. 

Bisexual cisgender women are twice as likely to have an abortion compared to heterosexual cisgender women. 

In 2022, the Human Rights Campaign released a fact sheet on the impact of the repeal of Roe vs. Wade on LGBTQI+ people in the US. They used data from a national survey on reproductive health issues. 

The report shows that of those who had ever been pregnant, 15% of heterosexual women had had at least one abortion. For lesbian women, this increased to 22%, and for bisexual women, 27%. 

Lesbian and bisexual women were also more likely to report being pregnant earlier than they would like to be, and having pregnancies that were unwanted or mistimed. 

Women belonging to sexual minorities were also more likely to experience pregnancies which were a result of abuse. For heterosexual women who had been pregnant, 1% reported becoming pregnant as a result of a non-consensual encounter. For bisexual women that rose to 3%, and for lesbians, 14%. A third of all lesbians seeking abortion reported physical or sexual abuse from the person who had caused their pregnancy.

Global research shows that queer women, trans men, and non-binary people need access to inclusive abortion care. 

Though a lot of the data on this topic comes from the US, research from other countries supports the prevalence of abortion experiences for women who are not heterosexual, and trans and non-binary people who were assigned female at birth. 

A study of ‘women who have sex with women’ in Kenya found that one in seven reported ever having had an abortion.  

A study of ‘sexual and gender minority females’ in India found unwanted or unplanned pregnancies to be a common experience, suggesting that those surveyed “may not see themselves as contraceptive users and use contraception less frequently”.  

In Bolivia, SAAF grantee partner Manodiversa interviewed 168 lesbian women, bisexual women, trans men, and non-binary people with the capacity to be pregnant and found that 6 out of 10 participants had experience of abortion.  

Queer and trans people have specific challenges and needs when it comes to reproductive health care. 

Manodiversa’s research found that young trans men faced some of the biggest barriers when it came to getting access to safe abortion and reproductive health care. They fear discrimination at health centres and experience refusal of reproductive health services. Some reported being forced by their families to give birth, as part of an attempt to deny their gender identity. 

Research from the US also shows that a third of trans, non-binary and gender-expansive people who had been pregnant considered ending the pregnancy on their own without clinical supervision. 

Bisexual women are at a higher risk of experiencing intimate partner violence than other groups. And queer women around the world are still at risk of ‘corrective rape’ in some communities. 

We need tailored information and support on abortion for the LGBTQI+ community. 

We know that pregnancy and abortion are not just experienced by straight, cisgender women. In fact, gender identity and sexual orientation can play a key part in how someone becomes pregnant, and the options they have available to them when they do. It’s time global public health messaging and interventions started to recognise this. 

A number of SAAF grantee partners are working specifically on reaching queer communities with tailored information about sexual and reproductive health, including safe abortion. For example, Women Working With Women and Women Spaces Africa in Kenya, Manodiversa in Bolivia, and CREA in India. 

All of us can think about how inclusive we are when we speak about reproductive rights and health. Are we including a diverse range of people in our work? Are we tailoring interventions to make sure no person is left behind when it comes to abortion care and pregnancy support?

Ugandan researcher Joaninne Nanyange encourages us not to separate health from dismantling systems of oppression: 

“We need to center the voices and experiences of people who would normally be overlooked and ensure that questions being asked get to the root causes, not the symptoms. We need to do research on patriarchy and advocacy to dismantle it.” 

By Laura Hurley, SAAF Programme Advisor

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