REPRODUCTIVE HEALTH DIGEST (1/15/26)

Developments in Abortion, Autonomy, and Access:

Happy New Year and welcome back to the Reproductive Health Digest. We appreciate your patience while our staff was on break for the holidays. 2026 has started with no shortage of reproductive health news, and in this Digest we discuss the Wyoming Supreme Court’s decision overturning the state’s abortion ban, attempts to criminalize abortion providers and patients, continued attacks on the LGBTQ+ community, abortion restrictions on trial in Missouri, and developments in reproductive health policy. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

Legislation & Litigation:

• Overview:

• The Wyoming Supreme Court has struck down the state’s total abortion ban, affirming a constitutional right to make healthcare decisions;  

• Louisiana is seeking to extradite and criminally charge a California doctor for allegedly providing medication abortion across state lines; 

• A group of federal employees have filed suit against the federal government over the cessation of gender-affirming care coverage; 

• A Kentucky woman is facing criminal charges over an alleged abortion; 

• Abortion laws in Missouri are on trial this week, as advocates seek to vindicate MIssourians ability to access care; and 

• The Supreme Court heard oral arguments this week over the rights of transgender people to participate in sports. 

• Wyoming Supreme Court Strikes Total Abortion Ban and Affirms a  Constitutional Right to Abortion:

• On January 6th, the Wyoming Supreme Court issued a decision affirming that abortion is a constitutionally protected right in the state. Following the overturn of Roe, Wyoming passed the “Life is a Human Right Act,” a total abortion ban, as well as a medication abortion ban and a series of other restrictions on care. A group of Wyoming citizens and medical providers brought suit, arguing that the abortion ban violates Wyoming’s constitutional guarantee that every adult has the right to “make his or her own health care decisions.” 

• The constitutional amendment enshrining that right was ironically passed in 2012 in response to concerns about the passage of the Affordable Care Act and its impact on individual healthcare decisionmaking. Last week, following a years long legal battle, the Wyoming Supreme Court affirmed that, although the state has an “interest in protecting the life than an abortion would end,” it failed to “meet its burden of justifying the abortion statutes’ restrictions on a woman’s right to make her own health care decisions, as expressly protected by the Wyoming Constitution.” The decision is the first in the nation to uphold abortion rights on the basis of a constitutional right to autonomy in healthcare. 

• Louisiana Seeks to Extradite and Charge California Abortion Provider:

• Louisiana is seeking to extradite and criminally charge California Doctor Remy Coeytaux  over allegations that he provided abortion medication into the state. This is the second doctor that Louisiana has targeted - the first being New York Doctor Maggie Carpenter. Both New  York and California have robust shield laws in place that protect physicians who prescribe abortion medication across state lines. These laws have allowed pregnant people in ban states and maternity care deserts to access medication abortion safely and securely. Louisiana’s efforts set up a legal stress test over the as-yet unanswered question of how courts will weigh one state’s shield law against another’s abortion ban. How that question is answered will significantly shape the nation’s abortion rights landscape and define the future of access to telehealth abortion care. Dr. Coeytaux and Dr. Carpenter are both facing separate lawsuits out of Texas, and thus far California and New York have stood behind their shield laws and refused to extradite their providers. 

• Federal Employees Sue the Government Over Cessation of Gender-Affirming Care Coverage:

• The Trump Administration has announced a new policy that eliminates coverage for gender-affirming care for federal employees, continuing its  onslaught of attacks on the LGBTQ+ community and our nation’s civil rights structures. Human Rights Campaign has filed a class action challenging the policy and arguing that it unjustifiably discriminates on the basis of sex. This attempt to strip coverage from federal employees comes at the same time that CMS has proposed new rules that would bar Medicaid and CHIP coverage from entities that provide gender-affirming care to minors. If implemented, these rules would force countless providers to choose between losing funding and having to close their doors or discontinuing evidence-based care for trans youth. This kind of governmental intrusion into the healthcare decisions of transgender people and their families furthers the same ideological agenda of control and conformity that underlies abortion bans and restrictions. 

• Kentucky Woman Facing Criminal Charges Over Alleged Abortion:

• A Kentucky woman is facing criminal charges following an alleged medication abortion. Law enforcement arrested Melinda Spencer at her home on New Year’s Day after a healthcare provider contacted them to report her for inducing an abortion. She was initially charged with fetal homicide, abuse of a corpse, and tampering with physical evidence, despite the fact that Kentucky’s laws explicitly prohibit charging a pregnant person with homicide for an abortion or miscarriage.  The fetal homicide charge was subsequently dropped after the prosecuting attorney acknowledged that the charge could not be supported; however, Spencer still faces the remaining charges. We will continue to report on this story as it develops. 

• Research from Pregnancy Justice shows that there have been over 400 post-Dobbs prosecutions for pregnancy-related conduct. In many instances, healthcare providers were responsible for involving law enforcement, even where no law was broken. States across the country have investigated or prosecuted women for their handling of miscarriages, decisions to have abortions, conduct while pregnant, and other pregnancy-related outcomes. 

• Abortion Laws in Missouri Go to Trial:

• As we have reported on extensively in this Digest, Missouri passed an abortion rights constitutional amendment and overturned a total abortion ban in the 2024 elections. However, since that vote, the state has successfully done everything in its power to block Missourians from actually accessing care. This week, the state went to trial to defend a host of abortion restrictions and regulations, commonly referred to as Targeted Restrictions on Abortion Providers, or “TRAP”, laws. Although the state argues that these laws are medically necessary and ensure patient safety, abortion rights advocates argue that they violate the Missouri Constitution and are merely a way for the state to maintain a tight grip on individuals' reproductive choices. 

• The regulations at issue in trial include, among other things: a near-total abortion ban that remains on the books, a 72-hour waiting period, burdensome informed consent requirements, a telehealth ban, strict facility licensing requirements, and state-approved complication plans. If these TRAP laws are overturned, Missourians will be able to actually access their constitutionally protected right to care in their state. 

• Supreme Court Hears Arguments in Cases About the Rights of Trans People to Participate in Sports:

• This Tuesday, the U.S. Supreme Court heard oral arguments in Little v. Hecox and West Virginia v. B.P.J., two cases challenging state bans on transgender girls and women participating in sports that align with their gender identity. The rights of trans people to participate in sports has become a hot button issue as the Trump Administration and state-level Republicans work relentlessly to rollback the rights of trans people in all aspects of public life. 

• Lawyers in the case argued that Idaho and West Virginia’s sports bans violate both the equal protection clause and Title IX. But, depending on the breadth of the Court’s ruling, it could have implications for individual rights far beyond participation in sports. Specifically, the question of what burden of proof the government must carry in order to discriminate on the basis of a person’s transgender status is on the line – a question that the Court has skirted in previous trans rights cases. If the court rules that the states only have to meet the lowest burden of proof (known as rational basis review), it will open the floodgates for states to pass and enforce openly discriminatory legislation with little accountability or recourse for the impacted individuals. During arguments, the conservative majority appeared sympathetic to the states’ arguments that their bans could pass constitutional muster. Justice Alito specifically (and unsurprisingly) honed in on the questions of what it means to be a “boy or girl” and whether trans participation in sports threatened the rights of women and girls. Meanwhile, the liberal justices inquired about how they could craft a narrow ruling that respects conflicting laws in red and blue states. Throughout the arguments, multiple justices wrestled with questions about the multitude of contexts and competition levels involved in youth sports and how individual abilities line up with sweeping bans. The Court will likely not issue a decision for several months, and we will report closely on the ruling once it is published. 

Trend and Policy Watch:

• Veterans Lose Access to Abortion Coverage:

• The Trump Administration has issued a legal opinion rescinding nearly all abortion coverage for veterans. Previously, the VA provided abortion counseling and care in cases where there was a threat to the life or health of the pregnant person or in cases of rape or incest. Now,  veterans will only be able to access coverage if their life is at risk. The VA has reportedly announced internally that it will begin complying with the new opinion immediately, without going through the formal regulatory process for finalizing agency rules. This prohibition on coverage applies to all VA facilities, including those that serve the 51% of veterans that, according to the Center for Reproductive Rights, live in states that permit or protect abortion rights. 

• Abortion May Not Be As Motivating in the 2026 Midterms as in Elections Past:

• In the elections immediately following the overturn of Roe, abortion was a highly motivating issue for voters. Recent polling, however, shows that that may not be the case in the 2026 midterms. The Public Religion Research Institute found that the percentage of Democrats who stated that abortion was important to their voting choice dropped from 55% to 36% between 2024 and late 2025. Abortion importance among Republican voters stayed steady, seemingly showing that the electorate most motivated by the issue at this time is the group who would see abortion banned. With Democrats seeking to take back power and several states set to vote directly on abortion rights, it is important that reproductive autonomy is a central part of the conversation in the run up to the midterms. 

• The City of San Antonio Shuts Down its Abortion Travel Fund:

• Last year, the San Antonio City Council approved $100,000 to support abortion patients needing to travel. Texas Attorney General Ken Paxton brought suit almost immediately, arguing that the allocation of the funds conflicted with state policy banning abortion, and a Texas court agreed with him and temporarily blocked the funds. In August, the state passed SB 33, which bars the use of public funds for any logistical support related to abortion. As a result, San Antonio’s city attorney’s office determined that state law no longer permitted the allocation of funding to support abortion travel, and the case was non-suited. Paxton’s office issued a statement referring to San Antonio’s actions as attempted funding for “abortion tourism” and claiming that he will do everything possible “to prevent radicals from manipulating the system to murder innocent babies.” 

• Senate Health Committee Holds Hearing Over Safety of Mifepristone:

• On Wednesday, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing purportedly to examine the safety of medication abortion. This hearing comes as FDA Commissioner Marty Makary and the Department of Health and Human Services under RFK Jr. have committed to reviewing the safety of mifepristone. Mifepristone has been used safely and effectively for abortion care and miscarriage management for decades; however, as medication abortion rises in popularity, anti-abortion groups have escalated their calls to restrict access to the drug. Throughout the Senate hearing, Republican lawmakers repeated debunked talking points about the purported dangers of medication abortion, while Democrats and their witness attempted to redirect the conversation towards the settled science around the safety of the drug. Continued access to mifepristone - particularly through telehealth - has acted as a post-Roe lifeline for individuals in need of care. 

REPRODUCTIVE HEALTH DIGEST (12/18/2025)

Developments in Abortion, Autonomy, and Access:

As we near the close of 2025 and publish our final Digest of the year, I want to open with a sincere thank you. This has been a challenging year for everyone in our community, and your presence here and engagement with these critical  issues matters. This space exists because of a shared belief in the importance of bodily autonomy, reproductive freedom, and equity and dignity for all people, and I am so grateful for the community that we have built. Thank you for sticking with us this year, and we look forward to continuing this work in 2026. 

This week’s Digest discusses the new lawsuit brought by Texas and Florida challenging access to mifepristone, an update in the Trump Administration’s efforts to defund Planned Parenthood, new details about the ongoing attacks against the transgender community, ballot initiative news, and more. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Ms. Magazine and outlines the 2026 policy priorities that the Heritage Foundation – the group behind Project 2025 – released to the public this week. As Ms. Magazine reports, the new document “picks up where Project 2025 left off: banning abortion pills, weaponizing the 150-year old Comstock Act to criminalize medication by mail, embedding fetal personhood across federal agencies, and stripping every federal safeguard protecting reproductive freedom.” The Heritage Foundation has already been exceedingly successful in implementing its Project 2025 agenda, but many conservatives have been frustrated with what they perceive as a lack of effort to restrict abortion on the Trump Administration’s part. Going into 2026, it is critical that we are prepared for attacks on all aspects of reproductive freedom and autonomy to escalate. 

Legislation & Litigation:

• Overview:

• Texas and Florida have filed a new lawsuit in the Northern District of Texas challenging the FDA’s approval of mifepristone and two subsequent generic versions and the FDA’s relaxation of certain regulations for the medication’s use, including removing in-person dispensing requirements; 

• A federal appeals court has sided with the Trump Administration in its ongoing efforts to defund Planned Parenthood, placing over a million Americans access to healthcare at risk; 

• Texas Attorney General Ken Paxton has expanded his lawsuits against Texas clinicians who he alleges violated the state’s ban on gender-affirming care for minors; and 

• A Missouri appeals court rewrote ballot measure language for an initiative that will go before voters next year, finding that the state’s proposed language failed to inform voters of the fact that the new initiative would put a total abortion ban back in place. 

• Texas and Florida File a New Lawsuit Challenging Mifepristone Access:

• Florida and Texas have filed a new lawsuit in the Northern District of Texas seeking to restrict access to medication abortion. The suit challenges 1) the FDA’s original approval of mifepristone in 2000 (a claim that the Fifth Circuit has previously found to be untimely); 2) changes made in 2016 to relax mifepristone’s regulations for use; 3) the removal of in-person dispensing requirements; and 4) the FDA’s approval of generic versions of mifepristone in 2019 and 2025. 

The case closely mirrors and expands upon the Alliance for Hippocratic Medicine v. FDA case that the Supreme Court dismissed for lack of standing in 2024. Following the Supreme Court’s dismissal, Missouri, Kansas and Idaho intervened in that case, and Texas and Florida attempted to do so as well. However, the case was transferred to Missouri, and Florida and Texas’s request was found to be moot. The new case is the latest in a series of aggressive attacks on access to medication abortion, including a campaign to discredit the drug’s safety record, attempts to link it to water safety issues, and calls by anti-abortion groups for FDA Commissioner Marty Makary to be fired for failing to take swift action to limit access to the drug. 

• Appeals Court Sides with Trump Administration in Attempt to Defund Planned Parenthood: 

• The First Circuit Court of Appeals has issued a ruling allowing the Trump Administration to move forward in its attempt to defund Planned Parenthood. The court found that the challenged provision does not constitute an unconstitutional bill of attainder and overturned a district court injunction temporarily blocking it. A separate lawsuit brought by 22 states and D.C. is ongoing in the district court, and the defund provision is currently blocked for those states. If the law takes full effect, entities that provide abortions and received more than $800,000 in Medicaid funds in 2023 will be stripped of Medicaid funding for a year. 

Although certain states may attempt to use state funds to mitigate the harm and keep clinics open, the reality is that this is not sustainable and Americans will lose critical access to services like cancer screenings, pregnancy testing, contraception, prenatal care, and STI testing. As we have reported on before, despite the fact that federal funds are already prohibited from paying for abortion care, ‘defunding’ Planned Parenthood has long been a key part of the anti-abortion right’s strategy. Already in 2025, nearly 50 Planned Parenthood clinics have closed their doors as a result of losing Medicaid and Title X funding, and 1.1 million Planned Parenthood patients are on the brink of losing basic healthcare. 

• Texas Attorney General Continues to Pursue Healthcare Providers: 

• Texas Attorney General Ken Paxton is continuing to aggressively target gender-affirming care in the state, announcing on December 10 that his office has expanded its lawsuits against two physicians who he claims unlawfully provided care to minors after the state banned it. Initial suits were brought against the providers in October and November; however, he now claims that “[n]ew evidence gathered by the Office of the Attorney General shows that there were deliberate efforts to conceal illegal activity by falsifying records, altering diagnosis codes, and submitting deceptive billing information.” He described the defendants’ alleged conduct as “evil” and “cruel child abuse.” According to the Texas Newsroom, an attorney for one of the doctors said that Paxton’s allegations were “false in every material aspect,” and that she “did not force any treatment on any of her patients and her care complied with Texas and federal law in every respect.” Notably, Paxton’s office brought a similar lawsuit against another provider last year and ultimately dropped the case after finding no evidence of wrongdoing. 

• Missouri Appeals Court Rejects Biased Ballot Initiative Language 

• Missouri is continuing its battle to overturn a citizen-passed constitutional amendment protecting pre-viability abortion rights and reinstate a total abortion ban. Earlier this month, a Missouri appeals court found that the state’s proposed ballot language and summary statement failed to adequately inform voters of the impact of the proposed abortion ban amendment. The now-rejected language stated that the proposed amendment would “Repeal Article I, section 36, approved in 2024; allow abortions for medical emergencies, fetal anomalies, rape, and incest.” It failed to directly inform voters that it would reinstate a near-total abortion ban and constitutionally enshrine a ban on gender-affirming care for minors. The state may appeal to the Missouri Supreme Court. The Appeals Court’s revised language now asks voters whether the Missouri Constitution should be amended to: 

• “Repeal the 2024 voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability;

• Allow abortions for rape and incest (under twelve-weeks’ gestation), emergencies, and fetal anomalies;

• Allow legislation regulating abortion;

• Ensure parental consent for minors’ abortions;

• Prohibit gender transition procedures for minors?”

Trend and Policy Watch:

• Telehealth Abortions are on the Rise: 

• Post-Dobbs, telehealth abortion has taken on new significance, as pregnant people in ban states struggle to access care and rely on telemedicine services. New data from the Society of Family Planning shows that telehealth abortion has increased substantially – from 5% in 2022 to 27% in 2025, with more than half of those abortions provided through shield laws. The rise in telehealth abortion and the access that it allows people is exactly why anti-abortion activists are aggressively pushing to limit medication abortion access through every available avenue, including prolific litigation challenging mifepristone’s availability and the recent calls for the firing of FDA Commissioner Marty Makary, as discussed above. In 2026, it is critical that states do everything in their power to continue to protect and expand access to telehealth and medication abortion. Without it, countless people in states where abortion is banned or severely limited will be left with no viable options for care. 

• South Dakota Issues Cease and Desist Against Telehealth Provider: 

• South Dakota is also working to restrict access to information about abortion pills and telehealth. Last week, the state’s Attorney General issued a cease and desist to Mayday Health, a nonprofit that assists with the provision of contraception and abortion medications. Mayday had launched a campaign placing advertisements that read “Pregnant? Don’t want to be?” at gas stations around the state. In response, the state is threatening a lawsuit under consumer protection laws. Mayday provided the South Dakota Searchlight with the following statement: “Mayday Health spreads awareness that abortion pills are safe, effective, and have been FDA approved for over 20 years…[t]his is First-Amendment protected free speech. Mayday is an education nonprofit. We don’t sell abortion pills, we just believe people should know their options.” 

• Missourians Still Struggle to Access Care, Despite Passing Constitutional Protections: 

• Despite having passed a citizen-led ballot measure last year legalizing pre-viability abortion, Missourians are still struggling to access care. Reportedly, between January and October, only 80 procedures were performed in clinics across the state, with another 79 abortions performed in hospitals as a result of medical emergencies. Following the passage of the abortion rights amendment, the state began the process of aggressively defending remaining abortion restrictions, including a restriction on telehealth. Those battles are continuing to play out in court. Compounding challenges to access is the fact that Planned Parenthood is currently the only operating abortion provider in the state as a result of Missouri’s long track record of instituting anti-abortion policies. As discussed above, the state is now attempting to nullify abortion rights altogether once again by putting an anti-abortion ballot measure before voters in 2026. 

• IVF Coverage for Military Members Remains Limited: 

• On Wednesday, the Senate passed the 2026 National Defense Authorization Act (NDAA), which provides for $900 Billion in defense spending. IVF coverage for service members was a subject of significant debate throughout the process, with Speaker Mike Johnson reportedly working to remove coverage from the bill due to his opposition to abortion. At present, TRICARE - the military healthcare program – only covers IVF in instances where infertility was caused by an active duty injury or illness. A bipartisan provision would have expanded TRICARE’s coverage to all enrollees; however, that expansion failed to make it to the finish line, despite President Trump’s campaign promises to expand access to IVF. The bill now goes to the President’s desk for his signature. 

• Anti-Abortion Lawmaker Josh Hawley Starts New Dark-Money Group: 

• Missouri Senator Josh Hawley and his wife Erin Hawley, an attorney who argued in favor of restricting access to mifepristone at the Supreme Court, have launched a new ‘dark money’ group to fund anti-abortion campaigns, advertising, and candidates. According to reports, the group, called “Love Life Initiative” will focus both on opposing abortion and promoting families. Senator Hawley is ardently anti-abortion and has been a vocal member of the coalition calling for the FDA to review mifepristone’s safety record. Hawley’s creation of the new organization has stirred up disagreements in the Trump Administration, which has appeared reluctant to make abortion a key agenda item in the President’s second term. 

REPRODUCTIVE HEALTH DIGEST (12/4/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Digest discusses the federal government’s attempts to defund Planned Parenthood, the reinstatement of North Dakota’s abortion ban, continued attacks on access to medication abortion, rulings and policy decisions limiting the rights of trans people, some important flags for the 2026 elections, and more. We thank you for your patience while we took a break last week for the Thanksgiving holiday. We will publish one final 2025 Digest on December 18th, prior to our office’s winter closure, and we will back in the New Year with all of the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s must-read comes from ProPublica and details the story of 37-year old Tierra Walker – yet another Texas woman who has died as a result of being denied an abortion. When she became pregnant, Walker was dealing with multiple health conditions, including seizures, hypertension, and diabetes, that put her at an extremely high risk for severe pregnancy complications like preeclampsia. She inquired about whether it would be safe for her to continue her pregnancy, but she was repeatedly told that there was no emergency - the only circumstance under which abortion is legal in Texas. At 20-weeks pregnant, her teenage son found her lifeless in bed. She had died of preeclampsia. Had Walker been given the choice to decide what care was best for her, experts agree that she would be alive today.  

Legislation & Litigation:

• Overview:

• A federal judge has once again ruled against the Trump Administration’s attempt to defund Planned Parenthood; 

• The North Dakota Supreme Court has ruled that the state can enforce its total abortion ban, reversing a lower court ruling blocking the law from taking effect. 

• The Supreme Court will allow the Trump Administration to enforce its new policy blocking people from changing their gender markers on their passports, even in cases where their gender markers have been legally changed on other documents; 

• The ACLU has filed a lawsuit seeking information about the scope of Congress’s reported review of the safety record of mifepristone, a common medication abortion drug; 

• A draconian South Carolina anti-abortion bill has hit a roadblock and is unlikely to pass; and 

• Three states have launched a challenge to the FDA’s recent approval of another generic version of mifepristone.

• Federal Judge Rules Against Trump Administration’s Attempt to Defund Planned Parenthood:

• The spending bill passed by Congress in July - known as the “One Big Beautiful Bill Act’ - included a provision that effectively defunded Planned Parenthood. As we have reported on previously, that provision was immediately subject to litigation and partially blocked by a federal judge on constitutional grounds.

This week, U.S. District Judge Indira Talwani once again ruled in favor of Planned Parenthood. In a lawsuit brought by 22 Democratic states, she found, among other deficiencies, that the provision attached conditions to state funding without providing clear notice of how and to whom those conditions apply. She also found that the plaintiff states could be irreparably harmed by the defund provision, as Planned Parenthood is a critical source of general healthcare in many states. The fight over Planned Parenthood’s funding is likely to be a lengthy one as multiple cases wind their way through federal courts. 

• North Dakota Abortion Ban Reinstated:

• On November 21, the North Dakota Supreme Court issued a ruling allowing the state’s total abortion ban to take effect. Last year, a lower court had blocked the ban, finding that it was unconstitutionally vague. The State appealed that ruling. Although three of the five North Dakota Supreme Court justices agreed with the lower court that the ban is unconstitutional, North Dakota law requires a supermajority of four out of five justices in order to declare a law unconstitutional. 

For the moment, the ruling does not functionally change access to abortion in the state, as the state’s only abortion clinic moved to Minnesota shortly after the Dobbs decision. However, it does not bode well for the future of reproductive rights in the state and will increase fear and uncertainty around when physicians are able to intervene to provide emergency terminations. 

• The Supreme Court Allows Anti-Trans Passport Policy to Take Effect:

• The U.S. Supreme Court ruled in early November that the Trump Administration can enforce its discriminatory passport policy, which prohibits individuals from changing the gender marker on their passports. The policy stems from a January Executive Order that effectively denied trans existence by declaring that there are only two sexes and that they are unchangeable. 

A Massachusetts federal court had previously blocked the policy, but the Supreme Court’s conservative majority overturned that order. Justices Kagan, Jackson, and Sotomayor dissented, with Justice Jackson calling out the Administration’s failure to explain how it can claim to face urgent harm when it intends to allow people whose gender markers have been changed to continue to use those documents until expiration. She described the Court’s actions as “an abdication of [its] duty to ensure that equitable standards apply equally to all litigants—to transgender people and the Government alike.” The new passport policy fails to plausibly justify itself or explain why the harm that it will cause to the dignity and privacy of Americans is somehow necessary for the wellbeing of the country. It will additionally create significant challenges for individuals who have already changed their gender markers on other legal documentation, like their drivers license and birth certificate. 

• The ACLU is Seeking Information About Congress’s Review of Mifepristone: 

• The ACLU has filed a Freedom of Information Act (FOIA) lawsuit seeking information about the FDA’s planned review of mifepristone, a medication commonly used for medication abortions. In August, the ACLU sent a FOIA request to the FDA seeking details about the scope of the intended review and communications that the agency has had with anti-abortion groups and lawmakers. The FDA failed to respond to that FOIA request. Of particular concern is the FDA’s seeming reliance on a widely criticized paper, publicized by an anti-abortion group that attempts to cast doubt on mifepristone’s well-established safety and efficacy record. This lawsuit follows on the heels of a similar case brought by the Center for Reproductive Rights. Although the case will likely take a while to yield any concrete outcomes, it will hopefully shed light on the current Administration’s decision making framework  around abortion access. 

• Draconian South Carolina Anti-Abortion Bill Hits Roadblocks: 

• A South Carolina bill that would have outlawed nearly all abortion care has failed to advance in the state Senate. The bill, which the ACLU of South Carolina called “an egregious attack on our autonomy, privacy, speech, and safety,” would have removed exceptions for rape, incest, and fatal fetal anomalies, and punished pregnant people and anyone who helped them access  abortion care with up to 30 years in prison. 

The bill also appeared to ban any form of contraception that prevents a fertilized egg from implanting, which would have effectively prohibited intrauterine devices (IUDs) and could have limited access to in vitro fertilization. The proposal also included language that would have made it illegal for doctors to provide patients with information about abortion, which critics of the bill said raised significant First Amendment concerns.

After four of the six Republicans on the Senate subcommittee declined to vote on the bill, the three Democrats on the subcommittee were able to block the measure from advancing. Notably, one of the bill’s own sponsors abstained from the vote, citing his concerns about the bill penalizing mothers. Although the bill is not officially dead, it is unlikely to move forward and become law.

• States Challenge FDA’s Approval of Generic Mifepristone:

• A group of anti-abortion states have moved to challenge the federal government’s recent decision to approve another generic form of mifepristone. Idaho, Missouri, and Kansas have filed an amended complaint in the pre-existing case challenging the FDA’s RIsk Evaluation and Mitigation Strategies (REMS) for mifepristone. 

The original lawsuit, formerly known as Alliance for Hippocratic Medicine vs. FDA, was filed in 2022  by anti-abortion doctors and organizations seeking to wholly undo the FDA’s approval of mifepristone. Following the Supreme Court’s dismissal of the case on standing grounds, the three states took up the charge, arguing that the FDA’s relaxation of conditions for mifepristone’s use was unlawful and posed a threat of harm to the states and their citizens.

The FDA has asserted that, because federal law requires approval of a generic version when it is identical to an already-approved drug, its approval of another generic version was merely a procedural matter. Medication abortion, which accounts for  two thirds of all abortions in the U.S., has been under relentless attack since the Dobbs decision overturned Roe. States like Texas and Louisiana have passed laws to curtail and criminalize possession of mifepristone. Anti-abortion state lawmakers and leaders have urged Congress to reevalute mifepristone’s safety and launched multiple lawsuits challenging its approval. And, the federal government has indicated that it is reviewing mifepristone’s safety record.

Trend and Policy Watch:

• Anti-Abortion Group to Invest $80 Million in 2026 Midterm: 

• In the runup to the 2026 midterm elections, anti-abortion groups are mobilizing to elect pro-life candidates. As reported by Politico, Susan B. Anthony Pro-Life America and its Super PAC have announced that they will invest $80 million into anti-abortion candidates in battleground states. Their multi-pronged campaign includes door-knocking, digital advertising, and extensive canvassing. This push comes after the Post-Roe success of pro-choice candidates and ballot measures highlights the salience of abortion access as an issue within the American electorate.

• U.S. Bishops Vote to Ban Gender Affirming Care at Catholic Hospitals: 

• In another attack on access to healthcare, U.S. Catholic Bishops have voted to ban gender-affirming care at Catholic hospitals nationwide. Catholic hospitals have been expanding for years, and the Associated Press reports that more than one in seven patients treated in America every day are treated at Catholic hospitals. Although the Church had already made its stance on the issue of gender-affirming care clear, the new vote solidifies that policy at a time when both federal and state governments are taking aggressive actions to limit access to healthcare for trans people.

• Wisconsin Introduces Bill that Would Require Miscarriage and Abortion ‘Catch-Kits’:

• A group of Wisconsin Republicans has introduced the “Clean Water for All Life Act,” a bill that would require patients who use medication abortion drugs to be issued ‘catch kits’ to collect blood and tissue and return it to their provider for disposal. The Republicans leading the bill claim - without evidence - that it is a water safety issue and that endocrine disruptors from the medications pose a danger to public health. This echoes an argument championed by Students for Life. In addition to the obvious surveillance and privacy concerns created by this bill, it raises concerns about patients experiencing miscarriages, who often are prescribed the same medications targeted by the bill. The bill also singles out medication abortion for particular treatment while ignoring wholesale all other medications that individuals take on a daily basis that may  enter the state’s wastewater.

• Ballot Measure to Overturn Idaho Abortion Ban Makes Progress:

• We have reported in the past on the overwhelming success of citizen-led ballot initiatives for constitutionally protecting reproductive rights at the state level. Reproductive rights have gone before voters in 16 states since the Dobbs decision, and they have succeeded in 13 of those instances. Voters in several states, including Idaho, are now gearing up for the 2026 elections. The group spearheading the efforts reports that it has amassed more than 50,000 of the 71,000 signatures needed to qualify for the ballot. If passed, the measure would override one of the strictest abortion bans in the country and enshrine pre-viability abortion rights into the state constitution. 

• Research Shows How Texas Abortion Ban Adversely Impacted Minors:

• New research from the American Journal of Public Health shows how Texas’s abortion bans have disproportionately impacted minors. As summarized by KUT News, researchers compared statistics from the two-year period after Texas enacted its initial 6-week abortion ban to the two years prior. They found that “facility-based abortions” received by minors decreased by almost 60%. Factoring in patients traveling out of state for care, minors overall received 26% fewer abortions than during the pre-ban time period. The stark impact is likely attributable to factors like minors’ access to a car or other transportation, financial resources, ability to miss school, and the logistical challenges of making an out-of-state medical appointment. Every state bordering Texas, with the exception of New Mexico, is now enforcing a total abortion ban, compounding barriers to care. 

REPRODUCTIVE HEALTH DIGEST (11/13/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest covers a preliminary injunction hearing in Arizona; a federal ruling that the FDA violated the law by maintaining restrictions on the abortion medication mifepristone in 2023; a New York judge blocking Texas Attorney General Ken Paxton’s attempt to force a county clerk to enforce a Texas default judgment against provider Margaret Carpenter; Florida’s Attorney General using consumer protection laws to target Planned Parenthood in efforts to restrict access to mifepristone; and other policy and access developments across the states. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day– so you’re always up to speed. 

Also, check out our Repro Blog of the Month, which explores how authoritarian governments manufacture public anxiety around gender and sexuality– and then weaponize those fears to undermine democratic institutions.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Politico; this exclusive report details how a major anti-abortion group, the Susan B. Anthony Pro-Life America along with its affiliated super PAC, is planning on  investing $80 million to back anti-abortion candidates in key battleground states ahead of the 2026 election. Abortion rights remain highly popular– evidenced by what Politico describes as a “string of post-Roe defeats at the ballot box.” In response, the anti-abortion group is using the millions in funding to launch an outreach campaign aimed at winning over swing voters.

Legislation & Litigation:

• Overview:

• Arizona called anti-abortion witnesses who have never performed an abortion during a preliminary injunction hearing challenging state laws that require women to wait 24 hours and undergo an ultrasound before an abortion.

• A federal judge in Hawaii ruled that the Food and Drug Administration (FDA) violated the Administrative Procedure Act (APA) when it maintained access restrictions on abortion medication in 2023.

• A New York judge dismissed a petition by Texas Attorney General Ken Paxton that sought to force a New York court clerk to enforce a Texas judgment against a New York doctor who allegedly prescribed abortion medication to a patient in Texas. 

• Florida Attorney General James Uthmeier has brought a $350 million lawsuit against Planned Parenthood for “deceptive marketing practices.” The complaint cites multiple anti-abortion sources, including the anti-abortion group Live Action and a non-peer reviewed report from the conservative think tank, Ethics and Public Policy Center (EPPC). 

• Arizona GOP Relies on Vocal Anti-Abortion Witnesses to Defend Abortion Restrictions 

• Earlier this month, Arizona Senate President Warren Petersen and House Speaker Steve Montenegro defended state laws that require women to wait 24 hours and have an ultrasound before getting an abortion, despite voters approving a constitutional right to abortion in 2024. To support their claim that the abortion restrictions do not offend this constitutional right, they called anti-abortion witnesses, none of whom have performed abortions. One witness, Maureen Curley, testified that she has made at least $22,000 for her anti-abortion testimony in other anti-abortion cases in North Dakota and Missouri. 

• Meanwhile, the reproductive rights attorneys who brought the legal challenge in May, relied on testimony from local abortion providers and medical experts to support their argument that the court should at least temporarily pause enforcement of the laws while the lawsuit proceeds.  

• Federal Judge Rules that the FDA Violated Law by Restricting Abortion Medication

• In October, a federal judge in Hawaii ruled that the FDA violated the Administrative Procedure Act “by failing to provide a reasoned explanation for its restrictive treatment of the drug” when it maintained restrictions on access to the abortion medication mifepristone in 2023. The court has ordered the FDA to review evidence it allegedly overlooked, including “the wealth of peer-reviewed evidence proving mifepristone’s safety, including when delivered by telemedicine, as well as how FDA’s restrictions burden patient access.”

• While the restrictions on access remain in effect for now, Julia Kaye, senior staff attorney with the ACLU Reproductive Freedom Project said in a statement that the court’s “decision is a victory for everyone who believes that our access to safe and essential medicines should be dictated by science, not politics.”

• New York Judge Blocks Texas Attempt to Enforce Abortion-Pill Judgment

• A New York trial court dismissed Texas’s petition seeking to compel a county clerk to enforce a Texas judgment against Dr. Margaret Carpenter, who allegedly prescribed abortion pills to a Texas woman. 

• In December 2024, Texas Attorney General Ken Paxton sued Carpenter, and after she declined to respond, a Texas judge entered a default judgment in February 2025, ordering her to pay a $113,000 fine. Paxton attempted to collect the fine in Ulster County, New York  but a county clerk refused, citing New York’s shield law, which bars state officials from enforcing out-of-state penalties against protected healthcare providers. In July, Paxton sued Bruck, arguing the shield law violates the Constitution’s Full Faith and Credit Clause, and in September, New York Attorney General Letitia James intervened to defend the law. 

• On October 31, Ulster County Supreme Court Judge David Gandin dismissed the case, ruling that Carpenter’s services are legal in New York and fall “squarely within the definition of ‘legally protected health activity’” under the shield law. The state has not yet confirmed whether it is planning on appealing the ruling. 

• Florida Goes After Planned Parenthood 

• In the latest move by anti-abortion Republicans targeting abortion medication, Florida Attorney General James Uthmeier brought a $350 million lawsuit alleging that Planned Parenthood misrepresented that abortion medication mifepristone is safer than Tylenol. According to Mother Jones, the lawsuit is “riddled with familiar anti-abortion arguments and misinformation” and cites openly anti-abortion sources. While UC Davis School of Law Professor Mary Ziegler wrote for MSNBC that Florida Judges may see this lawsuit as a “mere smokescreen for suppressing” reproductive rights in the state, she also warned that this lawsuit represents a new tactic anti-abortion Republicans are using in their “efforts to eliminate mifepristone.”

Trend and Policy Watch:

• Pro-abortion Candidates Win Big on Election Day 

• Reproductive rights scored major victories in New Jersey, Pennsylvania, and Virginia on November 4. 

• In New Jersey, reproductive rights supporter Mikie Sherrill was elected governor. Sherill has vowed to protect abortion access during her tenure as governor. 

• In Pennsylvania, three liberal justices secured new 10-year terms on the Pennsylvania Supreme Court, allowing Democrats to keep their 5-2 majority on a court that could play a crucial role in future rulings on abortion rights in the state. 

• In Virginia, voters elected “reproductive freedom champion” Abigail Spanberger to be the state’s first female governor. Democrats also secured control of both chambers of the Virginia legislature, helping to protect abortion access for both state residents and for people from neighboring states with strict abortion bans.

• The GOP Accused of Trying to Sneak Abortion Ban into Funding Bill

• Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, warned on November 8 that “Republicans said they might vote to lower Americans’ health care costs, but only if we agree to include a backdoor national abortion ban.” While Republicans reportedly had demanded that any extension of Affordable Care Act (ACA) subsidies include a provision preventing the tax credits from being applied to plans that cover abortion, Wyden noted that “[z]ero federal dollars [currently] pay for this care in ACA plans.” 

• Subsidies under the ACA were at the center of the government shutdown. Earlier this week, a handful of Senate Democrats broke ranks to pass a stopgap funding bill, which does not include an immediate extension of certain healthcare subsidies and will likely exponentially increase healthcare costs for millions of Americans.  

• FDA to Remove Black Box Warnings from Women’s Estrogen HRT Products

• Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced on November 10th, that the black box warning on women’s estrogen-based hormone replacement therapy (HRT) products will be removed. Women’s health celebrated the move and the American College of Obstetricians & Gynecologists has said that the label change will “increase access to hormone therapy.” 

• At the same time, the Trump administration has made restricting HRT access for transgender youth a central policy priority.

• Oklahoma Health Care Authority rejects abortion attestation rule

• In July, Oklahoma Gov. Kevin Stitt signed an executive order directing the Oklahoma Health Care Authority (OHCA) to stop funding any individual or organization connected to prohibited abortion providers. The order also required Oklahoma Medicaid, or SoonerCare, providers to submit a signed attestation confirming whether they, or any associated entities, “[p]erforms, refers for, or is affiliated with the performance of abortions not permitted under state law.” 

• At a special meeting on November 9, the  OHCA board declined to approve the emergency rule, citing concerns over its legality and potential impacts on providers. The board unanimously voted to request an opinion from the attorney general on the rule and asked OHCA CEO Clay Bullard and board chair Marc Nuttle to consult with Gov. Stitt to clarify the executive order and delay enforcement of the attestation requirement until formal rules are established.

REPRODUCTIVE HEALTH DIGEST (10/23/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest discusses a new lawsuit out of Louisiana that challenges the FDA’s handling of mifepristone, the continued fight over abortion access in Missouri, abortion-related prosecutions in Texas, an ongoing case in Tennessee, and policy and practical-access developments in the states. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Rewire News; it describes how increased restrictions on reproductive freedom and choice are a hallmark and warning sign of growing authoritarianism. Looking to international examples, the piece makes the case that “reproductive rights . . . are an essential element of democracy.”

Legislation & Litigation:

• Overview:

• Louisiana filed a lawsuit challenging the FDA’s regulations for mifepristone’s use and seeking to reinstate in-person distribution requirements; the state argues that telehealth is allowing Louisianians to continue to have abortions, despite the state’s ban; 

• A Missouri court has affirmed a lower court's decision pausing medically unnecessary requirements for care, allowing abortions to continue consistent with the state’s recently passed constitutional protections; 

• Texas Attorney General Ken Paxton announced that eight more individuals have been arrested in connection with the state’s first prosecution under its abortion ban; counsel for those arrested deny the charges that they engaged in illegal activity; and 

• A Tennessee court has ruled to allow a lawsuit challenging the state’s extremely narrow life and health exceptions to move forward. 

• Louisiana Brings a Lawsuit Challenging FDA’s Mifepristone Regulations:

• If you have read this Digest for a while, you are well aware that anti-abortion groups and states have been using every tool available to attack access to medication abortion post-Dobbs. As we discussed in the last issue, Texas Judge Matthew Kacsmaryk recently transferred a case challenging FDA’s approval and subsequent relaxations of regulations for use of mifepristone to the Eastern District of Missouri, where it is likely to be allowed to progress. Now, Louisiana Attorney General Liz Murrill has filed a separate lawsuit against FDA, challenging its approval of the use of telehealth for distribution of mifepristone. 

• In the Complaint, Louisiana alleges that telehealth has allowed “pro-abortion activists … to blanket pro-life states with mifepristone – with impunity and without any fear of liability” and that “hundreds of unlawful abortions occur every month in Louisiana.” The state argues that the FDA’s actions are a violation of both the Administrative Procedure Act and the Comstock Act. This direct invocation of the Comstock Act is particularly significant. The 1873 anti-vice law, by its language, bans the mailing of any materials involved in abortions; however, it has been largely treated as a dead law for decades. Anti-abortion activists are now attempting to revive it in order to block telehealth abortions, or – if read and enforced broadly – to halt the mailing of materials used for any type of abortion, including in-clinic procedural care. 

• Missouri Court Affirms Decision Allowing Abortions to Continue:

• Since last November’s passage of a constitutional amendment protecting reproductive healthcare in the state, Missouri has been locked in a battle to restrict access and block the implementation of that amendment by any legally available means. On paper, Missourians have a constitutional right to abortion pre-viability; however, the state has argued to enforce a number of practical barriers to access that have effectively halted care at multiple points in the past year. These include licensing requirements for clinics, state approval of complication plans, a 72-hour waiting period, and restrictions on telemedicine. Litigation challenging these restrictions has been making its way through Missouri courts, including the state supreme court. On October 14th, a panel of three judges in a Missouri appeals court affirmed a lower court's ruling that temporarily blocked many of the challenged restrictions, allowing care to continue in the state. While the state’s battle to restrict access plays out in the courts, anti-abortion lawmakers have also put forth a second constitutional amendment that, if passed, would undo the first and reinstate a total abortion ban, with limited exceptions. The proposed constitutional amendment will go before voters next November. 

• Texas Has Arrested Eight More People In Connection with an Investigation Into Alleged Unlawful Abortions:

• Texas has reportedly arrested eight more people in connection with a prosecution for the alleged provision of unlawful abortions. In March, a Houston-area midwife was arrested on charges of practicing medicine without a license and performing abortions in violation of state law.  Her attorneys vigorously deny these claims, arguing that the state relied heavily on circumstantial evidence that did not prove any of its allegations. Now, Texas Attorney General Ken Paxton has announced that the state is bringing felony-level charges against eight additional people associated with the previously-arrested midwife and her clinics. This case appears to be the first prosecution brought directly under Texas’s abortion ban. Paxton’s press release announcing the arrests was rife with inflammatory language, including labeling several of the individuals involved “foreign nationals,” despite that having no apparent relevance to the case. He also referred to the arrestees as a “cabal of abortion-loving radicals” and “dens of fake doctors” engaged in conduct that he described as “evil.” 

• Tennessee Chancery Court Allows Lawsuit Challenging State’s Ban to Move Forward:

• A three-judge panel in a Tennessee Chancery Court has ruled that a 2023 lawsuit challenging Tennessee’s extremely narrow life and health exceptions to its otherwise total abortion ban can move forward. The original lawsuit was brought by a group of Tennessee physicians and patients who had suffered medical harm as a result of the law’s vagueness and extremely punitive nature.  A court previously partially sided with those plaintiffs, temporarily blocking doctors from facing professional discipline for emergency abortion care. In 2025, Tennessee amended its ban to allow abortions in cases of previable preterm premature rupture of the membranes (PPROM), inevitable abortion, and fatal fetal diagnoses that lead to severe maternal health conditions or infections causing uterine rupture or loss of fertility. The state argued that this amendment rendered the plaintiffs’ case moot.  The court disagreed, writing that the “changes made by the 2025 amendment do not significantly alter the status” of the case, and plaintiffs “have sufficiently alleged that the defects in the Medical Necessity Exception place their lives at risk.” 

Trend and Policy Watch:

• Republican Senators Ask HHS and FDA to Restrict Access to Medication Abortion:

• In yet another attack on mifepristone, every Republican senator aside from Susan Collins (ME) and Lisa Murkowski (AK), has signed a letter published to FDA and HHS calling for restrictions on access to the safe, effective medication. Relying on anti-abortion talking points and slanted ‘studies,’ the senators ask the agencies to, among other things, conduct a new REMS safety review, suspend approval of any new generic versions of mifepristone, reinstate in-person dispensing requirements, “suspend the distribution of mifepristone” as an “imminent hazard under Section 505(e) of the Federal Food, Drug and Cosmetic Act (FDCA),” and withdraw permissions for pharmacy distribution of mifepristone. Earlier this year, 22 Attorneys General sent a similar letter urging FDA and HHS to reevaluate mifepristone’s regulations. The Administration has indicated that it is currently undertaking a review of the drug’s safety and efficacy, despite decades of reliable science supporting its use for early abortion care. 

• Virginia’s Upcoming Election May Determine the Future of Reproductive Rights in the State:

• Although Virginia remains a bastion of abortion access in an otherwise restricted South, that could change with the state’s upcoming election. This November, voters will choose their next governor (and the state’s first woman governor) and determine control of the Virginia House of Delegates. The outcome will be substantially determinative of the state’s reproductive rights policy moving forward. Current Republican Governor Glenn Youngkin has repeatedly vetoed pro-choice bills passed by the state legislature; however, if Virginians elect Democratic Candidate Abigail Spanberger and hold control of the house and senate, they could see expanded reproductive freedoms and rollbacks on medically unnecessary restrictions. Virginia’s elections will serve as an important signal of where abortion sentiment sits in the state and how powerful of a factor reproductive rights are in electoral decisions three years post-Roe. 

• Planned Parenthood Southeast Launched an Investigation into Anti-Abortion Sentiment From New Leadership:

• The Board of Directors at Planned Parenthood Southeast has reportedly hired a law firm to conduct an investigation into “troubling allegations” made about its Executive Leadership team and Board. A petition circulated earlier this year described a culture in which new leadership had systematically de-emphasized abortion policy and removed public policy and organizing staff. Reportedly, newly hired leadership included an executive director who once referred to herself as pro-life in an interview, and a VP for external affairs who raised the question of working with Students for Life. Former leadership also alleged that support for the LGBTQ+ community had waned. This internal investigation comes as Planned Parenthood nationwide faces attempts by the federal and some state governments to defund its operations. 

• Clinic Closures Continue Following Passage of the So-Called “Big Beautiful Bill”: 

• Maine Family Planning, a network of 19 clinics that serve primarily low-income Medicaid patients across the state, will cease providing primary care at the end of this month. As we reported on in our last Digest, clinics across the country are closing their doors or ceasing care following the federal administration’s rescission of Medicaid funding for clinics that provide abortions and received more than $800,000 in Medicaid funding in 2023. This is the case even for clinics where abortion is only one of many services offered. Clinics like Maine Family Planning are unable to absorb the cost of that loss, and thousands of state residents will lose critical primary healthcare services as a result. Although Maine Family Planning is attempting to fight the funding cuts in court, it has thus far been unsuccessful. 

REPRODUCTIVE HEALTH DIGEST (10/09/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Digest goes through legal developments in state ballot measures, access to medication abortion, minors’ ability to access care, and a potential total abortion ban in South Carolina. We also discuss trends in abortion rates, student activists filling a gap in need for contraception, and how abortion bans impact crime. As always, please read on to the end for the news that you need to know. 

We also invite you to read two blog posts published by L4GG this week. The first covers the politics around mifepristone, and the second calls on New York Governor Kathy Hochul to sign a slate of critical health laws.

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read: This week’s Must-Read comes from the Guardian and details a new Report from Pregnancy Justice finding that over 400 pregnant people have been charged with pregnancy-related crimes post-Roe. The majority of these cases involve allegations of substance abuse, and the cases are highly concentrated in the South, where abortion bans are in place in nearly every state. The kinds of charges described in the Report raise concerns about pregnancy surveillance, fetal personhood, and criminalization over care. 

Legislation & Litigation:

• Overview:

• A Nevada court has ruled to allow the state’s parental notification law to go into effect, requiring minors to involve their parents or obtain a court order prior to obtaining care; 

• Planned Parenthood clinics in Louisiana have closed their doors after over 40 years, resulting in thousands of residents losing access to cost-effective reproductive healthcare; 

• After a protracted legal battle, Missouri has settled on ballot summary language for a measure that would reinstate a total abortion ban; 

• Judge Matthew Kacsmaryk transferred the case challenging the FDA’s approval of mifepristone out of his court and to the Eastern District of Missouri, finding that the state-plaintiffs lacked venue in Texas. 

• Last week, South Carolina lawmakers heard testimony on a proposed total abortion ban that would be the most severe in the nation if enacted; and 

• A California doctor is facing criminal charges for mailing abortion medication into Louisiana; the same doctor faces a civil claim out of Texas. 

• Nevada’s Parental Notification Law Allowed to Stand:

• In late September, Nevada District Court Judge Erika Mendoza denied Planned Parenthood’s request to pause the state’s parental notification requirement. The law in question requires either notification to a parent or guardian prior to a minor receiving an abortion, or a court order finding that the minor is sufficiently mature and parental involvement is not in their best interest. The law was passed in 1985, and it has never been enforced; however, following the overturn of Roe, a federal court lifted the injunction blocking it. Planned Parenthood sued, alleging a number of constitutional arguments. In declining to pause the law, Judge Mendoza found that the plaintiffs had failed to establish a likelihood of success on the merits. Planned Parenthood has appealed this ruling. 

• Although the majority of pregnant minors do choose to involve a parent, advocates for reproductive rights argue that laws requiring such involvement create medically unnecessary barriers to minors making decisions about their own care – particularly for individuals who cannot safely involve a parent or guardian. Judicial bypass procedures also create obstacles by requiring a minor to navigate an intimidating and confusing legal process in a short window of time. The logic underlying the judicial bypass system has also been called into question, as it creates a paradox wherein a court that finds that a minor lacks the maturity to choose abortion has effectively decided that the minor possesses the maturity to parent a child. 

• Planned Parenthood Clinics Close Their Doors and Stop Offering Care:

• Planned Parenthood’s two Louisiana clinics have been forced to shut their doors following a federal court ruling allowing the government’s efforts to defund the organization to move forward. The President of Planned Parenthood Gulf Coast stated that the decision to close the clinics came about because of “compounding political attacks that have dismantled public health infrastructure, [and] blocked patients from care.” The clinics were in operation for over 40 years. Louisiana is already enforcing a total abortion ban, and federal funding is blocked from going towards abortions. Instead, the services most commonly accessed included “STI testing and treatment, birth control and HIV prevention,” as well as cancer screening and hormone replacement therapy. Thousands of primarily low-income patients will now lose access to cost-effective reproductive healthcare. Planned Parenthood Gulf Coast is also closing two of Houston’s six clinics. 

• Clinics operating in states where abortion is legal and protected are also having to make difficult decisions about continuing care. Earlier this month, Planned Parenthood in Wisconsin announced that it would stop providing abortions while it attempts to navigate the federal funding landscape. If the federal funding prohibitions stand, Planned Parenthood estimates that it will have to close 200 clinics, the majority of which operate in healthcare deserts. 

• Missouri Politicians Continue to Fight Over Anti-Abortion Ballot Measure Language:  

• In Missouri, where lawmakers are attempting to reinstate a total abortion ban via ballot initiative, a Cole County judge has approved summary ballot language. Previously, Judge Daniel Green had twice rejected proposed language that failed to directly inform voters that the measure would repeal the abortion rights constitutional amendment that they passed last year. The summary language now states the following: 

• “Shall the Missouri Constitution be amended to:

• Guarantee women’s medical care for emergencies, ectopic pregnancies, and miscarriages; 

• Ensure women’s safety during abortions; 

• Ensure parental consent for minors; 

• Repeal Article I, section 36, approved in 2024; allow abortions for medical emergencies, fetal anomalies, rape, and incest;

• and Prohibit sex-change procedures for children?”

Although the summary language now explains that the prior amendment would be repealed, advocates for abortion rights in the state argue that it is still insufficient and fails to fully notify voters of the consequences of a ‘yes’ vote. 

• The Case Challenging FDA’s Approval of Mifepristone Has Been Transferred to Missouri:

• The case challenging FDA’s approval of mifepristone and regulations for its use has been transferred from a Texas court to Missouri. As a reminder, the lawsuit was originally filed in notoriously anti-abortion Judge Matthew Kacsmaryk’s court in the Northern District of Texas by a group of anti-abortion doctors and organizations. Last year, the Supreme Court dismissed the case for lack of standing. Following that dismissal, Idaho, Missouri and Kansas joined as plaintiffs in an attempt to keep the dispute alive, and Texas, Florida and Louisiana all recently sought to intervene. Earlier this year, the Trump Administration argued that the case should once again be dismissed on the grounds that Missouri, Idaho and Kansas do not have standing in a Texas federal court. 

• Last week, rather than allow the states to move forward in his court, Judge Kacsmaryk transferred the case to the Eastern District of Missouri, finding that the state-plaintiffs lack proper venue in Texas and cannot piggyback on the original plaintiffs’ venue arguments. His Order was explicit in its disagreement with the Supreme Court’s finding that the original plaintiffs lacked standing, but conceded that the lower court was bound to follow that decision. As Mother Jones points out in its reporting on the case, Judge Kacsmaryk’s selection of the Eastern District of Missouri was likely an intentional move to stack the odds in favor of the anti-abortion plaintiff states. Of the nine judges presiding over the Eastern District of Missouri, 8 are Republicans, and 4 are Trump appointees. 

• South Carolina Lawmakers Heard Testimony Last Week on a Draconian Total Abortion Ban: 

• Last Wednesday, the South Carolina legislature heard hours of public testimony on SB 323, the “Unborn Child Protection Act.” If passed, the draconian abortion ban would be the strictest in the nation. It would ban abortion at all gestational ages and eliminate exceptions for rape, incest and lethal fetal anomalies. It would also criminalize aiding and abetting in unlawful abortions and levy severe criminal penalties on the abortion patient themselves. During testimony, South Carolina lawmakers heard impassioned pleas from both sides of the issue. Testimony in favor of the bill tended to rely on religious interpretations of when life begins, with several individuals arguing that the bill does not go far enough because it caps potential prison time at 30 years. Conversely, testimony in opposition focused on framing abortion as a part of reproductive health care and included arguments from advocates for reproductive rights and stories from women who had suffered miscarriages, faced agonizing fetal diagnoses, or encountered medical emergencies during pregnancy. Notably, the Senate Medical Affairs subcommittee–the body hearing testimony–was composed entirely of men. South Carolina’s legislative session will convene again in January 2026. 

• A California Doctor is Facing Criminal Charges For Mailing Abortion Medication Into Louisiana: 

• Louisiana has issued an arrest warrant for California doctor Remy Coeytaux as a part of its ongoing crusade to end the flow of abortion pills into the state. California’s shield laws seek to protect clinicians who mail the drugs over state lines, including into ban states like Louisiana. Dr. Coeytaux has allegedly been providing medication abortion under protection of these laws. Texas has also filed a wrongful death suit against Dr. Coeytaux in federal court in connection with a Texas resident’s medication abortion, and both Louisiana and Texas have initiated legal proceedings against a New York shield provider. New York has thus far stood behind its shield laws and refused to cooperate with the cases. Each of these proceedings creates an opportunity for the courts to test and weigh in on the legal strength and enforceability of post-Roe interstate shield laws. The question of how and to what extent one state can enforce its abortion laws across its border is likely to end up before the Supreme Court in the coming years.  

Trend and Policy Watch:

• The FDA Has Approved a New Generic Version of Mifepristone: 

• The FDA has quietly approved a new generic version of mifepristone as advocates on both sides of the issue fiercely fight over access to medication abortion. FDA approved the first generic version, manufactured by GenBioPro, in 2019, and GenBioPro is currently a party in the federal lawsuit challenging the agency’s approval of mifepristone and its terms of use. The approval of the new generic version is largely a matter of procedure and does not appear to reflect the administration’s position on access to abortion. Regardless, anti-abortion groups have reacted with outrage, particularly as FDA and HHS recently committed to conducting a review of the safety of mifepristone. 

•  Preliminary Data Shows a Decline in Abortion Numbers: 

• New data from Guttmacher appears to show a decline in abortion numbers in states without total bans. The research is preliminary, but it does mark the first time post-Roe that abortions appear to be decreasing, rather than slightly increasing. A full breakdown of the research can be found at the accompanying Policy Analysis. 

• At Some Catholic Universities, Students Rely on Student Networks to Obtain Prohibited Birth Control: 

• At DePaul University in Chicago – the largest Catholic university in the United States – distribution of any kind of contraception on campus is prohibited.  Students in need of resources are turning to student-run ‘womb-service’ operations that provide emergency contraception and condoms just off campus. DePaul is not the only school in the country where student activists are working to fill gaps left by restrictive institutional policies. As the federal administration and certain states work to defund access to cost-effective care and tighten restrictions on contraception, these networks will take on increasing urgency. 

• ​​Research Shows the Relationship Between Abortion Bans, Poverty and Crime: 

• Research published in the National Bureau of Economic Research and reported on by the 19th appears to show a link between abortion bans and increases in property crime. The study looked at Texas and controlled for how far individuals now needed to travel in order to access care; it found that property crimes increased the most in areas where the travel distance was greatest. This relationship between crime and abortion bans can likely be explained by the increased financial strain that an unplanned pregnancy places on a family. 

REPRODUCTIVE HEALTH DIGEST (9/25/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers the legal battles over abortion rights in states where voters have passed ballot initiatives, South Carolina’s attempt to pass a total abortion ban that would allow pregnant patients to be charged with homicide, legislation and litigation impacting access to medication abortion, and the federal government’s attempt to defund Planned Parenthood. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

Legislation & Litigation:

• Overview:

• Missouri, Ohio and Arizona continue to fight in the courts over the proper scope of their states’ abortion restrictions, despite citizens having passed constitutional amendments protecting the right to access; 

• South Carolina lawmakers have set a hearing on a draconian total abortion ban that, among other things, would allow prosecution of abortion patients for the crime of homicide; 

• Texas Governor Greg Abbott has signed HB 7 into law, severely restricting access to medication abortion and allowing citizens to bring ‘bounty-hunter’ style lawsuits against individuals possessing or transferring the drugs; and 

• The First Circuit Court of Appeals issued a ruling allow the federal administration’s attempt to “defund” Planned Parenthood to move forward during the pendency of litigation; 

• The Center for Reproductive Rights has filed a new lawsuit seeking detailed information about the Trump Administration’s decision to review mifepristone’s safety. 

• States With Citizen-Passed Abortion-Rights Constitutional Amendments Continue to Fight to Limit Access: 

• Missouri Judge Orders Ballot Initiative Summary Language to be Rewritten: 

• A Missouri Judge has ordered the state to rewrite ballot measure summary language for a proposed constitutional amendment that would reinstate a near-total abortion ban. Last November, Missouri became the first state to overturn a total abortion ban via citizen-led ballot measure. The state is now attempting to use that same process to rescind those newly-passed protections in the 2026 election. Missouri Secretary of State Denny Hoskins certified a ballot summary stating that the proposed amendment would do a number of things, including “ensure women’s safety during abortions,” and “guarantee access to care for medical emergencies, ectopic pregnancies, and miscarriages.” The summary failed to mention the proposed amendment’s most important function: banning abortion in Missouri once again. The ACLU sued, arguing that this language did not comply with state requirements to fairly portray the proposed amendment and that it violated the rule that any amendment contains only one subject. The court agreed, giving the Secretary of State seven days to provide revised language that accurately reflects the full scope of the measure. 

• Ohio Continues to Litigate Over the Scope of Abortion Restrictions in the State: 

• In 2023, Ohio voters passed a constitutional amendment guaranteeing the right to pre-viability abortion care, rendering the previously-enforced 6-week ban unconstitutional. Despite this, the state continues to assert that several of the ban’s provisions, including certain record-keeping requirements, should remain in effect. Ohio Attorney General Dave Yost’s legal team argued in court last week that the provisions are ‘severable’ from the ban itself – meaning that the legislature intended them to remain in effect even if portions of the law were struck down. Conversely, the other side argued that the remaining restrictions and regulations have no meaning on their own and cannot stand without the 6-week ban in place. In addition to fighting in the courts, the state is also attempting to pass renewed legislation imposing limitations on access to care, including a medically unnecessary 24-hour waiting period. 

• Arizona Anti-Abortion Lawmakers Defend Arizona Restrictions:

• In the 2024 election, Arizona voters utilized a citizen-led ballot initiative to enshrine pre-viability abortion rights into the state constitution. However, significant restrictions on care remain on the books – including a 24-hour waiting period, a ban on telemedicine abortions, and a ban on abortions sought because of a fetal genetic abnormality. Each of these laws has a disproportionate  impact on rural patients and those who already lack the financial and practical resources to access care. Last week, attorneys for Republican lawmakers in the state argued in court that the case challenging these restrictions should be dismissed on standing grounds, alleging that the plaintiff doctors have not shown a threat of prosecution. On Tuesday, Maricopa County Superior Court Judge Greg Como rejected that argument, finding that the doctors have a right to have the case heard and that, in light of the constitutional protections for abortion, “any restrictions on [abortion]  are presumptively invalid.” 

• South Carolina Lawmakers Push for Draconian Total Abortion Ban: 

• South Carolina lawmakers have set a hearing for SB 323, the ‘Unborn Child Protection Act’, a total abortion ban that would be the most severe in the nation if passed. The bill is being considered outside of South Carolina’s regular legislative session. At present, South Carolina bans abortion after detection of fetal cardiac activity, with exceptions for rape, incest, fetal anomalies, and medical emergencies. The Unborn Child Protection Act would render all non-emergency abortions illegal and prosecutable as homicide. In addition to banning abortion, the ACLU of South Carolina explains that the bill would: 

• “Allow imprisonment up to 30 years for a person having an abortion or aiding in abortion 

•  Prohibit transporting a minor out of state to obtain an abortion

• change the definition of a legal “contraceptive” to exclude anything that prevents ovulation or implantation of a fertilized ovum

• open the door to restrictions on in vitro fertilization (IVF) by defining a “human embryo” as a fertilized egg or zygote

• make it unlawful to possess any drug or substance that can be used for abortion 

• make providing information about abortion unlawful, including via a website or phone call; [and] 

• require public school students to watch a propaganda video called "Meet Baby Olivia," produced by the anti-abortion group Live Action”

• If passed, the bill would have devastating consequences on access to health care in South Carolina and open the door for sweeping restrictions on birth control and assisted reproduction. We will be following the bill’s progress closely and reporting on any new developments. However, regardless of its success or failure, it serves as an urgent reminder of how far the extreme anti-abortion movement would like to go if given the political power to enact their full vision. 

• Texas Governor Greg Abbott Signs Bill Severely Restricting Medication Abortion Access: 

• As we reported in our last Digest, Texas lawmakers recently passed HB 7, a law severely restricting access to medication abortion and allowing private citizens to sue for perceived violations. It is aimed at reducing the efficacy of shield laws by cutting off Texans’ ability to safely access abortion pills from across state lines. Last week, Governor Greg Abbott signed that bill into law. It will take effect in early December. 

• Federal Court Allows Trump Administration to Move Forward with ‘Defunding’ Planned Parenthood 

• The First Circuit Court of Appeals has lifted a lower court’s ruling temporarily blocking the Trump Administration from ‘defunding’ Planned Parenthood. Earlier this year, the Administration passed a spending bill that included provisions effectively precluding Planned Parenthood from receiving Medicaid Reimbursements for one year, handing the anti-abortion movement a major win in its decades-long crusade to shut down the reproductive healthcare provider. Planned Parenthood estimates that around 200 clinics may close, impacting over a million patients nationwide. Under the Hyde Amendment, federal funds are already prohibited from covering abortion, with extremely narrow exceptions. Defunding Planned Parenthood will instead cut off funding for low-income patients in need of pregnancy testing, cancer screenings, STI testing and treatment, prenatal care, contraception and other critical health services. 

• A New Lawsuit Challenges the Trump Administration’s ‘Review’ of Mifepristone’s Safety: 

• A new lawsuit filed by the Center for Reproductive Rights (CRR) seeks information about the government’s decision to review mifepristone’s safety record. The complaint alleges violations of the Freedom of Information Act (FOIA), following FDA and HHS’s failures to adequately respond to the CRR’s inquiries. In June, FDA Commissioner Marty Makary announced that the Agency would conduct a review of mifepristone, despite the drug’s decades of safe and effective use. CRR filed FOIA requests seeking information about that review process and the data driving the Agencies’ decision. In its press release regarding the lawsuit, CRR cites evidence for its concerns that the decision was motivated by anti-abortion politics rather than legitimate scientific or medical concerns. Earlier this week, Makary and HHS Secretary RFK Jr. sent a letter to 22 Republican attorneys general affirming that FDA is conducting an investigation into the drug’s record. 

Trend and Policy Watch:

• Texas Attorney General Ken Paxton Has Dropped a Lawsuit Against a Texas Doctor:

• Texas has dropped a lawsuit against a pediatric endocrinologist accused of providing gender-affirming care to minors in violation of Texas law. Despite previously referring to doctor Hector Granados as a “scofflaw who is harming the health and safety of Texas children,” the AG’s office has concluded that no legal violations occurred and filed a nonsuit in the case. The state is continuing to pursue two other Texas providers based on similar accusations. 

• Federal Judges Investigate Transgender Civil Rights Lawyer: 

• Prosecutors in Alabama have indicted a transgender civil rights attorney for allegedly making false statements under oath. Although that might not sound like cause for alarm, the attorney and others like him have faced a years-long campaign of harassment and questionable prosecutorial behavior. Mother Jones has done in-depth reporting on this case and why it  reflects an alarming escalation in scrutiny and investigation into advocates fighting for LGBTQ+ rights in the South. 

• Oregon Looks to Protect Access to Abortion as the Federal Landscape Shifts: 

• As the federal government seeks to use the federal budget to strip Medicaid funding from Planned Parenthood, abortion-protective states like Oregon are looking at ways to ensure their citizens continue to have access to care. Oregon House Democrats announced last week that they will be forming working groups ahead of their 2026 legislative session in order to assess options for preserving continued abortion access and protections for clinicians who provide care. Members of the proposed working groups denounced the Administration’s actions with respect to Planned Parenthood and reaffirmed Oregon’s commitment to honoring abortion and gender-affirming care as fundamental rights and critical components of health care. 

REPRODUCTIVE HEALTH DIGEST (9/11/2025)

Developments in Abortion, Autonomy, and Access:

Today’s Digest is a bit shorter than usual, as the author is at a conference much of this week. However, as always, we strive to bring you the most important news on reproductive rights and bodily autonomy from around the country. This week’s edition goes through the latest attacks on the rights of transgender people, litigation developments at the state and federal levels, increasing concern around abortion surveillance, and proposed legislation out of Texas. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

Legislation & Litigation:

• Overview:

• Texas and Florida are seeking to intervene as plaintiffs in a federal lawsuit challenging the FDA’s approval of mifepristone; 

• Texas lawmakers have passed legislation prohibiting the sending of medication abortion into the state, making it more difficult for Texans to access care; 

• A dispute that pits New York’s shield laws against Texas’s abortion ban is continuing to accelerate, with New York Attorney General Letitia James joining the lawsuit; 

• Illinois has passed two bills improving access to reproductive care in the state; and 

• A federal judge has blocked a DOJ subpoena seeking the records of trans minors from Boston Children’s Hospital. 

• Texas and Florida Seek to Intervene in Mifepristone Lawsuit:

• Florida and Texas are seeking to intervene in the lawsuit formerly known as Alliance for Hippocratic Medicine vs. FDA. The plaintiffs in the case aim to roll back FDA’s regulations approving the use of mifepristone for medication abortions in the first 10 weeks of pregnancy. The lawsuit was originally brought by a group of anti-abortion doctors and organizations; however, their case was dismissed for lack of standing. Following that dismissal, Idaho, Missouri and Kansas joined as plaintiffs in an attempt to keep the dispute alive. The lawsuit is currently in front of far-right judge Matthew Kacsmaryk, who has a history of rubber-stamping anti-abortion lawsuits. 

• Earlier this year, the Trump Administration argued that the case should once again be dismissed on the grounds that Missouri, Idaho and Kansas do not have standing in a Texas federal court. If allowed to join, Texas’s presence in the case could help quell those arguments and spur a change in position. Texas and Florida argue that their intervention is appropriate because Missouri, Kansas and Idaho are not able to adequately represent the interests at stake. The case is likely to eventually end up back before the Supreme Court, where it will play a substantial role in shaping access to medication abortion in the U.S. 

• Texas Lawmakers Pass Legislation Restricting Medication Abortion:

• Texas lawmakers have passed HB 7, a new law restricting access to medication abortion. It now awaits Governor Greg Abbott’s signature. Although Texas is already enforcing a total abortion ban, the legislation makes access to care even more legally fraught by allowing  private citizens to bring lawsuits against anyone who mails or distributes abortion pills in the state. This citizen ‘bounty-hunter’ style of law is one that Texas originated with its pre-Dobbs “heartbeat” ban.  The new law applies even if an abortion does not actually take place. It also specifically declares that another state’s shield laws are not a defense, adding another layer to the ongoing interstate disputes over shield laws and abortion bans. Anti-abortion lawmakers insist that HB 7 is necessary to protect Texans from the supposed dangers of medication abortion, casting the women who utilize them as victims. 

• Shield Law Dispute Between Texas and New York Accelerates:

• A dispute that pits Texas’s abortion ban against New York’s abortion shield law continues to develop. Earlier this year, Texas brought a lawsuit against New York shield provider Dr. Maggie Carpenter for mailing abortion pills into Texas. Although a Texas court issued a judgment against her, New York has declined to enforce that judgment or extradite Dr. Carpenter to Texas, citing the state’s shield protections. New York Attorney General Letitia James announced this week that she will intervene in the dispute to defend New York’s law, stating that Texas “cannot commandeer New York’s courts to enforce its punitive abortion laws, and that New York has the legal right and responsibility to safeguard its residents, its providers and its courts from out-of-state overreach.” The case is one of the first substantive legal battles over the enforceability and strength of post-Dobbs shield laws. Experts speculate that the issues involved will likely end up before the U.S. Supreme Court.

• Illinois Expands Protections for Reproductive Rights and Access:

• Illinois Governor JB Pritzker has signed two new bills expanding reproductive rights in the state. The first, HB3637 extends the state’s current shield law to cover all healthcare providers, including midwives and drug distributors. It also amends the Illinois Food, Drug and Cosmetic Act to allow providers to continue to prescribe drugs as long as they remain approved by the World Health Organization, even if the FDA revokes its approval. The second measure, HB 3709, requires public universities to offer contraception and medication abortion on campus in order to address gaps in care. 

• A Federal Judge Has Blocked a Subpoena Seeking the Records of Trans Minors from a Boston Hospital:

• In July, Attorney General Pam Bondi announced that the Department of Justice had issued over 20 subpoenas to health care facilities providing gender-affirming care to minors. She claimed that they were for the purpose of investigating fraud and similar unlawful activities; however, the subpoenas requested expansive information concerning the care provided to individual patients. One of the recipient hospitals, Boston Children’s, asked a federal court to block the subpoena. This week, Judge Myong Joun granted that request. In his order Judge Joun pointed to the Administration’s open animus towards the transgender community and stated that “it is abundantly clear that the true purpose of issuing the subpoena is to interfere with [Massachusetts’] right to protect [gender-affirming care] within its borders, to harass and intimidate [Boston Children’s Hospital] to stop providing such care, and to dissuade patients from seeking such care.” This court order comes as over 20 hospitals and clinics nationwide have ceased providing care to minors under mounting pressure from the federal government. 

Trend and Policy Watch:

• New Mexico Becomes the First Care to Make Child Free:

• New Mexico Governor Michelle Lujan Grisham announced this week that, beginning in November, childcare will be cost-free for New Mexico residents. The new policy applies regardless of a family’s income and is expected to save families up to $12,000 a year. New Mexico is the first state to take this step and will serve as a model for other states to follow, bringing the United States more in line with childcare assistance in comparator nations. 

• Austin Decides to Close its Abortion Travel Fund:

• The City of Austin has made the decision to end its abortion travel fund under pressure from the state and newly passed prohibitive legislation. The city had originally allocated $100,000 for organizations that help Texans travel out of state for care. However, in late August, Greg Abbott signed SB 33 into law, which prohibited governmental entities from funding logistical support for abortion. Texas Attorney General Ken Paxton had previously sued the city for what he called an illegal appropriation of funds. 

• Missouri Continues to Attempt to Stymie the Will of its Voters:

• Missouri continues to fight to get an anti-abortion and anti-gender-affirming care ballot measure on the ballot for 2026. If passed, the measure would undo the recently-passed constitutional amendment legalizing abortion until viability in the state. Simultaneous with this effort, lawmakers are legislating to raise the threshold for citizens to enact constitutional amendments altogether, following successful voter passage of abortion rights, legalization of marijuana and increased minimum wage. If the new law passes, citizen-led initiatives would need a statewide simple majority and a majority in all eight congressional districts, allowing a small cohort of voters to effectively defeat any proposed measure. 

• Lawmakers Embrace ‘Restorative Reproductive Medicine’: 

  • As debates around access to fertility treatments continue at both the federal and state levels, some conservative lawmakers are backing policies supporting so-called “restorative reproductive medicine” (RRM).  Restorative Reproductive Medicine purports to offer holistic alternative approaches to infertility involving “ultrasounds, blood tests, hormone measurements, exploratory surgeries, ‘natural procreative technology” and fertility awareness methods like cycle tracking. Some states, including Arkansas, are passing laws requiring insurance coverage for RRM. Although access to a broad spectrum of supportive reproductive practices is facially positive, experts warn that RRM is not a proven alternative to assisted reproductive technologies like IVF. And, the supporters of the practice often come from groups ideologically opposed to assisted reproduction and contraception.

REPRODUCTIVE HEALTH DIGEST (8/21/25)

Developments in Abortion, Autonomy, and Access:

Today’s Digest is a bit shorter than usual, as the author is at a conference much of this week. However, as always, we strive to bring you the most important news on reproductive rights and bodily autonomy from around the country. This week’s edition goes through the latest attacks on the rights of transgender people, litigation developments at the state and federal levels, increasing concern around abortion surveillance, and proposed legislation out of Texas. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Legislation & Litigation:

• Overview:

• Following the Supreme Court’s Skrmetti decision, federal courts for the 10th and 8th Circuit Courts of Appeals have issued rulings allowing states to enforce their bans on gender-affirming care for minors; 

• Tennessee has issued subpoenas to four medical groups, requesting records related to abortions provided in the state. Although the subpoenas arise out of a case challenging the scope of the state’s abortion ban, it raises alarms about abortion surveillance; 

• The Missouri Supreme Court has declined to review a lower court ruling enjoining certain abortion restrictions prior to the case moving through the appellate process;

• An Indiana Appeals Court has ruled that the state can continue to enforce its total abortion ban without modification or expansion of its current exceptions and requirements; and 

• The Texas legislature appears poised to pass a law that would further expand liability around medication abortion and restrict access to care from out-of-state  shield providers. 

• Federal Courts Rule that Oklahoma and Arkansas Can Enforce Their Bans on Gender-Affirming Care:

• Both the 10th Circuit and the 8th Circuit Courts of Appeals have ruled to uphold state-level bans on gender-affirming care for minors in light of the Supreme Court’s Skrmetti decision. The states involved, Oklahoma and Arkansas, both passed laws banning gender-affirming care for minors, and in both cases, healthcare providers and the families of trangender minors sued on constitutional grounds. However, since the filing of those lawsuits, the U.S. Supreme Court issued its landmark decision in U.S. v. Skrmetti. In its order, the Court found that Tennessee’s ban on gender-affirming care for minors did not discriminate on the basis of sex or transgender status, but instead merely distinguished based on age and medical use. To date, over half of U.S. states have implemented bans on gender-affirming care, and we are likely to see more federal courts apply Skrmetti’s analysis to uphold those laws. Indeed, the Skrmetti decision has already had a significant precedential impact on many ongoing cases involving the rights of transgender people, creating a blueprint for states to lawfully discriminate.  

• Tennessee has Issued Subpoenas Requesting Records of Abortions Performed: 

• Tennessee has issued subpoenas to four medical groups seeking records and information about abortions performed in the state. The subpoenas are a part of a lawsuit brought by a group of women who were denied medically necessary care under the state’s total abortion ban. In requesting records related to the guidance that Tennessee providers use to determine if a patient is eligible for an abortion, Tennessee is likely seeking to establish a case that the law itself is not a problem as written, but instead, providers are simply failing to apply it properly. Although certain confidentiality and privacy protections are in place for the subpoenas, the investigation raises alarms around heightened government scrutiny into the individual actions of healthcare providers and the surveillance of patients’ care. 

• The Missouri Supreme Court Has Refused to Prematurely Review a Lower Court Ruling That Blocked Abortion Restrictions: 

• Since the passage of a ballot measure overturning Missouri’s total abortion ban last November, Missourians have been locked in a battle with the state to vindicate their now constitutionally-enshrined reproductive rights. Although the constitutional amendment technically protects abortion rights up until ‘viability,’ the state has repeatedly argued in favor of strict restrictions that make actually accessing care extremely difficult. Circuit Judge Jerri Zhang has repeatedly enjoined those restrictions. In response to Judge Zhang’s most recent ruling, Tennessee Attorney General Andrew Bailey requested that the Supreme Court take up the case directly, without it going through the normal appeals process. Last week, the court declined that request, finding that jurisdiction is proper in the appellate court. For now, abortion will remain available in the state. 

• An Indiana Appeals Court has Ruled to Uphold the State’s Abortion Ban:

• An Indiana Appeals Court has ruled to uphold the state’s abortion ban without alteration. Plaintiffs argued that the law, which bans abortion at all gestational ages with extremely limited exceptions, was too narrow and placed patients at risk. However, the Court found that it did not violate the “life, liberty, and the pursuit of happiness” clause of the Indiana Constitution and affirmed that only certain extreme medical scenarios create a constitutional right to abortion. It also rejected a challenge to the law’s requirement that abortions be performed in a hospital or outpatient surgical center, reasoning that a constitutionally-protected abortion would almost always involve a circumstance where a patient would need to be in the hospital. 

• Texas Poised to Pass a Law Expanding Liability around Medication Abortion:

• Texas appears poised to pass yet another law limiting and criminalizing abortion access. Although the state is already enforcing a total abortion ban, Senate Republicans have introduced a new bill, the “Women and Child Protection Act,” which would both expand civil liability for anyone involved in the manufacture, prescription, mailing, delivery, or distribution of abortion pills and permit wrongful death lawsuits related to the pregnant person or fetus within a 6-year statute of limitations. The law also takes aim at other states’ ‘shield laws,’ by declaring that they are not a defense to the statute’s prohibitions. Senator Brian Hughes, the sponsor of the bill, sought to cast it as an effort to protect women, stating his view that “moms are the victims here.” Texas’s latest attempted crackdown comes as more and more Americans are relying on medication abortion to access care. 

Trend and Policy Watch

• Trump Administration Moves to Block Health Insurance Coverage for Transgender Federal Employees:

• The Trump Administration has reportedly taken actions to quietly remove coverage for gender-affirming care for adults from the programs that administer benefits to federal employees. Echoing the strategy of many state-level bans, the policy change specifically only applies to transgender people seeking care to treat gender dysphoria. It does not apply to other treatments that might require hormone therapy like cancer or certain reproductive conditions. The letter indicating the change also includes exceptions for ‘counseling services’ for gender dysphoria and requires carriers to create an exceptions process, to be applied case-by-case, for individuals who are mid-treatment. This latest move to strip adults of evidence-based care undercuts any assertions by the Administration that it is primarily concerned with impacts of gender-affirming care on minors. 

• Despite Campaign Promises, the Trump Administration Will Not Cover IVF Treatment:

• The Federal Administration reportedly has no plans to cover IVF treatments, despite promises made on the campaign trail. In the run-up to last year’s presidential election, the Trump Campaign announced that “under the Trump administration, your government will pay for – or your insurance company will be mandated to pay for – all costs associated with IVF treatment.” Then-candidate Trump even referred to himself as “the father of IVF” during a Fox News town hall event. Despite these lofty promises, mandating coverage of IVF would require an act of Congress, and the Administration reportedly does not intend to ask Congress to draft or pass such legislation. However, as Rolling Stone points out, the White House does “plan to redirect funds from a long-standing federal program that helps low-income women access birth control and testing for [STIs]” and instead give those funds to an “‘infertility training center’ that promotes ‘holistic’ approaches to combatting infertility.” 

REPRODUCTIVE HEALTH DIGEST (8/7/25)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers litigation challenging the federal government’s attempts to withhold funding for healthcare, interstate conflicts over shield laws, new state-level regulations restricting care, and the Trump Administration’s move to strip veterans and their beneficiaries of abortion coverage in emergencies and cases of rape or incest. As always, please read on to the end for the news that you need to know.

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s must-read comes from Time and tells the story of a woman who was denied prenatal care because she is unmarried. The provider reportedly told her that it goes against their Christian values to treat an unwed mother. She was not seeking an abortion - just standard prenatal care. However, Tennessee recently expanded its so-called “conscience” laws to allow providers to decline to provide or participate in any healthcare that “violates the conscience of the healthcare provider.” Historically conscience laws, which permit a provider to decline services that conflict with their sincerely held beliefs, have been cabined to narrow circumstances or specific types of care, like abortion. However, expansions like Tennessee’s could open the door to broad and arbitrary denials of care. 

Legislation & Litigation

• Overview:

• A coalition of Democratic state attorneys general have brought a lawsuit against the Trump Administration over its attempt to ‘defund Planned Parenthood’ through the recently passed budget reconciliation bill; 

• Louisiana has passed two new laws restricting abortion. The first makes it easier for patients to bring lawsuits against out-of-state medication abortion providers, and the second expands the definition of ‘coerced abortion;’  

• Oklahoma Governor Kevin Stitt passed an executive order restricting state Medicaid funds from going to entities affiliated with abortion; 

• State attorneys general filed a complaint against the Trump Administration over its intimidation of gender-affirming care providers, arguing that the government’s actions violate the Administrative Procedure Act and constitutional protections; 

• The Trump Administration has announced its plans to cut abortion coverage for veterans and their dependents in medical emergencies or cases involving rape or incest; 

• A group of anti-abortion lawmakers have sent a letter to Congress urging it to pass a law preempting state shield laws; 

• Missouri Attorney General Andrew Bailey has filed a lawsuit against Planned Parenthood, arguing that their claims about the safety of mifepristone violate consumer protection laws; and 

• Nevada has reinstated parental notification requirements for minors seeking abortion care. 

• Democrat State Attorneys General Sue the Administration Over “Defunding” of Planned Parenthood:

• A coalition of Democratic attorneys general and governors are suing the Trump Administration over its attempt to defund Planned Parenthood through the recently-passed budget reconciliation bill. The lawsuit argues that the spending bill intentionally targets Planned Parenthood – even if it doesn't identify the entity by name – through its revocation of federal funding for entities that are associated with the provision of abortion and receive over $800,000 in Medicaid funding annually. The Complaint alleges a host of constitutional deficiencies, including a lack of due process, unconstitutional vagueness, and a First Amendment claim based on the targeting of Planned Parenthood for its advocacy activities. In a press conference about the lawsuit California Attorney General Rob Bonta said the following: “we need to just call it what it is: punishment for Planned Parenthood’s constitutionally protected advocacy for abortion.”

• Planned Parenthood itself has filed a similar lawsuit challenging the same spending bill provision. In that case, Judge Indira Talwani has preliminarily blocked the provision from taking effect. Although the Trump Administration appears reticent to take anti-abortion action as overt as passing a federal abortion ban, actions like aggressively cutting Medicaid funding for providers are an effective backdoor way to legally enshrine restrictions on care. 

• Louisiana Passes Two New Laws Restricting Abortion:

• Louisiana has passed two new laws targeting abortion care. The state is already enforcing a total abortion ban with exceptions only for the life or health of the patient. It has also aggressively pursued other legislative avenues for limiting access to abortion, including the reclassification of abortion pills as controlled substances. Last week, two new restrictive laws took effect. The first, HB 575, targets medication abortion providers by allowing Louisiana residents to sue out-of-state doctors and activists for providing them with abortion pills. It also expands the statute of limitations to file suit from three years to five years. The second bill, HB 425, expands the definition of ‘coerced abortion’ to include control or intimidation, as well as physical force.

• Oklahoma Governor Passes Executive Order Expanding Restrictions on Medical Funding:

• Oklahoma Governor Kevin Stitt has passed an Executive Order barring state Medicaid funds from going to any “individual or entity directly affiliated with a physician, medical practice or other organization providing abortion services or facilitating the procurement of abortion services.” The EO further directs the Oklahoma Health Care Authority (OHCA) to exclude certain providers, including those who are “under common ownership” of an entity that provides abortions that are unlawful in Oklahoma. Because abortion is entirely banned in Oklahoma, this EO is very clearly targeting entities like Planned Parenthood that run state clinics under a national umbrella organization. Those state clinics do not, of course, provide abortions; instead, they provide services including cancer screenings, pregnancy testing, contraception, prenatal care, and STI screening and treatment. The new order comes on the heels of the Supreme Court’s ruling in Medina v. Planned Parenthood South Atlantic, which found that individuals do not have a right to sue over a state’s decision to exclude Planned Parenthood from Medicaid coverage. 

• State Attorneys General Sue Administration Over Gender-Affirming Care Restrictions:

• A coalition of 17 Democrat-Led states are suing the Trump Administration over its intimidation of clinicians and hospitals that provide gender-affirming care to minors. This lawsuit comes after a month of back-to-back announcements that hospitals and clinics in states where care is legal are shuttering their gender-affirming care programs.  A sample of those cases are detailed below: 

• On July 22nd, Children’s Hospital Los Angeles (CHLA) closed its Center for Transyouth Health and Development.  CHLA initially paused care for new patients under 19 in February, then resumed services following backlash. But after hospital leadership reportedly looked to federal agencies for guidance, including the FBI, HHS, DOJ, and CMS,  CHLA made the final decision to close the clinic. Though CHLA claims patients will be transitioned to other providers, advocates warn that many young people will be left without specialized, life-saving care. 

• On July 18th, Children’s National Hospital in Washington, D.C announced  that it will cease offering gender-affirming care for minors at the end of this month. The hospital cited “escalating legal and regulatory risks” tied to DOJ subpoenas and federal pressure. While medical transition services will no longer be offered, Children’s National says it will continue mental health and other supportive services. 

• On July 18th, University of Chicago Medical Center announced that it was ending its gender-affirming care services for minors, citing a need to protect its ability to continue to serve Medicare and Medicaid patients.

• Also in Illinois, University of Illinois indicated in late-July that it would cease providing gender-affirming surgical care for patients under the age of 19. 

• In Connecticut, Yale Medicine and Yale New Haven Hospital have confirmed that they will no longer be offering care for minors under 19; as with the other hospitals, they cited the looming threat created by the Trump Administration’s executive orders. They indicated that they will continue to offer support and mental health services. 

• In California,  Kaiser Permanente will cease offering gender-affirming surgery for individuals under 19 at the end of August as a result of federal pressure. It will continue to offer non-surgical care. 

• In the opening paragraph of the Plaintiffs’ Complaint, they assert that “since taking office on January 20, 2025, President Donald J. Trump and his administration have relentlessly, cruelly, and unlawfully targeted transgender individuals” by seeking to “deny their very existence, banish transgender residents from the public square, and refuse them medically necessary healthcare through unlawful Executive Orders [ ] and a raft of federal agency actions.” The states assert a number of Administrative Procedure Act and constitutional claims, arguing that the Administration is unlawfully intimidating states in an attempt to effectuate a nationwide ban on gender-affirming care for minors. The states are asking the court to declare the challenged actions unlawful and issue an order blocking their continued implementation. 

• Trump Administration Takes Moves to Cut Abortion Access for Veterans:

• The Department of Veterans Affairs under the Trump Administration has announced plans to change its policy of offering abortion coverage for victims of rape or incest or individuals facing life-threatening emergencies. The coverage policy was enacted under the Biden Administration in the wake of Dobbs; it created a lifeline for servicemembers and their families located in ban states. However, the Trump Administration claims the coverage expansion was a matter of federal overreach, saying it “contradicted decades of federal policy against forced taxpayer funding for abortion.” However, the federal policy that prohibits federal funding for abortion includes exceptions for emergencies or in cases of rape or incest, contradicting the Administration’s purported policy rationale for the change. Revoking already extremely limited coverage for servicemembers serves no discernible policy purpose other than further restricting access to abortion. The move is especially cruel when considering that servicemembers and veterans face disproportionately high rates of sexual assault and PTSD related to their service. 

• Anti-Abortion Lawmakers Send Letter Urging Congress to Restrict Shield Laws:

• Republican attorneys general from 15 states have sent a letter to Congress calling on it to take steps to preempt abortion shield laws. Following the Dobbs decision and the proliferation of abortion bans across the country, nearly half of U.S. states passed some form of ‘shield law’ – laws which are intended to protect providers and patients from legal consequences related to reproductive health care. These laws have allowed many patients to continue to safely access healthcare, either by traveling to a shield state or by utilizing telehealth. The letter sent to Congress decried these laws, calling them a “blatant attempt[] to interfere with States’ ability to enforce criminal laws within their borders.” This move is the latest escalation in the interstate battle over how and to what extent states are able to enforce their abortion restrictions in an increasingly complex web of conflicting state laws. 

• While anti-abortion states call on the federal government to take action against shield laws, Texas and New York continue to dispute New York’s shield law at the state level. As we have reported on previously, Texas and Louisiana are both attempting to enforce their abortion laws against New York doctor Maggie Carpenter, who prescribed abortion pills into the states – an action protected by New York’s shield law. Thus far, New York has rebuffed Texas’s attempt to enforce a judgment against the doctor. Last week, Texas Attorney General Ken Paxton escalated his efforts by suing Ulster County Clerk Taylor Bruck in his official capacity. Bruck responded by saying that the act was “unprecedented” but not unexpected, and that he is acting to “uphold[] New York State’s Shield Law.” 

• Missouri Attorney General Files Lawsuit Against Planned Parenthood:

• Missouri Attorney General Andrew Bailey has filed a lawsuit against Planned Parenthood, arguing that the organization violated consumer protection laws by making “deceptive” claims about the safety of medication abortion drug mifepristone. Despite the medication’s exemplary safety and efficacy record, the lawsuit argues that Planned Parenthood has failed to adequately disclose risks associated with its use. AG Bailey is seeking a court order blocking Planned Parenthood from advertising mifepristone, as well as substantial monetary damages and reimbursement of Medicaid funded emergency care related to medication abortion complications. If the lawsuit is successful, it will create a blueprint for leadership in other anti-abortion states. This is particularly concerning as the federal government takes aim at Planned Parenthood and states continue to crack down on access to mifepristone. 

• Nevada Reinstates Parental Notification Requirement for Minors:

• For the first time since it was passed in 1985, a Nevada law requiring minors to notify a parent or guardian before getting an abortion is now in effect. The law had been blocked by a federal injunction for decades, but that block was recently lifted after prosecutors argued it no longer applied following the overturning of Roe v. Wade. In response, Planned Parenthood Mar Monte filed a lawsuit to stop the law, saying it’s vague, lacks clear guidance for minors to seek an exception, and could put young people—especially those in foster care or facing abuse—at risk by delaying or denying care. 

Trend and Policy Watch: 

• The Trump Administration Appears Poised to Have $10 Million in Contraceptives Incinerated:

• The Trump Administration appears poised to burn nearly $10 million worth of contraceptives that were originally designated for use by women and girls overseas. The contraceptives are currently being held in Belgium and reportedly expected to be sent to France for destruction. They were owned by the now-defunct USAID, and State Department spokesperson Tommy Pigott has reportedly said that issuing the contraceptives may be in violation of a policy – known as the Mexico City Policy – that bars U.S. funds from going to organizations that provide abortions. He also stated that the products being held include “abortifacients”, or abortion-inducing drugs. However, a review of the supplies contradicts that assertion. The stock includes copper IUDs, rod implants, birth control injections, and birth control pills, none of which cause abortion, despite certain anti-abortion activists' insistence to the contrary. France and Belgium have faced pressure from the international community to take steps to stop the destruction of the medications, which do not expire until, at the earliest, 2027. And, multiple groups have offered to either purchase the medications for distribution or handle their transfer and distribution. The State Department has reportedly not reached any such agreement. The destruction of the medications will not only be a catastrophic loss of critical resources intended for underserved populations, but it will also cost U.S. taxpayers. 

• New Data Shows that Over a Third of Idaho’s Ob-Gyns Left the State Following the Enactment of its Abortion Ban:

• A new study shows that Idaho lost over a third of its ob-gyns following the implementation of its abortion ban. Although 20 obstetric physicians came to the state in that time, “another 114 of 268 physicians stopped practicing obstetrics, left the state, closed their practices within the state or retired.” According to the study, 37 counties, comprising 569,000 Idahoans are being served by only 23 ob-gyns. As maternity care deserts expand, patient outcomes worsen, and Idaho is a direct example of how abortion bans diminish the efficacy of an already strained healthcare system. 

REPRODUCTIVE HEALTH DIGEST (6/26/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Digest walks through major decisions from the U.S. Supreme Court, including a decision undercutting Medicaid patients’ right to choose their provider, two religion-based cases involving reproductive freedom, and the much-anticipated Skrmetti decision. We also discuss litigation developments before the lower federal courts and in the states. Finally, we take a brief look at the current policy landscape for reproductive health, nearly three years after the Dobbs decision. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News: 

This week’s must-read: 

This week’s must-read comes from the New York Times and details a day in the life of an abortion provider who prescribes medication in ban states under Delaware and New York’s shield laws. The piece offers an intimate and compassionate perspective on what it entails to take on significant personal and professional risks in order to continue providing care. It also illustrates how shield law providers act as a lifeline for pregnant people from all walks of life, including those who identify as pro-life but find themselves in need of care. In a Digest issue full of bad news and challenging Supreme Court decisions, I found it valuable to read the perspective of one of the many steadfast advocates who continue to show up and do the work every day. 

Legislation & Litigation: 

• Overview: 

  • The Supreme Court has issued its decision in U.S. v. Skrmetti, finding that Tennessee’s ban on gender-affirming care for minors does not violate the equal protection clause of the Fourteenth Amendment; 

  • The Supreme Court issued a ruling in Medina v. Planned Parenthood South Atlantic finding that patients do not have a right to sue to enforce Medicaid’s any qualified provider provision; 

  • A federal judge has struck down the 2024 HIPAA reproductive health care privacy rule; 

  • The Supreme Court waded back into abortion waters in two religion-based cases; it sided with the religious entities in both instances; 

  • A federal judge has issued an order siding with trans rights in a case involving the Trump Administration’s attempts to ban trans people from obtaining passports consistent with their gender identity; 

  • Louisiana Legislators have once again declined to add an exception for rape or incest to the state’s total abortion ban; and 

  • Arizona’s Attorney General has indicated that the state will not defend remaining abortion restrictions in light of the new constitutional amendment protecting pre-viability care. 

• The U.S. Supreme Court Determines that Tennessee’s Ban on Gender-Affirming Care for Minors Does not Violate the Equal Protection Clause: 

  • On June 18th, the Supreme Court handed down its much-anticipated decision in United States v. Skrmetti. The Court was asked to rule on the question of whether Tennessee’s ban on gender-affirming care for minors violates the equal protection clause of the Fourteenth Amendment by discriminating on the basis of sex and transgender status. In a 6-3 decision authored by Chief Justice John Roberts, the Court allowed the law to stand, holding that it did not merit heightened scrutiny because it merely discriminated on the non-protected bases of age and ‘medical use.’ The law in question, SB1, prohibits the provision of gender-affirming care to minors in order to treat gender dysphoria, while explicitly allowing identical treatments for cisgender minors to treat any number of conditions. For example, a person assigned female at birth who seeks hormone therapy to stop unwanted growth of facial hair would be legally permitted to access that care, while a minor assigned male at birth would not be able to do so in order to treat gender dysphoria. In other words, the patient’s sex assigned at birth is precisely what determines whether or not they are able to access care. The Court went out of its way to avoid this obvious reality, reasoning instead that the law merely discriminates on the sex-neutral basis of medical use by allowing hormone therapy and puberty blockers to treat certain conditions, while prohibiting it for others. The flaw in this logic is, of course, that the factor determining the underlying medical use is based entirely on the patient’s sex and gender identity. 

  • Although the Court’s ruling was cabined to Tennessee’s law, it is likely to have significant implications for the 27 states that have enacted similar gender-affirming care bans. The majority’s reasoning could also be extended to restrict adult access to care by arguing that such a ban is based only on medical diagnosis and not on sex or any other protected classification warranting heightened scrutiny. And, by weakening the standards for what is considered sex-based discrimination, the Court’s decision could have ramifications for challenges to any law involving distinctions on the basis of sex, including in the abortion and reproductive rights contexts. As Justice Sotomayor articulated in her dissent, the court's finding “invites legislatures to engage in discrimination by hiding blatant sex classifications in plain sight.” 

  • Although a devastating blow, the Court stopped short of issuing a sweeping declaration that discrimination on the basis of transgender status is per se constitutional and left undisturbed other important precedents protecting trans rights. Legal strategies remain available to continue challenging discriminatory laws, and the advocates in the case have indicated that they fully intend to pursue them. 

• The Supreme Court Rules that Medicaid Patients Cannot Sue to Enforce Their Right to See Any Qualified Provider:

• Today, the Supreme Court issued a 6-3 ruling in Medina v. Planned Parenthood South Atlantic (PPSAT), finding that Medicaid patients cannot sue to enforce their right to see any qualified healthcare provider. The case originated from South Carolina Governor Henry McMaster’s 2018 directive that state Medicaid funds should not go to Planned Parenthood, based on PPSAT’s provision of abortion care. The case before SCOTUS focused on the technical legal question of whether the Medicaid provision at issue, which allows patients to receive care from any clinician qualified to provide it, is enforceable by individual patients. The Court ruled in the negative, opening the doors for anti-abortion states to strip funding from Planned Parenthood and other reproductive health entities without accountability to the patients who rely on those clinics’ services. As Justice Jackson wrote powerfully in her dissent, “Today’s decision is likely to result in tangible harm to real people[;] [a]t a minimum, it will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them. And, more concretely, it will strip those South Carolinians – and countless other Medicaid recipients around the country – of a deeply personal freedom: the ‘ability to decide who treats us at our most vulnerable.’ 

• Federal Judge Strikes Down HIPAA Reproductive Healthcare Privacy Rule 

• Northern District of Texas Judge Matthew Kacsmaryk issued a ruling last week striking down a Biden-era HIPAA privacy rule protecting reproductive healthcare information. The Rule was enacted post-Dobbs in response to rising threats of investigation and criminalization of reproductive health care and gender-affirming care. It protected only against the disclosure of patient information related to the provision or receipt of lawful healthcare, while creating exceptions for functions like public health or law enforcement investigations into unlawful practices. However, Judge Kacsmaryk – notorious for his anti-abortion rulings – issued a nationwide order striking down the Rule on the grounds that the Department of Health and Human Services exceeded its authority in creating special protections for reproductive healthcare. It is not yet clear whether HHS will attempt to appeal the ruling.

• The Supreme Court Weighs in on Abortion and Religious Liberty Once Again:

• The U.S. Supreme Court took two actions relating to abortion rights last week, siding with religious groups in both cases. First, the Court agreed to hear First Choice Women’s Resource Centers v. Platkin, a New Jersey case involving a state investigation into a crisis pregnancy center. The case was brought by the Alliance Defending Freedom, a prominent right-wing group involved in anti-abortion litigation around the country. In the suit, the New Jersey Attorney General subpoenaed the centers as a part of an investigation into whether they had violated consumer protection laws by misleading donors and patients about their services. The Court agreed to take the case on the question of whether the plaintiff centers must proceed in state court prior to bringing their First Amendment action before a federal court. 

• The Court’s second action involved sending a case back to the New York Court of Appeals for reconsideration of whether the state’s employer-provided insurance plan coverage requirements unconstitutionally violated the plaintiffs’ religious beliefs. The requirements in question mandate coverage for medically necessary abortions and include religious exemptions; however, the plaintiffs argued that those exemptions were too narrow. Although the New York Court of Appeals ruled against the plaintiffs, the Supreme Court is requiring it to reconsider that ruling in light of a recent decision about tax exemptions for religious employers. In both of these cases, the Supreme Court issued rulings favorable to the religious entities, strengthening the legal theory that assertions of religious objection to abortion can trump state laws protecting access to care. 

• Federal Judge Sides with Trans Plaintiffs in Case Involving Gender Identity and Passports: 

• Despite the Skrmetti ruling, many federal courts are continuing to rule against the Administration’s attempts to aggressively limit the rights of transgender and gender-diverse people. Last Tuesday, the federal district court over Massachusetts issued a ruling blocking the Trump Administration’s changes in passport policy. Previously, the State Department allowed passport holders to select the gender marker that aligns with their gender identity, and permitted an “X” indicator for intersex,  nonbinary, and gender non-conforming individuals. However, in January, the federal administration issued an executive order requiring individuals to only have documentation that reflects their sex assigned at birth, even in cases where the person’s legal documentation has been changed to accurately reflect their gender identity. In April, the Massachusetts District Court issued a preliminary injunction as to the six individual plaintiffs in the case. This week, that injunction was expanded to all persons impacted by the administration’s policy change. This means that individuals can, at least for the time being, apply for and renew travel documentation that is consistent with their gender identity.

• This ruling comes as other federal courts have similarly ruled against the Trump Administration's discriminatory policies against the LGBTQ+ community. Earlier this month, a federal judge for the D.C. District Court issued an order finding that the Bureau of Prisons must continue to provide gender-affirming care to incarcerated individuals. And, two weeks ago, a California federal court ruled against the Administration’s revocation of federal funding for groups providing critical support to the LGBTQ+ community. The Court explicitly called out the Administration’s open animus towards the rights of gender-diverse people in making its ruling. 

• Louisiana Legislators Decline to Add an Exception for Rape or Incest to the State’s Abortion Ban: 

• For the third year in a row, Louisiana lawmakers have declined to add any exceptions for rape or incest to the state’s total abortion ban. The proposed legislation would have created a limited exception to allow minors under the age of 17 to access care if they became pregnant following an assault. The debate over the measure was significantly focused on the religious beliefs of the legislators involved, with one Democratic representative citing her Christian beliefs as a reason why she could not approve adding the exception. Louisiana’s law will continue to include a total ban with exceptions only for the life or health of the pregnant person or in certain cases of grave fetal abnormalities. 

• Arizona Attorney General Will Not Defend Laws Restricting Abortion Care: 

• As we reported in our last Digest, advocates in Arizona have brought challenges to abortion restrictions that remain on the books following the state’s passage of an abortion rights ballot measure. The restrictions at issue include 1) a prohibition on abortion because of nonfatal genetic conditions; 2) a requirement that a patient receive an ultrasound 24 hours prior to an abortion; and 3) a ban on telehealth abortion care, including for medication abortion. In a piece of good news, Arizona Attorney General Kris Mayes has indicated that the state will not defend the laws, citing her determination that they run afoul of the newly added constitutional protections. 

Trend and Policy Watch: 

• New Data Finds Abortion Bans are Extremely Costly: 

  • Three years after the Dobbs decision overturned Roe, we are starting to get a clear picture of the consequences of widespread abortion bans and restrictions, including the financial consequences. New analysis from the Institute for Women’s Policy Research has found that the “16 states with the most restrictive abortion policies cost the US economy more than $64 billion annually.” And, when “factoring in state-level policies that impose significant barriers, such as mandatory waiting periods and medically unnecessary restrictions on providers…the annual economic toll rises to over $133 billion.” 

• Republican Lawmakers Have Asked the EPA to Investigate Mifepristone’s Effect on Water Safety: 

• A group of Congressional Republicans has asked the EPA to investigate whether mifepristone, a drug commonly used for medication abortions, is contaminating the water supply. The lawmakers issued a letter in which they point to unfounded concerns about potential effects that the “byproducts” of mifepristone could have on fertility and the safety of drinking water. As Abortion Every Day’s Jessica Valenti explains, this is not a new anti-abortion strategy. Students for Life has been championing the idea that medication abortion harms the water supply for years, and its Vice President for Policy testified to Texas legislators last month that we “are all drinking other people’s abortions.” 

• The UK Parliament Has Voted to Decriminalize Abortion: 

• In a significant victory for international abortion rights, the U.K. Parliament has voted to decriminalize all abortions, meaning that women cannot face arrest or prosecution for their pregnancy outcomes, regardless of the gestational age of their pregnancy. The vote was 379 to 137. One author of an amendment to the new law, MP Tonia Antoniazzi, explained that the decriminalization efforts are “about recognizing that these women need care and support, and not criminalization.” 

• Abortion Is Still On the Rise, 3 Years After Dobbs: 

• WeCount’s newly released data shows that, despite the enactment of state-level abortion bans post-Dobbs, abortions have continued to rise in the past two years. According to the research, although the majority of abortions continue to take place in person, telehealth abortions have been steadily increasing, likely a significant contributing factor to the rising numbers. Additionally, protective states’ shield laws have allowed those residing in abortion ban states to continue to access care both in person and via telehealth. 

REPRODUCTIVE HEALTH DIGEST (6/5/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Digest goes through the federal government’s decision to rescind guidance directing hospitals to provide emergency abortions, new lawsuits filed by reproductive rights advocates in Arizona and Kansas, and litigation developments in Kentucky and Missouri. We also discuss new research about the safety and efficacy of gender-affirming care, the closure of Planned Parenthood clinics, and trends in pregnancy criminalization. Please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News: 

This week’s must-read: 

On Tuesday, the Trump Administration announced its decision to rescind Biden-era guidance directing hospitals to provide emergency abortion care regardless of state-level abortion laws. Under the federal Emergency Medical Treatment and Active Labor Act (EMTALA), all hospitals that receive Medicare funding are required to provide stabilizing treatment to any patient that presents with an emergency. In response to the Dobbs decision and the wave of state abortion bans that followed, the Biden Administration issued guidance clarifying hospitals’ continued obligation to stabilize patients–even if the treatment required is an abortion that may conflict with a state’s abortion ban. The Biden-era guidance did not create any new abortion rights, it merely allowed providers to treat patients facing acute medical crises without fear of being prosecuted under their states’ laws. By rescinding that guidance, the Trump Administration places the lives of pregnant patients at immediate risk and further confuses the question of when providers can and cannot safely intervene. 

Legislation & Litigation: 

• Overview: 

• Following the passage of an abortion rights constitutional amendment last November, Arizona providers have filed a new lawsuit challenging remaining restrictions on care; 

• The Missouri Supreme Court has issued a decision overturning lower court rulings that allowed abortion to resume in the state; for the time being, care has once again been paused; 

• In Texas, a dangerous bill that would have further restricted access to medication abortion has seemingly failed to cross the legislative finish line this session; 

• The ACLU has voluntarily dismissed its lawsuit challenging Kentucky’s abortion ban; and 

• A lawsuit has been filed in Kansas challenging the state’s laws interfering with end of life choices for pregnant patients. 

• Arizona Providers File Lawsuit Challenging Remaining Arizona Abortion Restrictions: 

• Two Arizona physicians and the Arizona Medical Association have brought a new lawsuit challenging remaining restrictions on abortion care in the state. Last November, Arizona voters passed Proposition 139, an abortion rights amendment legalizing care until ‘fetal viability.’ In light of those new constitutional protections, a state court struck down the prior 15-week abortion ban; however, multiple medically unnecessary restrictions remain on the books. These restrictions include 1) a prohibition on abortion because of nonfatal genetic conditions; 2) a requirement that a patient receive an ultrasound 24-hours prior to an abortion; and 3) a ban on telehealth abortion care, including for medication abortion. Removing these restrictions would significantly improve access to care in the state, particularly for individuals who cannot travel to an in-person clinic or take multiple days off of work to comply with the current waiting period. Democratic Arizona Attorney General Kris Hayes will now have to determine whether the state intends to defend the laws. 

• Missouri Supreme Court Overturns Lower Court Rulings that Allowed Abortion to Resume in the State: 

• The Missouri Supreme Court issued a ruling last week functionally reinstating the state’s abortion ban. Last November, voters made Missouri the first state to overturn a total abortion ban through citizen-led ballot initiative. However, that victory has faced relentless opposition from anti-abortion lawmakers in the months since, including an attempt to outright overturn the amendment. The most recent blow comes from the state supreme court, which ordered a lower court to lift an injunction blocking medically unnecessary abortion restrictions, including an abortion clinic licensing requirement. The supreme court argued that the lower court had applied the wrong legal standard. The previous lifting of the licensure requirement had allowed abortions in the state to resume for the first time since Dobbs. However, in light of the latest ruling, clinics once again were forced to cancel appointments and cease providing care. Advocates are hopeful that this is only a temporary setback, and that the lower court will issue a renewed injunction allowing care to resume. 

• Dangerous Texas Bill Restricting Medication Abortion Fails to Move Forward: 

• As the Texas legislative session comes to a close, it seems efforts to pass a dangerous anti-abortion bill will end with it–at least for this year. SB 2880 would have further restricted access to mifepristone by allowing citizens to sue individuals who manufacture or distribute the medication in Texas. The bill clearly aimed to eliminate Texans’ ability to access care from out-of-state providers and organizations. However, despite its previous forward progress, SB 2880 failed to be scheduled for a floor vote prior to the deadline, likely ending any chance of its imminent passage. The bill is highly likely to be reintroduced in the next legislative session. 

• The ACLU has Dismissed its Lawsuit Challenging Kentucky’s Abortion Ban: 

• The ACLU has voluntarily dismissed its lawsuit challenging Kentucky’s abortion ban. The suit was brought on behalf of a pregnant woman who later traveled out of state to receive care. No legal explanation was offered for the voluntary dismissal; however, the ACLU issued the following statement: “people have the right to control their own bodies without government interference, and we will never stop fighting to restore abortion access in Kentucky. We are strategizing our next steps in this fight. In the meantime, our work to address the commonwealth’s maternal mortality rates and lack of widespread paid leave coverage will continue as long as Kentucky remains a forced-birth state.”

• Lawsuit Filed in Kansas Challenging Law Interfering with End-of-Life Choices for Pregnant Patients:

• A group of physicians and women in Kansas have filed a lawsuit challenging the state’s regulations on end-of-life treatment in cases involving pregnant patients. Kansas law allows the state to interfere with or override a pregnant patient’s advance directive, regardless of the fetus’s gestational age. In other words, if a person has indicated that, in the event of an incapacitating accident or illness, they do not wish to be kept on life support, the state can disregard that directive in the interest of preserving fetal life. The Kansas plaintiffs argue that this is unconstitutional and violates equal protection, privacy, autonomy, and freedom of speech rights. Ethical and legal questions around end-of-life care for pregnant patients have been brought to the forefront of public discourse in recent weeks following reporting about a braindead pregnant woman in Georgia who is being kept alive in an attempt to gestate her fetus to viability. 

Trend and Policy Watch: 

• A Utah Study Ordered by Republicans Finds that Gender-Affirming Care for Minors is Safe and Effective:  

• Over two years ago, Utah Governor Spencer Cox put a “moratorium” on the provision of gender-affirming care for minors. At the same time, he ordered the Utah health department to undergo a systematic review of medical evidence around the safety and efficacy of such treatment. That review is now complete and publicly available, and its findings are clear – gender-affirming care is a safe and effective treatment for gender dysphoria. As reported by Mother Jones, the authors of the review summarized their findings in the following way: “[t]he consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of body changes consistent with the affirmed gender in pediatric [gender dysphoria] patients. The evidence also supports that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer…It is our expert opinion that policies to prevent access to and use of [gender-affirming hormone therapy] for treatment of [gender dysphoria] in pediatric patients cannot be justified based on the quantity or quality of medical science findings or concerns about potential regret in the future, and that high-quality guidelines are available to guide qualified providers in treating pediatric patients who meet diagnostic criteria.” 
  
  The Utah review’s findings contrast with guidance issued in a letter from the Department of Health and Human Services urging healthcare providers to follow a highly-criticized government-issued report, rather than existing clinical practice guidelines. The HHS report was produced in response to the Trump Administration’s executive order disavowing government support for gender-affirming care and referring to it as “chemical and surgical mutilation.” 
  

• Investigations into Miscarriages Continue: 

• Law enforcement in Toledo, Ohio are reportedly investigating fetal remains found at an apartment complex. The coroner examined the fetal tissue and found that it was nonviable and at an early stage of development–in other words, the remains of a miscarriage. Although this story on its own may not seem important, it is a part of an ongoing trend of law enforcement investigating women for miscarriages, and in some cases even arresting and charging women with crimes like abuse of a corpse. Just this week, a West Virginia prosecutor indicated that criminal charges could be levied against women who miscarry, depending on how they dispose of fetal remains. It is unclear at this time whether the investigation into the Toledo incident is ongoing; however, the fact that law enforcement was involved at all is cause for concern. 

• Texas Police Have Reportedly Used a Nationwide License Plate Tracking System to Track a Woman Who Self-Managed An Abortion:

• In Texas, the Johnson County Sheriff’s Office reportedly used a nationwide surveillance system comprising more than 83,000 license plate readers to try and track down a woman who self-managed an abortion. The search was initiated after the woman’s family contacted law enforcement with concerns that she would “bleed to death,” and it extended into states where abortion is legal. Although the sheriff involved stated that they were not attempting to stop the woman from leaving the state, reproductive rights advocates warn that such surveillance could be used to track, monitor and criminalize people traveling for abortion care. 

• Planned Parenthood is Shuttering Over 20 Clinics Across Seven States As it Faces Renewed Threats: 

• Planned Parenthood is reportedly shuttering over 20 clinic locations across seven states as it faces renewed threats, including loss of Title X funding and a reconciliation bill that calls for its ‘defunding.’ In Iowa alone, four of the six remaining clinics are set to close, including the one clinic that provides abortion services. The organization has been forced to lay off employees and limit services offered, impacting access to cost-effective healthcare for countless Americans. The CEO of Planned Parenthood North Central States, Ruth Richardson, gave the following statement: [w]e have been fighting to hold together an unsustainable infrastructure as the landscape shifts around us and an onslaught of attacks continues.” 

REPRODUCTIVE HEALTH DIGEST (5/22/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Reproductive Health Digest goes through litigation developments out of South Carolina, Florida, Missouri, and Michigan. We also walk through legislation out of Georgia and Texas, Missouri’s ongoing efforts to reverse the abortion rights ballot measure passed by voters last year, and Louisiana’s second case against a New York shield provider. Finally, we outline major reproductive healthcare news and policy developments at the federal and state levels, including a sweeping attempt to defund abortion and gender-affirming care. Please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News: 

• This week’s must-read: This week’s Must-Read from ProPublica underscores the critical role that institutional support for clinician decision-making plays in patient outcomes. ProPublica’s analysis of post-abortion ban sepsis rates in Texas found that, despite rates skyrocketing statewide, the numbers differed drastically between Houston and Dallas. The key difference appears to be that Dallas hospitals and institutions have taken an active role in creating workable protocols and supporting their physicians in providing emergency abortion care, while Houston hospitals have taken a far more conservative approach to pregnancy terminations. 

Legislation & Litigation:

• Overview:

  • The South Carolina Supreme Court has issued a ruling finding that the state’s ban on abortion after detection of fetal cardiac activity applies around the 6-week mark; 

  • Missouri Lawmakers passed a resolution that will ask voters to undo the abortion rights constitutional amendment that they passed via citizen-led ballot measure last November; 

  • A Florida court has found that the state’s judicial bypass law–the legal process by which a minor can seek a court’s permission to obtain an abortion–unconstitutionally infringes upon the rights of Florida parents; 

  • Georgia Governor Brian Kemp has signed a bill banning state funding from going to support gender-affirming care for trans inmates; 

  • A Missouri Court has ruled that Planned Parenthood must turn over de-identified patient records relating to the provision of gender-affirming care; 

  • A Michigan Court has struck down certain medically unnecessary barriers to care, including a 24-hour waiting period, restrictions on who can perform abortions, and biased counseling requirements;  

  • Louisiana has opened up a second case into New York shield provider Dr. Margaret Carpenter; 

  • SB 31, a Texas bill purporting to clarify the state’s abortion ban, has passed another critical hurdle; and 

  • A federal court has struck down Pregnant Workers Fairness Act workplace protections for abortion patients. 

The South Carolina Supreme Court Upholds the State’s “Heartbeat” Ban at 6-weeks: 

• The South Carolina Supreme Court has issued a ruling finding that the state’s ban on abortion after detection of fetal cardiac activity applies around 6-weeks gestational age. Planned Parenthood argued that, because the chambers of the fetal heart have not formed by 6 weeks, the law’s use of the phrase “repetitive rhythmic contraction of the fetal heart” means that abortion must be permitted until closer to 9 weeks, when the fetal heart comes together and rhythmic contraction begins. While the court acknowledged the medically ambiguous nature of the law’s phrasing, it turned to the legislative record and found that both sides appeared to clearly understand and represent that the heartbeat bill was functionally a 6-week abortion ban at the time of its original consideration by the general assembly.  South Carolina’s ban will remain unchanged for the time being. 

• Missouri Lawmakers Ask Voters to Undo Abortion Protections: 

• Missouri lawmakers continue to push to repeal the state’s new abortion rights constitutional amendment. This week, the Missouri Senate used a rare mechanism to end a Democrat-led filibuster and force a vote on House Joint Resolution 73, which will ask voters to once again ban most abortions in the state. The Resolution comes mere months after Missouri voters soundly passed a constitutional amendment protecting pre-viability abortion rights and overturning a total abortion ban. The secondary measure will either appear on the 2026 ballot or go before voters via special election. 

• Missouri lawmakers’ attempts to turn back the clock on the 2024 amendment have been broadly criticized as an anti-democratic attempt to supersede the will of the people. Senate Minority Leader Doug Beck criticized the Resolution, stating that “24 Republican Senators decided that they think what’s best for Missourians” over Missourians own votes on the issue. 

• Florida Court Invalidates Judicial Bypass for Minors: 

• Florida’s Fifth District Court of Appeals issued an opinion last week finding that the state’s judicial bypass procedures unconstitutionally violate parental rights. States that require parental involvement for a minor to access abortion care also have procedures in place for judicial bypass–the process by which a minor can petition the court for permission to get an abortion without parental consent or notification. Judicial bypass is often utilized in cases where the minor cannot safely involve a parent or guardian. It has been an established norm since the U.S. Supreme Court determined in 1979 that the rights of parents must be balanced against the constitutional right of pregnant people to access abortion, and therefore states that mandate parental involvement must also provide an alternative avenue to care.

• The Florida court in the present case found, however, that judicial bypass procedures–with the exception of those in place for victims of abuse–violate parents’ rights to make decisions about their children’s care. The opinion cited Dobbs to repudiate the idea that minors retain any independent right to access abortion care. The court invited the Florida Supreme Court to review its decision, where it will face a panel of justices hostile to abortion rights. The outcome of this case will likely create a strategic blueprint for other abortion-hostile states that are seeking to limit minors’ ability to access care.

• Georgia Governor Brian Kemp has Signed a Bill Banning Gender-Affirming Care for Trans Inmates: 

• Georgia Governor Brian Kemp has signed a law prohibiting the use of state funds for gender-affirming care for transgender inmates. SB 185, the bill in question, is discriminatory on its face. It explicitly allows identical treatment to be delivered to inmates for reasons other than gender dysphoria, including intersex inmates or inmates who are de-transitioning. The population of transgender inmates in Georgia prisons is exceedingly small, and removing their ability to access care subjects them to unnecessary harm and suffering while providing little to no benefit to the state. In response to the bill, Minority Caucus Chair Tanya Miller stated “[y]ou are wasting our time – better still, wasting the taxpayers’ money . . . solving problems that no one asked you for, that do not in fact exist.” 

• A Missouri Court has Ruled that Planned Parenthood Must Turn Over Patient Records Related to Gender-Affirming Care: 

• Attacks on the rights and privacy of trans people continue in Missouri, where a court has ruled that Planned Parenthood must turn over documents relating to gender-affirming care to the Attorney General’s office. Attorney General Andrew Bailey is purportedly seeking these records from Planned Parenthood and other providers as a part of an investigation into whether the provision of gender-affirming care in the state violates consumer protection laws. His office is alleging that clinics in the state may have engaged in “deception, fraud, false promises, misrepresentation, unfair practices, and/or the concealment, suppression or omission of material facts.” Planned Parenthood has declined to turn over patient records, arguing that this is a violation of patient privacy law and an improper use of consumer protection laws. Judge Rebeca Navarro-Mckelvey disagreed, finding that the investigation may proceed and Planned Parenthood can turn over de-identified records without violating HIPAA’s privacy protections. 

• A Michigan Court Has Struck Down the State’s 24-hour Waiting Requirement: 

• In 2022, Michigan became one of the first states to enshrine abortion rights into its constitution. The Reproductive Freedom for All Amendment (RFFA) prohibits the state from infringing upon or burdening the right to pre-viability abortion; however, it did not automatically unwind other restrictions on care that remain on the books. Advocates have brought those remaining challenges before the courts. Last week, in a win for reproductive freedom, a Michigan court struck down a 24-hour waiting period, as well as biased counseling requirements and a prohibition on advanced practice providers, like nurse practitioners and physicians assistants, providing abortion care. Judge Sima Patel found that the provisions infringed upon or burdened the right to access reproductive healthcare in violation of the RFFA. Judge Patel allowed a provision requiring screening for signs of coercion to remain in place. 

• Louisiana Opens  a Second Case Against New York Shield Provider:

• Louisiana Attorney General Liz Murrill is leading a second investigation into New York shield provider Margaret Carpenter, based on her alleged provision of abortion pills to a woman in Shreveport. To date, New York has refused to comply with cases brought against Dr. Carpenter by both Louisiana and Texas, citing its shield law’s protections from out-of-state investigations and extradition requests. These cases are currently in their early stages, but they will eventually lead to the first real test of whether shield laws can withstand judicial scrutiny. The Trump Administration has seemingly indicated its willingness to side with and potentially assist anti-abortion states.  

• Texas Abortion Clarification Bill Progresses: 

• A controversial bill purporting to clarify Texas’s abortion ban has cleared another hurdle. It now only faces one more procedural vote before it will go to Governor Abbott, who has indicated his support for the measure. SB 31 does not expand access to care in the state or establish new exceptions; instead, it removes the words “life-threatening” from the current language of the life or health exception and states that an emergency does not need to be imminent or irreversible in order for a doctor to intervene. The bill had drawn criticism from both sides, with anti-abortion lawmakers raising concerns that it would give doctors a free pass to perform abortions, and pro-choice advocates arguing that it fails to meaningfully provide relief from the current ban’s deficiencies. 

• Federal Court Strikes Down Workplace Accommodations for Abortion Patients:

• On Wednesday, a federal judge issued an order striking down the Biden Administration’s rule applying the Pregnant Workers Fairness Act to employees needing abortions. The rule did not require employers to provide paid leave or other direct support; it merely required employers to provide unpaid leave unless doing so would constitute undue hardship. Wednesday’s Order found that the EEOC exceeded its statutory authority in promulgating the rule. 

Trend and Policy Watch: 

• House-Passed Reconciliation Bill Drastically Expands Efforts to Defund Abortion and Gender-Affirming Care. 

• Anti-abortion and anti-trans rights lawmakers have long been engaged in state and federal-level efforts to defund Planned Parenthood and other prominent care providers. But on Thursday, the House passed a reconciliation bill that includes a stunning escalation of these efforts. At the final hour, two provisions were added that would not only ban federal funding for minors, but would, as reported by Mother Jones, “ban Affordable Care Act health care plans from covering abortion and gender-affirming care for all Medicaid patients, including adults.” If passed, this reconciliation bill will effectuate the largest cuts to Medicaid in American history, depriving millions of people of essential care and effectively codifying a backdoor abortion ban for large swaths of the population. Experts report that initial proposals to ‘defund Planned Parenthood’ using the federal budget would cost taxpayers over $300 million. And, because the Hyde Amendment already blocks federal funding from going to abortion, defunded services would include things like preventative care, STI testing and treatment, cancer screening, contraception, and prenatal care. The current version of the reconciliation bill cannot be allowed to pass, and it is incumbent on each of us to raise our voices and demand accountability from our lawmakers. 

• A Woman Being Kept on Life Support in Georgia Raises Ethical and Legal Questions:

• As you have likely read in recent days, reports have come out that a brain dead Georgia woman’s body is being kept alive in an attempt to allow her pregnancy to continue until fetal viability. Although all of the details of the case are not known to the public, the circumstances raise serious questions around medical ethics, fetal personhood and the rights of pregnant people and their families to make medical decisions. Adriana Smith suffered brain death in February at around 8-weeks pregnant. However, Georgia’s abortion ban does not allow abortion after detection of fetal cardiac activity, and the fetus still had a heartbeat. The family reports that they were not given a choice in how to proceed after Ms. Smith’s death. The Georgia Attorney General has since released a statement saying that Georgia’s ban does not require a hospital to keep a brain dead patient on life support to sustain a pregnancy. 

• Secretary of Health and Human Services RFK Jr. Has Ordered a Review of the Safety of Mifepristone: 

• Secretary of Health and Human Services RFK Jr. has ordered Food and Drug Administration Commissioner Dr. Martin Makary to conduct a “complete review” of the safety of mifepristone. Despite decades of usage and over 100 scientific studies on the drug’s safety and efficacy, the Trump Administration appears to be ordering this review based on a recently released report from a right-wing group. This report purports to show that over 10% of women who take mifepristone suffer serious complications–a number far higher than the less than 1% of patients shown by credible data. However, the report has been broadly criticized for a lack of transparency and scientific rigor. Even the report’s own supporters have admitted its severe limitations; Dr. Christina Francis, CEO of the American Association of Pro-Life OBGYN’s stated that the report is “not a study in the traditional sense” and “not conclusive proof of anything.” 

REPRODUCTIVE HEALTH DIGEST (5/8/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Repro Health Digest is a bit shorter than usual, as our team has been partially out of office–but, we are determined to still hit the highlights and cover the most important updates from the past two weeks. This week’s Digest discusses the ongoing legal battle over access to mifepristone, litigation around the rights of minors, positive and negative state legislative developments, and the government’s sustained attack on the rights of trans people. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed. 

Reproductive Rights and Health Equity News: 

This week’s must-read: This week’s must-read from the Guardian examines how the idea of abortion ‘abolitionism,’ a movement that champions fetal personhood and endorses treating abortion as homicide, has entered the mainstream of American anti-abortion politics. At least 12 states have introduced legislation that would open the door to criminally charging pregnant people for abortion–a charge that carries the death penalty in several of these states. And, the scope of who is being targeted for punishment and what conduct is punishable continues to widen as more extreme views and voices gain traction. 

Legislation & Litigation: 

• Overview: 

• The Trump Administration is continuing the Biden Administration's efforts to dismiss a case challenging FDA approval of mifepristone on jurisdictional grounds; 

• Lawmakers in Vermont and Colorado have passed legislation strengthening protections for reproductive healthcare in their respective states; 

• A Missouri abortion text hotline is challenging the state’s parental involvement requirements; 

• Alabama’s abortion funds have resumed providing assistance following a decision finding that the state cannot prosecute groups for helping people obtain lawful out-of-state care; 

• Nevada has paused enforcement of its parental notification law while Planned Parenthood seeks to stay the law pending appeal; 

• A federal court has declined to allow Guam’s attorney general to revive a total abortion ban in the territory; 

• The Texas Senate is continuing to advance a bill that purports to clarify the medical exceptions to the state’s total abortion ban; 

• Virginia Governor Glenn Youngkin has once again vetoed protections for contraception in the state; and 

• The Supreme Court will allow the Trump Administration to enforce its trans military ban. 

• The Trump Administration Continues to Urge Dismissal of Case Challenging Mifepristone on Jurisdictional Grounds: 

• On Monday, the Department of Justice filed a brief continuing to urge the Northern District of Texas to dismiss a case challenging FDA’s approval of mifepristone for medication abortion. The case was initially filed in 2022 by the Alliance for Hippocratic Medicine, a group of anti-abortion doctors and medical groups. The Supreme Court dismissed their claims last year for lack of standing, finding that the parties could not demonstrate how they had been injured by FDA’s actions. In a bid to keep the case alive, Idaho, Kansas and Missouri moved to intervene before the district court. The Biden Administration argued for dismissal on the grounds that the intervenor states similarly lacked standing and were not properly venued in the Northern District of Texas. While that motion was pending, however, the federal administration changed from Biden to Trump, raising the question of whether the new administration would continue to defend the suit. 

• On Monday, the government filed its reply brief, wherein it continued to urge the Biden Administration’s position and argue for dismissal. Although the government’s continued defense of the case is welcome, whether it signals an intention to preserve access to mifepristone remains an open question. While the law involved in this case plainly cuts against the Idaho, Kansas and Missouri’s current arguments, the government’s brief left open the possibility of the states filing an independent challenge in a proper jurisdiction. 
  

• Vermont and Colorado Lawmakers Pass Legislation Strengthening Protections for Reproductive Healthcare in Their States:

• Lawmakers in both Vermont and Colorado have passed legislation to strengthen protections for providers and recipients of reproductive healthcare in their states. 

• In Vermont, legislators passed a bill that would streamline access to medication abortion by allowing providers to use an online questionnaire for prescription purposes, further regulate advertising around reproductive health care under existing consumer protection laws, and put in place additional privacy protections for providers. In Colorado, Governor Polis signed two new bills protecting abortion rights. The first repeals a prohibition on the use of state funds for abortion, following the passage of an abortion rights amendment last November. The second increases protections for providers by allowing them to remove their individual names from prescriptions and requiring subpoenas seeking patient information to affirm that the information is not sought for the purpose of  investigating lawful healthcare. 
  

• A New Lawsuit is Challenging Missouri’s Parental Involvement Requirements: 

• Abortion support text line ‘Right By You’ has filed a lawsuit in Missouri seeking to overturn two of the state’s restrictions on minors accessing care. The lawsuit argues that these statutes violate the recently-passed reproductive rights constitutional amendment. Together, the challenged laws require parental consent and notification prior to a minor obtaining an abortion and prohibit the provision of practical or financial support to a minor without the requisite parental involvement. The lawsuit challenging parental involvement requirements comes as Missouri Attorney General Andrew Bailey continues to argue for enforcement of additional medically unnecessary restrictions on abortion in the state. 

• Alabama Abortion Fund Resumes Providing Assistance:

• For the first time in almost three years, the Yellowhammer Fund has resumed funding abortion in Alabama. The Fund’s mission has been in legal limbo for the past several years while litigation unfolded over the state’s ability to prosecute groups for helping patients obtain out of state care. In April, Judge Myron Thompson ruled against the state, finding that such prosecutions would violate constitutionally protected rights to speech and travel. This is an important victory both for Alabamians and nationally, as states across the country test whether they can extend their abortion bans beyond their own borders. 

• Nevada has Paused Enforcement of its Parental Notification Law: 

• As we reported in April, U.S. District Court Judge Anne Traum ruled last month that, in light of the Dobbs decision, Nevada can revive its parental notification requirements for minors seeking abortions in the state. Although the law was set to go into effect on April 30th, Judge Traum has granted Planned Parenthood’s request to pause enforcement of the law while it seeks a stay from the Ninth Circuit Court of Appeals pending appeal. 

• A Federal Court Declines to Allow Guam to Revive its Abortion Ban:

• Last week, the Ninth Circuit issued a ruling dismissing Guam Attorney General Douglas Moylan’s attempt to revive a total abortion ban. The Court determined that a Guam Supreme Court decision finding the ban to be legislatively repealed rendered the case moot. The U.S. Supreme Court has declined to review the Guam Supreme Court’s ruling. 

• The Texas Senate has Advanced a Bill that Purportedly Clarified the State’s Abortion Ban: 

• The Texas Senate is moving forward with a controversial bill that Republican lawmakers claim will help clarify the state’s abortion ban. Prompted by reports of Texans dying or facing devastating health outcomes as a result of the current ban’s vague language, the amended law would clarify that a medical emergency need not be imminent or actively causing injury to the patient at the time of treatment. Critics of the bill argue that, in practice, it will make little meaningful difference to doctors and patients. They also point to the fact that the amendment fails to create exceptions for lethal fetal anomalies or cases of rape or incest   

• Virginia Governor Glenn Youngkin has Once Again Vetoed Protections for Contraception: 

• Virginia Governor Glenn Youngkin has once again vetoed a bill that would expressly protect the right to full-spectrum contraception in the state. Although Governor Youngkin claims that the bill is unnecessary and anti-choice actors continue to insist that concerns about the future of birth control access are alarmist exaggerations, Republican lawmakers at the state and federal levels have repeatedly blocked protective bills. Some of those same lawmakers have erroneously claimed that contraception methods like IUDs and emergency contraception are ‘abortifacients,’ or abortion-causing drugs. 

• The Supreme Court Supreme Court Will Allow the Trump Administration to Implement its Trans Military Ban:

• The U.S. Supreme Court ruled this week that the Trump Administration’s ban on transgender service members may go into effect while legal challenges continue to play out in the lower courts. The opinion was unsigned and provided no legal reasoning for the Court’s determination. Justices Sotomayor, Kagan and Jackson dissented. If implemented, the ban would not only block trans people from joining the military, it would also force out those currently serving. 

REPRODUCTIVE HEALTH DIGEST (4/24/25)

Developments in Abortion, Autonomy, and Access: 

In this week’s Reproductive Health Digest, we discuss legislative developments in Texas, Missouri, and Nebraska, as well as litigation in both state and federal courts. We also report on new data on the numbers of abortions performed across the country and the impacts that federal funding freezes are having on Title X clinics. As always, please read on to the end for the news that you need to know. 

Reproductive Rights and Health Equity News: 

Legislation & Litigation:

• Overview: 

  • An Idaho judge has issued a limited ruling purporting to clarify the scope of the state’s abortion ban; 

  • The status of abortion in Wyoming continues to shift, as a judge blocks restrictions on care, and the state supreme court considers the constitutionality of proposed bans; 

  • Texas has proposed legislation to prohibit state funds from going to any entity or individual who provides practical support for abortion seekers; 

  • The Trump Administration has sued Maine over the state’s refusal to exclude trans girls from girls sports teams; 

  • Missouri lawmakers have advanced a proposed constitutional amendment that would repeal the abortion rights amendment passed by voters last year; 

  • The parties to an Arizona challenge to a fetal personhood law have voluntarily dropped their suit; 

  • The Nebraska legislature is advancing burial and cremation requirements for aborted fetuses; 

  • Texas legislators want to test wastewater for birth control and abortion medication; and

  • A federal judge has ruled that a group of Catholic employers do not have to comply with certain federal protections for pregnant and LGBTQ+ workers.

Idaho Judge Issues Limited Ruling Allowing Emergency Abortions:

• This week, an Idaho state court judge issued a ruling purporting to clarify the scope of the state’s abortion ban and its exception for the life of the patient. The Center for Reproductive Rights brought this lawsuit on behalf of four patients who were denied emergency abortions, two Idaho physicians and the Idaho Academy of Family Physicians. Collectively, the plaintiffs argue that Idaho’s abortion ban, which only permits abortion to save the patient’s life, violates Idaho’s Declaratory Judgment Act and the state’s constitutional guarantees of life, happiness and safety. In a limited ruling, state District Judge Jason Scott found that abortion is not prohibited if the patient’s pregnancy or health condition puts them at a “non-negligible risk of dying sooner without an abortion,” even if death is not imminent or assured. 

• The Status of Abortion in Wyoming Continues to be in Flux: 

• The legality of abortion in Wyoming continues to be in flux with legal fights playing out across multiple courts. As we previously reported, although abortion remains legal until viability, cumbersome state requirements have rendered it functionally unavailable. However, earlier this week, Wyoming’s only remaining abortion clinic resumed abortion care after a judge halted medically unnecessary laws requiring abortion clinics to be licensed as outpatient surgical centers and patients to have an ultrasound prior to obtaining medication abortion. 

• As care resumes in the state, the Wyoming Supreme Court is considering the constitutionality of two abortion bans that a state judge blocked in November of last year. The arguments in the case turn on whether a 2012 state constitutional amendment guaranteeing the right of individuals to make healthcare decisions encompasses the right to choose abortion. That amendment was passed in response to the Affordable Care Act. The Wyoming Supreme Court heard oral arguments in the case on April 16th; it will likely hand down its ruling within a few months. 
  

• Texas Attempts to Pass Further Restrictions on Funding for Logistical Support for Abortion: 

• The Texas Legislature is once again attempting to tighten the noose on abortion access both inside and outside of the state. Although abortion is banned and unavailable in Texas except in emergency cases, the state is attempting to pass a law that would expand the definitions of “abortion provider” and “abortion assistance entity” and block state funds from going to entities or individuals assisting with the logistics of out-of-state abortion access. Abortion assistance is defined expansively in the bill and would effectively encompass any and all practical support including travel, child care, counseling, lodging, or reimbursement for the cost of the abortion, regardless of where it takes place. The proposed legislation takes clear aim at abortion funds in the state, as well as other entities and individuals who would help pregnant Texans leave the state to obtain lawful care.  

• Trump Administration Sues Maine Over Inclusion of Transgender Girls in School Sports: 

• The Trump Administration is escalating its attack on trans rights with a lawsuit against Maine over the state’s inclusion of transgender girls in girls' sports. The Justice Department has asked the court to direct schools in the state to prohibit participation on girls' teams by minors who were not born female. The Administration argues that their inclusion violates Title IX’s anti-discrimination provisions. Maine officials disagree, contending that the Trump Administration’s position would force the state to violate its own human rights laws. In response to Maine’s refusal to comply with its demands, the Administration has threatened to pull funding for education in K-12 schools. It also attempted to freeze Department of Agriculture funds; however, that move has been blocked by a federal court. 

• Missouri Lawmakers Advance Proposed Amendment to Undo Recently-Passed Abortion Rights Amendment: 

• Last year, Missouri voters made history by being the first state to undo a total abortion ban via citizen-led ballot measure. However, undeterred by the clearly expressed will of the people, Missouri lawmakers are moving forward with a secondary proposed constitutional measure asking voters to repeal the first. House Resolution 2454 does not state at what gestational age abortion would be banned, but it does specify exceptions for cases of rape or incest prior to 12 weeks, fatal fetal anomalies and medical emergencies. Opponents of the Resolution argue that lawmakers are attempting to make an end-run around the outcome of last November’s election, but those supporting the bill insist that they are merely giving voters a second chance. 

• Arizona Parties Voluntarily Drop Lawsuit Against State Fetal Personhood Law: 

• Parties to an Arizona lawsuit challenging a fetal personhood measure have voluntarily dismissed the case. The contested law purported to give fetuses the same rights as Arizona residents; however, it never went into effect as a result of ongoing litigation. The parties agreed that the current challenge was rendered moot by the passage of an abortion rights ballot measure last November. 

• Nebraska Legislature Advances Burial Requirements for Aborted Fetuses: 

• The Nebraska Legislature is advancing LB632, a  bill that would mandate certain burial and cremation requirements following an abortion. The bill would not apply to fetal remains resulting from a miscarriage or stillbirth. Proponents of the bill insist that it is about supporting the dignity of the fetus; however, critics argue that its true purpose and effect is to penalize the pregnant person and shame patients who seek abortion. The measure also raises concerns about heightened surveillance and criminalization of pregnant people and their providers. 

• Texas Legislators Want to Test Wastewater for Birth Control and Medication Abortion: 

• The Texas Senate has introduced a bill that would require wastewater testing for hormones found in abortion medication, gender-affirming care and hormonal birth control. Author of the bill Senator Bryan Hughes cited concerns about hormones leading to health risks and environmental contamination, a claim championed by anti-abortion group Students for Life. Health experts have found no credible evidence that mifepristone and other targeted medications are entering the water supply in high levels, and advocates point to the fact the lawmakers raise no similar concerns about far more commonly used medications like Tylenol and ibuprofen. 

• A Federal Judge Has Ruled that A Group of Catholic Employers Do Not Have to Comply with Certain Protections for Pregnant and LGBTQ+ Workers: 

• Federal Judge Daniel Traynor issued a ruling earlier this week finding that a group of Catholic employers do not have to comply with an updated Pregnant Workers Fairness Act Rule and Title VII guidance regarding discrimination on the basis of reproductive choices, gender identity and sexual orientation. The new Pregnant Workers Fairness Act rule requires reasonable accommodations for pregnant employees–including those seeking abortion or fertility treatments. It does not obligate employers to provide paid time off or other direct support for abortion seekers. But, it would require the employer to provide unpaid leave unless doing so would cause undue hardship. The challenged Title VII guidance bars workplace discrimination on the basis of a person’s gender identity or sexual orientation. The Diocese of Bismarck and the Catholic Benefits Association brought their lawsuit last August arguing that both of these provisions violate their beliefs about the Catholic Church’s teachings on reproductive rights and LGBTQ+ issues. Judge Traynor agreed, finding that the requirements substantially burden the Plaintiffs freedom of religion. 

Trend & Policy Watch: 

• Center for Medicare and Medicaid Services Issues Guidance Directing States  Not to Use Medicaid Funds for Gender-Affirming Care for Minors:

• Continuing the Administration’s attack on trans rights and access to gender-affirming care, the Center for Medicare and Medicaid Services (CMS) has issued a letter urging states not to use medicaid funding for gender-affirming care for minors. Although Dr. Mehmet Oz, the Administrator for CMS, alleges that there is insufficient evidence to support the efficacy and safety of gender-affirming care, the treatment is supported by all major American medical associations. 

• Title X Clinics Are Beginning to Close Following Loss of Federal Funding: 

• Clinics are beginning to close their doors following the Trump Administration’s decision to freeze millions of dollars in Title X grant funding. The funding freeze targeted nine Planned Parenthood affiliates, and the Administration cited concerns about the group’s position on diversity, equity and inclusion–including statements stressing its “commitment to black communities.” Although the government purported to give the groups ten days to demonstrate compliance with anti-discrimination laws, the groups who responded within the deadline reported that they have received no new information. As a result of the funding freeze, countless patients will lose access to cost effective reproductive healthcare, including contraception, preventative care, and pregnancy testing. 

• Abortion Continues to Rise in the U.S.: 

  • Data released by the Guttmacher Institute on April 15th shows a slight increase in abortions nationwide, with significant variability from state-to-state. The data also shows how abortion laws in one state impact other states in the region. For example, when abortion decreased in Florida after the state passed a 6-week ban, numbers spiked in Virginia, where abortion is permitted until about 26 weeks. The continued national rise in abortions is attributable in large part to individuals traveling to access care and the increased accessibility of medication abortion.

REPRODUCTIVE HEALTH DIGEST (4/10/25)

Developments in Abortion, Autonomy, and Access: 

In this week’s Reproductive Health Digest, we discuss an important Supreme Court case about Medicaid and Planned Parenthood, newly introduced and passed state legislation, developing policy trends, and updated reporting and analysis on public opinion about reproductive healthcare and abortion. As always, we welcome your feedback on how we can best make this Digest suit your needs and support your work. Please read on to the end for the news that you need to know.

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed. 

This Week’s Must Read:

This week’s must-read is a long, but important, one. The National Women’s Law Center has published a new report outlining the myriad strategies being employed to undermine access to birth control post-Roe. Access to abortion and access to birth control are inextricably intertwined issues, and there are many ways to erect barriers to contraception that don’t require passing a sweeping ban. The strategies described in the Report are ongoing in many states, and we will be watching closely as the policy landscape develops. 

Legislation & Litigation: 

Overview: 

• On April 2nd, the U.S. Supreme Court heard oral arguments in a case about Medicaid funding for Planned Parenthood that will have sweeping implications for the rights of Medicaid recipients nationwide; 

• Texas is considering a bill that purports to clarify its abortion ban, but it has met resistance from both sides of the aisle; 

• North Carolina lawmakers have proposed a total abortion ban; 

• Texas has filed a lawsuit against San Antonio, arguing that the city’s allocation of funds for abortion travel violates state law; 

• The Oklahoma House has passed a bill that would treat the possession and delivery of abortion-inducing medications as a drug trafficking offense; 

• A federal judge has ruled that the Alabama Attorney General cannot prosecute people for helping individuals obtain lawful out-of-state abortion care; 

• Nevada is poised to reinstate parental notification requirements for minors seeking abortion care in the state; and 

• The Illinois House has passed novel protections for abortion medications.

• U.S. Supreme Court Hears Case About Medicaid Funding for Planned Parenthood:

  • As we reported in our last Digest, the U.S. Supreme Court heard oral arguments on April 2nd about whether individual patients have standing to bring a lawsuit challenging the denial of Medicaid funding for Planned Parenthood. Federal law allows Medicaid recipients to obtain care from any qualified provider. But, South Carolina Governor Henry McMaster has sought to block funding from going to Planned Parenthood, despite conceding its qualifications. The outcome of this case will have far-reaching consequences for Medicaid recipients’ ability to choose their provider without political interference from the state. 

  • Oral arguments centered on whether or not the specific language in the relevant Medicaid provision gives individuals the ability to enforce their federally-conferred right to see a qualified provider of their choosing. John Bursch, arguing on behalf of South Carolina, urged that it does not, because the Medicaid statute doesn’t use the word “right” or its “functional equivalent.” During arguments, several of the Justices appeared skeptical of this argument, with Justice Kagan pointing out that the Medicaid Provision was revised specifically to include a freedom of choice requirement. Justice Barrett appeared to echo the concern that the state’s argument would roll back this congressionally created right. A decision in the case is expected this summer. 
    

• Texas Considers Abortion Bill ‘Clarification’: 

• The Texas legislature’s consideration of a bill purporting to clarify the state’s abortion ban has sparked controversy. The bill, SB 31, does not expand access to abortion, but–according to its proponents–clarifies when a doctor is able to intervene and provide care to protect their patient. Specifically, the measure removes the words “life-threatening” from the exception for the life or health of the pregnant person and states that an emergency does not need to be imminent or irreversible in order for a doctor to act. The latter change is intended to address cases where doctors have been forced to wait until their patient gets “sick enough” before they are able to provide care. 

• Proponents of the law argue that it is a clear-cut measure that merely provides needed clarity. However, it has drawn opposition from both sides of the aisle. During a House committee meeting, some lawmakers raised concerns that the amendment could be used as a loophole for clinicians to provide ‘abortion on demand.’ Conversely, pro-choice groups point to the law’s potential to bolster arguments that a 1925 pre-Roe abortion ban can be revived and enforced. Abortion advocates have also raised concerns that these kinds of clarification bills give anti-choice legislators political cover while failing to meaningfully address the healthcare crisis precipitated by post-Roe abortion bans. 
  

• North Carolina Proposes Total Abortion Ban: 

• North Carolina lawmakers have introduced a total abortion ban, entitled the “Human Life Protection Act of 2025.” The bill would ban abortion at all gestational ages with only an exception to save the life of the pregnant person. At present, abortion is banned in North Carolina after 12 weeks, with exceptions for rape, incest, lethal fetal anomalies and the life or health of the pregnant person. If passed, the Human Life Protection Act would significantly curtail access in the state and further strangle reproductive healthcare in the South, where most states already ban abortion. 

• Texas Files Lawsuit Against San Antonio Over Allocation of Funds for Reproductive Healthcare: 

• Texas Attorney General Ken Paxton has filed a lawsuit against San Antonio, based on the city’s allocation of $100,000 for reproductive health. The money, which was recently approved by the San Antonio City Council, will be used for out-of-state abortion travel. Although none of the money will directly fund abortion, Paxton alleges that the funding is a “misuse of public funds” and an attempt to “circumvent state law and take the innocent lives of unborn children.” He is requesting a temporary restraining order and injunctive relief on the grounds that the city has violated Texas’s Gift Clause, Human Life Protection Act, and other pre-Roe abortion statutes. 

• Oklahoma House Passes Abortion Medication ‘Trafficking’ Bill:

• The Oklahoma House has passed a bill that would treat the possession or delivery of “abortion-inducing drugs” as a drug trafficking offense, subject to up to $100,000 in fines and 10 years in prison. The bill would not allow for the prosecution of someone possessing the drugs for their own use, and it would not apply to cases where the intended use of the drug was lawful, such as to treat an ectopic pregnancy or manage a miscarriage. Several other states where abortion is banned have passed similar restrictions on access to medication abortion. The measure will now go to the state senate for consideration. 

• Federal Court Rules Alabama Attorney General Cannot Prosecute People for Helping Others Obtain Lawful Out-of-State Abortions: 

• In a critical victory out of Alabama, District Court Judge Myron Thompson has ruled that Alabama Attorney General Steve Marshall cannot prosecute people for helping others obtain lawful out-of-state abortion care. Following the Dobbs decision, Marshall repeatedly threatened that individuals who helped others cross state lines for abortions could be prosecuted under the state’s conspiracy and abortion statutes. Judge Thompson’s decision found that these threats violated constitutionally protected speech and travel rights. The Court’s ruling allows providers to once again freely and openly counsel their patients on their lawful healthcare options. Alabama is likely to appeal this decision up to the 11th Circuit Court of Appeals, but Judge Thompson’s decision is an important precedent as anti-choice states test the boundaries of their abortion restrictions. 

• Nevada Poised to Revive Parental Notification Requirement for Minors: 

• Nevada appears poised to revive a long-dormant 1985 parental notification requirement for minors seeking abortion care. Although the law has been blocked by an injunction for decades, a group of district attorneys argued that the Dobbs decision rendered it once again enforceable. U.S. District Court Judge Anne Traum agreed. The law is set to take full effect on April 30th; however, it is likely that advocates will request that it remain blocked while they litigate its constitutionality. 

• Illinois House Passes Protections for  Medication Abortion: 

• The Illinois House has passed a novel piece of legislation bolstering protections for medication abortion. In anticipation of potential federal restrictions, the bill would allow healthcare providers to continue providing abortion medication as long as the World Health Organization recommends it, even if the FDA revokes its approval. FDA approval of mifepristone is the subject of ongoing litigation, and the Trump Administration has indicated its interest in Health and Human Services Secretary Robert F. Kennedy Jr. reviewing the safety of abortion pills.

Trend & Policy Watch:

• Missouri Rejects Planned Parenthood’s Complication Plan: 

  • In Missouri, where voters overturned a total abortion ban last November, the state continues to erect roadblocks to access. In late March, the Missouri Department of Health sent a letter to Planned Parenthood Great Rivers informing them that their complication plans did not meet state requirements. Under an emergency rule published that same day, the state requires facilities that prescribe medication abortions to more than 10 patients a month to set forth a complication plan that meets certain strict requirements. Following the rejection of their plan, Planned Parenthood renewed its challenge to the complication plan requirements, citing Missouri’s “endless end-runs around” the abortion ballot measure passed 5 months ago. 

• Wisconsin Supreme Court Race is a Victory for Reproductive Rights: 

• Wisconsin scored a victory for reproductive rights with the election of Judge Susan Crawford to the state Supreme Court. Judge Crawford has a history of supporting abortion rights, including previously representing Planned Parenthood in litigation. Her election secures a liberal majority on the court at a time when it has two cases about an 1849 abortion ban before it. 

• States Show Appetite to Prosecute Abortion-Seekers: 

• Trends across state legislatures show an appetite to increase restrictions on abortion, including prosecuting the pregnant person themselves, a line that the anti-abortion movement has historically been unwilling to cross. Although few, if any, of these bills are likely to pass this session, the increase in their volume and their repeated introductions in state legislatures year after year show an alarming trend. 

• Study Shows Low Support for Fetal Personhood: 

• Recent analysis from the National Women’s Law Center shows that support for fetal personhood is low. And, the more people learn about its implications, the less supportive they are. The analysis also shows that there is significant  concern around government interference in pregnancy decisions, and that support for abortion and reproductive choice remains high. 

• Emergency Contraception Will Be Available for Free in England: 

• In an effort to reduce healthcare inequalities, England is set to make emergency contraception, or the morning after pill, free. In the United States, emergency contraception is legal and available over the counter at many pharmacies, but the medication’s cost can be a barrier to access. It has also become a subject of significant post-Roe political debate, with some lawmakers inaccurately casting it as an abortion-causing drug and calling for it to be restricted or made illegal. 

• American Doctors Go to Mexico to Receive Abortion Training: 

• American doctors and medical students are turning to other countries, including Mexico, to gain comprehensive abortion training and experience. Even in abortion-supportive states, residents frequently receive minimal abortion training, as medical schools run by large hospitals often take risk-averse approaches to providing training for fear of losing funding or other support. 

REPRODUCTIVE HEALTH DIGEST (3/27/25)

Developments in Abortion, Autonomy, and Access: 

Welcome back to the Reproductive Health Digest, and thank you for bearing with us while we took a week off. We are jumping right back in with important developments in federal and state litigation, legislative changes and challenges across the country, and policy updates that continue to shape American public health. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed. 

This Week’s Must Read:

This week’s must-read comes from Jezebel. The piece discusses how restrictions on reproductive care increase the dangers faced by victims of domestic abuse and make the jobs of advocates and supporters more difficult and legally uncertain. As Sara Ainsworth, senior legal and policy director at If/When/How, explained, homicide is the leading cause of death for pregnant people in America and abuse often escalates during pregnancy, but now “between fears for their own safety, or confusion about how these very new, untested laws are going to be enforced,” the work of supporting victims has become a minefield. 

Legislation & Litigation: 

Overview: 

• The Department of Justice has dropped a challenge to Idaho’s total abortion ban under EMTALA; however, St. Luke’s has stepped in as a new plaintiff;  

• On April 2nd, the Supreme Court will hear oral arguments in a case about whether states can deny Medicaid Funding for Planned Parenthood; 

• Kentucky Governor Andy Beshear has vetoed a bill purporting to clarify the state’s abortion ban; 

• A Federal Court has blocked the Trump Administration’s attempt to strip funding for all gender-affirming care for minors; 

• The South Dakota Legislature, alongside several other states legislatures, is attempting to restrict access to citizen-led ballot measures; 

• Texas has arrested a midwife and her colleagues on charges of allegedly providing unlawful abortions; 

• An Arizona court has permanently blocked the state’s 15-week abortion ban, further clearing the way for full implementation of the new constitutional amendment protecting pre-viability access; 

• Wyoming is taking actions to further restrict access to abortion; and 

• Ohio’s ban on gender-affirming care for minors has been blocked by an appeals court.

• The Department of Justice Drops EMTALA Challenge to Idaho’s Abortion Ban: 

• The Department of Justice under the Trump Administration has dropped a Biden-era lawsuit challenging Idaho’s right to restrict emergency abortion care under its abortion ban. For a recap of the history of the case, read here. In anticipation of the Administration’s move, St. Luke’s Health System filed its own lawsuit, preserving the challenge. On Thursday, March 20th, a federal judge issued a preliminary order shielding St Luke's-affiliated clinicians from liability for providing emergency abortions under EMTALA during the pendency of the litigation. 

• Medicaid Funding for Planned Parenthood To Go Before the Supreme Court: 

• The Supreme Court is set to hear oral arguments on April 2nd over Medicaid funding for Planned Parenthood patients. Although federal law requires states to allow Medicaid recipients to obtain care from any qualified provider, South Carolina Governor Henry McMaster has sought to block Medicaid funding for Planned Parenthood, labeling it an abortion clinic. The state concedes that Planned Parenthood providers are competent to provide care. Planned Parenthood provides a broad spectrum of non-abortion related reproductive healthcare including pregnancy and STI testing, prenatal care and preventative care. 

• Although the case plainly arises out of abortion policy, the specific legal issue before the Supreme Court turns on a technical question about whether individual patients can bring suit to enforce the implicated Medicaid provisions. The Court’s ruling in this case will have broad implications outside of the abortion context, impacting access to care for Medicaid patients nationwide. 

• Kentucky Governor Vetoes Abortion ‘Clarification’ Bill: 

• Kentucky Governor Andy Beshear has vetoed a Republican-supported bill that purported to clarify the state’s total abortion ban. The bill set forth a list of emergency conditions wherein a doctor may take action “separating a woman from her unborn child.” However, opponents of the bill argue that no list can adequately account for the complicated medical realities of pregnancy and that bills like HB 90 undermine providers’ independent medical judgment, replacing it with that of non-expert legislators. The Republican supermajority may override Governor Beshear’s veto. 

• A Federal Court has Blocked the Trump Administration’s Executive Order Targeting Gender-Affirming Care:

• A federal judge has extended a block on the Trump Administration’s Executive Order purporting to pull federal funding for medical institutions that provide gender-affirming care to individuals under the age of 19. Judge Lauren King found that the orders improperly encroach upon Congressional authority over federal funding and violate the Equal Protection Clause by discriminating on the basis of sex and transgender status. The Administration’s aggressively implemented anti-trans agenda has faced significant setbacks in courts across the country. 

• South Dakota Legislature Attempts to Restrict Ballot Measures: 

• Lawmakers in South Dakota have introduced several measures to restrict the state’s citizen-led ballot initiative process. Governor Larry Rhoden vetoed one of the proposed changes, which would have required signatures to be gathered from every legislative district, effectively giving any one district veto power over an initiative. A second proposal would move the deadline to submit signatures from May to February of the election year, narrowing the window for activists to gather the necessary number of signatures. This is before the Governor for his signature. A third proposal will go before voters in November, 2026; if passed, it would raise the threshold to pass a ballot measure from a simple majority to 60%. 

• Other states, including Florida, are similarly attempting to tighten access to the ballot initiative process. The Fairness Project warns that over 100 anti-ballot initiative bills have been introduced across 15 different states. This wave of restrictions follows the use of the citizen-led ballot measure process to protect abortion rights in seven states in the 2024 elections. 

• Texas Arrests Midwife and Colleagues for Alleged Provision of Unlawful Abortions: 

• Texas has made its first arrests under its total abortion ban. Houston-area midwife Maria Margarita Rojas and two of her colleagues were arrested for allegedly providing unlawful abortions at three clinics. The clinics have been temporarily shut down, and Rojas’s midwifery license has been suspended. If charged, Rojas could face up to twenty years in prison. 

• These arrests mark an escalation in Texas’s vigorous efforts to enforce its anti-abortion laws. Texas has also brought a lawsuit against New York Doctor Maggie Carpenter, attempting to hold her liable for providing medication abortions to Texans. New York has refused to enforce the judgment against Dr. Carpenter–citing the state’s shield laws. Attorney General Ken Paxton has vowed to prosecute individuals who perform illegal abortions “to the full extent of the law.” 

• Arizona Permanently Blocks 15-week Ban:

• An Arizona court has permanently blocked the state’s previously enforced 15-week abortion ban. Maricopa County Judge Frank Moskowitz held that the 15-week ban was rendered unconstitutional by the passage of a 2024 abortion rights ballot initiative. 

• Abortion Care in Wyoming Further Restricted: 

• Wyoming has instituted new requirements for abortion clinics and providers. Governor Mark Gordon recently signed a bill mandating that facilities that provide abortions be licensed as surgical centers, leading the state’s only remaining abortion clinic to pause care. Although Gordon vetoed a bill requiring pregnant people to have an ultrasound 48-hours prior to receiving a medication abortion, the legislature overrode his veto. Although abortion remains legal until viability in Wyoming, it is functionally extremely difficult to access, with many patients forced to leave the state to obtain care. 

• Ohio’s Ban on Gender-Affirming Care Blocked by Appeals Court:

  • An Ohio appeals court has permanently blocked the state’s ban on gender-affirming care for minors, holding that it is unconstitutional. In a majority opinion authored by Judge Carly Edelstein, the court noted that the state’s ban does not outlaw the use of identical drugs for other purposes–it only does so in the context of gender-affirming care. Judge Edelstein also referred to parents’ rights to make care decisions about their children’s health without excessive interference from the state. The state will pursue an appeal of the decision.

Trend & Policy Watch:

• Texas’ Abortion Ban Has Adverse Impacts on Colorado Patients:

  • Highlighting the ripple effects of abortion bans, a new study from JAMA finds that Texas’s ban has caused delays and disruptions in care for Coloradans. According to the study, Texas’s 2021 ban taking effect caused a surge in demand in Colorado, resulting in Coloradans being 83% more likely to have second-trimester abortions as appointments bottlenecked and care was delayed. 

  • States without abortion bans have taken action to try and address the shortage of providers. In New York, for example, Senator Liz Krueger and Assembly Member Harvey Epstein have introduced a bill to create a state-funded training program. Maryland has similarly started training advanced practice clinicians, including nurse practitioners, to administer abortion care. 

• How State Abortion Policies are Shaping Decision-Making: 

• New data from the Institute for Women’s Policy Research shows how state-level abortion bans and restrictions are impacting individual decision making–particularly for people who plan to have children. In one striking finding, the data showed that one in ten adults have or know someone who has relocated or applied to a job in another state because of a state’s abortion ban. This number doubles for individuals who plan to have children. The research also shows that employees heavily prioritize how their employer handles reproductive health care coverage, meaning that they are less likely to move for or stay in a job where care is not prioritized. 

• Trans Healthcare Preemptively Curtailed In Light of Administration’s Orders:

• Some hospitals and health care providers are preemptively complying with the slew of anti-trans executive orders handed down by the Trump Administration. In response to the Administration’s January Order entitled “Protecting Children From Chemical and Surgical Mutilation,” which seeks to defund gender-affirming care for people under 19, several hospitals across the country have paused or ceased providing such care. Despite the sweeping language of the Administration’s executive order, it does not actually change existing law or supplant state regulations, and it is currently blocked by litigation. Preemptive over-compliance by health care institutions creates unnecessary patient harm and may result in institutions violating state anti-discrimination laws. 

• Appointment of FDA Commissioner Raises Questions About Mifepristone:

• The appointment of Dr. Marty Makary as commissioner for the FDA is raising concerns about the future of mifepristone. During his confirmation hearings, he refused to commit to any action regarding the pill, including preserving access to it. Advocates worry that the Trump Administration will direct the FDA to reassess mifepristone’s availability, despite its exemplary safety and efficacy records. 

REPRODUCTIVE HEALTH DIGEST (2/27/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Digest goes through important litigation developments impacting abortion access in states across the country, including a decision out of Missouri that paves the way for abortion to resume for the first time in years. We also discuss emerging research in the public health space post-Dobbs and policy battles that are ongoing at both the state and federal levels. As we continue to report on the news that is shaping the reproductive health landscape, we encourage you to share this resource with anyone in your own networks who may benefit from its analysis. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed. 

This Week’s Must Read:

This week’s must-read story comes out of Missouri, where Republican lawmaker Phil Amato has proposed legislation that would mandate surveillance of pregnant people “at risk” of seeking an abortion. Specifically, the bill would require the state to “maintain a central registry of each expectant mother who is at risk for seeking an abortion . . . and make the same available to a prospective adoptive parent.” It is unclear how the state would define “at risk” pregnant people, but the creation and maintenance of a registry would clearly require surveillance of individuals’ private medical decisions and detailed demographic information. Last year, Missourians passed an abortion rights ballot initiative, legalizing pre-viability abortion; however, anti-abortion lawmakers continue to work to limit the scope of those protections. 

Legislation & Litigation: 

Overview: 

• A Missouri judge has overturned a state abortion clinic licensure requirement, allowing abortion clinics to reopen in the state; 

• Louisiana and Texas are continuing to pursue criminal and civil legal actions against a New York abortion provider; 

• The Eighth Circuit Court of Appeals has issued a ruling allowing a lawsuit challenging the Pregnant Workers Fairness Act’s protections for abortion patients to move forward; 

• An Indiana judge has temporarily blocked individual abortion records from being made public; 

• The Kansas Legislature has overridden Governor Kelly’s veto of a ban on gender-affirming care for minors; 

• The Georgia Supreme Court has sent a case over the state’s abortion ban back to the lower court to reevaluate the plaintiffs’ standing; 

• Montana lawmakers have introduced a bill that would criminalize traveling out of state for abortion care; and 

• GenBioPro, the manufacturer of generic mifepristone, has moved to intervene in the lawsuit challenging the FDA’s approval of the drug.

  Missouri Judge Issues Ruling Allowing Clinics to Reopen:

• A Missouri Judge has issued a ruling striking down the state’s clinic licensure requirement, which had functionally blocked abortion clinics from reopening in the state. Abortion has been largely unavailable in Missouri since 2022, when the Dobbs decision triggered the state’s abortion ban. However, last November, Missourians voted to pass an abortion rights ballot measure, which restored pre-viability access. Despite the passage of this measure, legislation severely restricting the conditions under which abortions could be performed remained on the books, including a requirement that clinics be licensed by the State. This medically unnecessary requirement meant that clinics like Planned Parenthood were unable to resume providing services. The ruling striking this requirement led Planned Parenthood to announce that it would resume services in Missouri. The state is likely to appeal. 

• Louisiana and Texas Continue to Pursue Legal Actions Against New York Doctor: 

• Texas and Louisiana continue to pursue legal actions against New York abortion provider Dr. Maggie Carpenter. Under the protection of New York’s shield law, Dr. Carpenter prescribed abortion pills to patients in Texas and Louisiana - two states with abortion bans in place. Texas brought a civil lawsuit against Dr. Carpenter in Collin County, Texas,  arguing that she violated Texas’s abortion ban and practiced medicine in the state without proper licensure. The Judge in the case issued a default judgment ordering her to pay $100,000 in penalties and enjoining her from continuing to prescribe medication abortion to Texas patients. New York is standing behind Dr. Carpenter and refusing to participate in the out-of-state investigation into her provision of reproductive care, consistent with the requirements of its shield law. 

• Similarly, Louisiana has brought criminal charges against Dr. Carpenter based on her provision of care and is seeking her extradition to the state. New York Governor Kathy Hochul has declined to extradite, saying she would not sign the order, “not now, not ever.” 

• As we have reported on previously, the cases against Dr. Carpenter represent the first legal clashes between abortion ban states and shield law states. They will shape the future of these protections. Although the path forward is unsettled, legal action attempting to force New York’s participation in the out-of-state cases is all but certain.

• Eighth Circuit Allows Lawsuit Challenging Abortion Protections to Move Forward: 

• The Eighth Circuit Court of Appeals has issued a ruling allowing a lawsuit challenging the Pregnant Workers Fairness Act’s application to abortion accommodations to move forward. The PWFA requires reasonable workplace accommodations for pregnant people, including time off for appointments for prenatal care or miscarriage recovery. Under the Biden Administration, the EEOC published guidance explaining that the PWFA’s pregnancy accommodations requirement also requires covered employers to allow time off to obtain an abortion and recover. The rule does not require the employer to pay for the procedure or even provide paid time off. Seventeen states brought a lawsuit challenging the rule, arguing that it illegally broadens the scope of the PWFA. A lower court dismissed the lawsuit for lack of standing; however, the Eighth Circuit revived it, finding that the states have a justiciable interest because they are regulated by the rule. Whittling away at employment protections is one tactic used by anti-abortion states and actors to narrow reproductive freedom and access to care.

• Indiana Judge Temporarily Blocks Abortion Records from Being Made Public: 

• In the last Digest, we reported on Indiana’s dangerous decision to make individual abortion records public and the legal challenge that immediately followed. In a piece of good news, a Marion County judge has issued a temporary restraining order blocking the Indiana Department of Health from releasing the records for at least 10 days, while the case is considered. The providers behind the lawsuit argue that, in light of how few abortions are being performed in Indiana under the state’s ban, the patient information included in a pregnancy termination report could be reverse-engineered to identify individual patients, endangering their safety and privacy interests.

• Kansas Legislature Overrides Governor’s Veto of Gender-Affirming Care Ban:

• The Kansas legislature voted to override Democratic Governor Laura Kelly’s veto of a gender-affirming care ban for minors. Kansas is now the 27th state to attempt to ban such care, and the federal government has issued a slew of orders in the past month tightening restrictions and erasing protections for the trans community. Advocates and families of transgender youth are likely to challenge the law in court. 

• Georgia Supreme Court Sends Case Over Abortion Ban To Lower Court to Reconsider Standing:

• The Georgia Supreme Court is sending a challenge to the state’s heartbeat ban back to the trial court on the question of standing. The ban has been the subject of litigation for several years, with advocates arguing that it is unconstitutional under Georgia’s privacy protections. However, in January, the Georgia Supreme Court issued a decision in a separate case that altered state jurisprudence on the question of third-party standing. In light of that ruling, the justices voted to send the case back to the trial court to reconsider whether the plaintiffs, including lead plaintiff SisterSong Women of Color Reproductive Justice Collective, are properly before the court. 

• Montana Introduces Bill Criminalizing Traveling Out of State for Abortion Care: 

• A bill introduced in Montana would make it a criminal offense to travel out of state to receive abortion care - even when that care is legal. Relying on misleading “trafficking” language, House Bill 609 would criminalize transporting, or aiding a person in transporting, “an unborn child that is currently located in [Montana]” to obtain an abortion that would be illegal in Montana. If passed, this would be the first time that a state has criminalized the act of traveling out of state for legal abortion care. Unlike abortion trafficking bills passed in Tennessee and Idaho, this law is not cabined to assisting minors over state lines; instead, it defines the fetus itself as the trafficked party. 

• At present, Montana allows abortion until fetal viability. However, under HB 609,  if a person were to discover a fetal anomaly later in pregnancy and travel out of state for healthcare, they could be prosecuted and face jail time of up to five years.  Although it is unclear at this time how much support the bill has, at a hearing, two proponents testified in favor of the bill, while over two dozen offered comments opposing it. We will continue to report on this bill as it moves through the legislative process. 
  

• The Manufacturer of Generic Mifepristone Moves to Intervene in Lawsuit:

• GenBioPro, the manufacturer of generic mifepristone, has filed a motion to intervene in Missouri et al. v. FDA, the case previously known as Alliance for Hippocratic Medicine v. FDA. The previous iteration of the case was thrown out by the U.S. Supreme Court for lack of standing. But, Northern District of Texas Judge Matthew Kacsmaryk allowed Missouri, Kansas, and Idaho to continue the suit, despite glaring issues in the states’ standing and venue arguments. GenBioPro seeks to defend the FDA’s approval of mifepristone and preserve access to the drug. 

Trend & Policy Watch:

• ProPublica Reporting Shows Sepsis Rates in Pregnant People Skyrocketed Under Abortion Bans:

  • New reporting from ProPublica shows that rates of sepsis in pregnant Texans have dramatically increased under the state’s abortion bans. Using the methodology detailed in the reporting linked above, their findings showed an increase in sepsis rates of 55% from comparable time periods before and after the state’s first abortion ban went into effect. The “surge was most pronounced in cases in which the fetus may still have had a heartbeat when the patient arrived at the hospital.” Post-Dobbs, countless stories have been reported of pregnant patients being denied miscarriage care until fetal cardiac activity ceases, as their providers fear legal reprisal for acting too early under the law. ProPublica’s reporting is particularly critical as the Texas Maternal Mortality and Morbidity Review Committee has declined to review pregnancy outcomes data for 2022 and 2023. 

• Progressive States Work to Pass Marriage Equality:

• Several states are working to pass ballot measures constitutionally protecting marriage equality amidst rising concerns over the security of lgbtq+ rights. At least nine states have introduced measures aimed at undoing marriage equality protections. Lawmakers in Michigan, Idaho, Montana, North Dakota and South Dakota have called on the Supreme Court to reverse Obergefell, the decision that legalized gay marriage. Four other states have proposed legislation that would create “covenant marriage” - a category of marriage available only between one man and one woman. In response, advocates across the country hope to take the issue directly to the voters via ballot measure, a strategy that is likely to yield success, as data shows that the vast majority of Americans continue to support marriage equality. 

• Comprehensive Update on Policy Developments at the Federal Level: 

• The federal government has undergone a fundamental paradigmatic shift in the past month. Through a slew of executive actions, the government has aggressively targeted trans rights and so-called “gender ideology”, moved to dismantle diversity, equity, and inclusion efforts in the public and private sectors, and attempted to implement widespread funding freezes. For a comprehensive update on where things stand one month into the new administration, read here. 

• Cuts to USAID Threaten the Lives of Thousands of Pregnant People Worldwide: 

• On January 20th, the new administration issued a 90-day pause in U.S. foreign development assistance, halting urgent work worldwide and threatening the lives of thousands of pregnant people. This freeze in funding disrupts critical programs that distribute contraception, provide life-saving healthcare for pregnant women, and facilitate healthcare initiatives for low-income and developing nations. According to Amy Friedrich-Karnik, director of federal policy at Guttmacher Institute, “[e]very single day that the freeze is in place, there are 130,000 women who are being denied contraceptive care.” Guttmacher estimates that if the USAID funding lasts the full 90 days, around 4.2 million women will experience unintended pregnancies, and “8,340 will die from complications during pregnancy and childbirth.” 

• Education Opportunities Around Patients’ Rights and ICE in Healthcare Settings:

• Before we end this week’s Digest, we wanted to uplift two trainings being hosted by coalition partner organizations on the subject of how to protect patients when ICE enters healthcare settings. Please see below for more details:

• On Tuesday, March 4 at 5:30pm PST / 8:30pm EST - Service Employees International Union (SEIU) is hosting a workshop designed specifically to provide healthcare providers with legal guidance and resources for responding to ICE in healthcare settings. Register and join to learn more about how you can assert your rights as a physician while defending patient care.

• On Thursday, March 6 at 5:00pm PST / 8:00 pm EST - Doctors For America (DFA) is hosting a training designed to understand how immigration status impacts healthcare access and how our Healthcare Advocacy Toolkit can be used in clinical settings. Attendees will have a chance to discuss civic engagement with patients and examine potential threats under new federal immigration policies. Register here.

REPRODUCTIVE HEALTH DIGEST (2/13/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Digest dives into ongoing attacks against the trans community from the federal government, proposed legislation regulating abortion and reproductive rights at the state level and litigation developments in state and federal courts. Please read on for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed. 

This Week’s Must Read:

This week’s must-read from Mother Jones discusses the history of mifepristone and its FDA approval. Post-Dobbs, anti-abortion groups have challenged the legality of the medication in court, arguing that it is unsafe and was rushed through the FDA’s approval process. However, the drug’s actual history tells a different story, revealing how political and social factors around abortion resulted in a much longer and more convoluted approval process than is typical and underscoring the inaccuracy of legal arguments attacking its safety record. 

Legislation & Litigation: 

Overview: 

• Indiana abortion providers file lawsuit to protect patient privacy;

• D.O.J. withdraws from Skrmetti case challenging the constitutionality of bans on gender-affirming care; 

• Colorado and New York shore up shield laws; 

• Missouri lawmakers attempt to overturn newly-passed constitutional protections for abortion; 

• New Hampshire scraps 15-week abortion ban proposal; 

• South Carolina Supreme Court hears oral arguments around the state’s abortion ban; 

• Kansas and Montana consider fetal personhood legislation; and 

• House Republicans introduce a federal abortion ban.

• Providers in Indiana File Lawsuit to Protect Patient Privacy: 

  • Two Indiana doctors have filed a lawsuit challenging the Indiana Department of Health’s agreement to make individual abortion reports public, citing concerns about patient privacy. The two providers are asking the Marion County Superior Court to enter a temporary restraining order blocking the public release of the records on the grounds that, with so few abortions being performed in the state, the information contained therein could be reverse-engineered to determine the identities of individual patients. Following the implementation of Indiana’s total abortion ban, the state began issuing quarterly aggregated data on abortions, in order to preserve patient confidentiality; however, anti-abortion activists have pushed to reverse that policy. The court held an emergency hearing on the matter on February 11th. 

• DOJ Withdraws Its Support for Gender Affirming Care for Minors:

• The U.S. Department of Justice under the new Trump Administration has withdrawn from U.S. v. Skrmetti, the case challenging the constitutionality of gender-affirming care bans for minors. The Supreme Court heard oral arguments in the case late last year, and a change in DOJ’s position on the issue was anticipated in light of the new administration’s extreme anti-trans agenda. The individual plaintiffs in the case remain, and despite its withdrawal, the DOJ has urged the Court to issue a ruling. The Court’s decision, which is anticipated in early summer, will determine the constitutionality of a swath of anti-trans laws nationwide. 

• Colorado and New York Shore Up Shield Laws: 

• Blue states, including Colorado and New York, are shoring up their abortion shield laws as hostile states ramp up efforts to stem the flow of medication abortion across state lines. In New York, a doctor has been sued by the state of Texas and indicted by a grand jury in Louisiana for mailing abortion bills to patients in those states under the protection of New York’s shield law. In response, New York Governor Kathy Hochul has vowed that she will not issue an extradition order for the doctor and signed new legislation allowing individual providers to keep their names off of prescriptions. The legal showdown between New York, Texas, and Louisiana will mark the first true test of the strength of shield laws. 

• In Colorado, Democratic lawmakers are similarly attempting to strengthen their state’s protections. They have introduced legislation that would expand Colorado’s existing laws by 1) anonymizing names on prescription labels; 2) prohibiting local governments from working with out-of-state authorities on issues related to abortion care; and, 3) allowing the state’s AG to “block hostile actions and allow for retaliatory civil lawsuits against states.” 

• Missouri Lawmakers Attempt to Overturn Newly Passed Abortion Protections: 

• Last November, Missourians voted to enshrine abortion rights in the state constitution, becoming the first state to overturn a total abortion ban through the ballot initiative process. However, anti-abortion lawmakers are not content to let the will of the people stand. Instead, they have introduced a new resolution that, if passed, would undo the protections of Amendment 3 and reinstate a total abortion ban, with narrow exceptions for rape, incest, medical emergencies and serious fetal anomalies. Lawmakers behind the new resolution insist that voters did not fully understand the implications of passing the abortion ballot measure. 

• New Hampshire Will Not Pass a 15-week Abortion Ban: 

• A New Hampshire bill that would have instituted a 15-week ban in the state has been withdrawn by its sponsors, who cited a “flaw” in the bill that prevented it from moving forward. Abortion is currently legal until 24 weeks, and although the state’s governor is a Republican, she has vowed to veto any legislation that would further restrict access to care in the blue state. 

• South Carolina Supreme Court Hears Oral Argument Over Heartbeat Bill: 

• Abortion was back before the South Carolina Supreme Court this week for the third time in as many years. On Wednesday, the court heard arguments on the question of whether the state’s ban on abortion after detection of fetal cardiac activity applies at 6 weeks, as previously determined, or at 9 weeks. Planned Parenthood argued that, because the law does not specify 6 weeks, medical terminology must control, and doctors do not consider there to be a fetal heartbeat until at least 9 weeks. They also argued that the use of the word “fetal” weighs in favor of a later cut-off, as 6 weeks gestational age is still medically considered an embryo. During arguments, the judges repeatedly called out the fact that attorneys and advocates on both sides of the law previously referred to it as a 6-week abortion ban, but it is unclear how heavily that history will factor into the court’s ultimate determination. 

• Montana and Kansas Advance Fetal Personhood Legislation:

• Montana, Kansas, and other state legislatures are considering proposed fetal personhood measures, which would grant legal rights to embryos and fetuses. Montana’s proposed law would give embryos legal status from the moment of conception, banning abortion outright, increasing pregnancy criminalization, and interfering with access to IVF. The fact that the bill would disrupt IVF in the state was acknowledged by its sponsor, who stated that he doesn’t have a solution for infertility that doesn’t involve “killing so many human beings.” This anti-IVF argument was echoed by at least one doctor who testified that IVF destroys human lives. 

• In Kansas, lawmakers are attempting to pass a less direct but still concerning fetal personhood bill. HB 2062 would grant pregnant people the right to child support from the moment of conception. Although the anti-abortion groups supporting the bill argue that it will protect pregnant people’s financial security, detractors point out that it would codify fetal personhood into state law and create few rights that do not already exist elsewhere in the state code. 

• House Republican Introduces National Abortion Ban:

  • Missouri Republican Eric Burlison has introduced the “Life At Conception Act” in the House of Representatives. If passed, the bill would codify fetal personhood by extending equal protection rights to fetuses, functionally banning abortion nationwide. The law would throw the legality of IVF into question and create legal uncertainty around proper protocol for miscarriage care and the treatment of other pregnancy-related medical conditions. Although it is highly unlikely to pass, as there is not enough support in Congress for extreme fetal personhood legislation, it is an important political and ideological indicator of how far anti-abortion lawmakers are willing to go.

Trend & Policy Watch:

• Several States Push For Schools to Use Misleading “Baby Olivia” Video as Educational Tool: 

  • Several states are looking to mandate the use of a misleading video about fetal development as an educational tool in schools. The video, featuring “Baby Olivia” was created by anti-abortion groups and shows a medically inaccurate depiction of what takes place in the womb during different stages of pregnancy. 

• Hospitals and Clinics Preemptively Cancel Gender-Affirming Care Procedures: 

• In response to President Trump’s executive orders attacking the trans community, several hospitals have reportedly begun canceling gender-affirming care procedures for individuals under the age of 19. Many of the relevant executive orders are currently being challenged in court, and several state attorneys general have issued warnings that hospitals discontinuing gender-affirming care may be in violation of state anti-discrimination laws. 

• Federal Judge Orders Agencies to Restore Purged Webpages: 

• A federal judge has issued a temporary order requiring HHS, CDC and FDA to restore webpages that were deleted pursuant to a Trump executive order targeting “gender ideology.” The pages deleted included information about HIV treatment and prevention, youth risk behaviors, lgbtq+ health, and contraception. The judge found that the plaintiff, Doctors for America, was likely to succeed in its claim and emphasized that the party who is ultimately harmed is everyday Americans losing access to healthcare information.

• U.S. Military Begins Blocking Transgender People from Entering Service: 

• Newly appointed Defense Secretary Pete Hegseth has begun implementing Donald Trump’s Executive Order attempting to halt the participation of transgender people in the U.S. military. Secretary Hegseth has reportedly directed the military not to integrate new transgender recruits and to block gender-affirming care for current service members. Lambda Legal and the Human Rights Campaign have filed a lawsuit on behalf of trans servicemembers, arguing that the new order is unconstitutional and harms military readiness. 

REPRODUCTIVE HEALTH DIGEST (1/30/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Digest goes through efforts to curtail reproductive rights and bodily autonomy at the federal level, proposed state legislation that would further restrict access to abortion, updates on litigation and constitutional amendments, and a look at the trends that we are watching. Please read on to the end for the news that you need to know.

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed. 

Note: Last year, the “Abortion Laws by State” portion of our Policy Resource Hub was behind a login wall. We have since removed that login requirement, and the Hub is now fully open and available to the public at the above link.

This Week’s Must Read:

This week’s must-read comes from Vermont, where a new lawsuit alleges facts showing that Vermont has been tracking the pregnancies of pregnant people who it sees as potentially unsuitable parents. In an alarming account of pregnancy surveillance and criminalization, the lawsuit sets forth how Vermont’s child welfare agency received unproven allegations about a pregnant woman’s mental health and proceeded to seek and take custody of the unborn child before she was even born. The patient had no idea that custody of her child had been decided without her involvement or consent until her newborn was removed from her care immediately after birth.

Legislation & Litigation: 

Overview: 

• North Dakota abortion ban to remain on hold pending litigation; 

• Lawsuit challenging FDA’s approval and regulation of mifepristone to move forward in Texas-based federal court; 

• Abortion rights are enshrined in the Maryland Constitution; 

• Indiana, North Dakota, Mississippi, Oklahoma, South Carolina, Nebraska, and other states introduce legislation that would further limit reproductive freedom; and 

• The first week of the Trump Administration brings a flurry of executive orders taking aim at bodily autonomy, reproductive rights and health equity.

• North Dakota Abortion Ban to Remain on Hold:

  • Last December, a North Dakota state judge struck down the state’s abortion ban as unconstitutional. In defending its abortion ban, the state asked the North Dakota Supreme Court to allow the law to take effect pending appeal. Last week, the court rejected that request, meaning that the ban will remain blocked. Although this means that abortion technically remains legal until viability, no abortion providers remain in the state, and abortion is only functionally available in emergency situations. 

• Lawsuit Challenging Mifepristone to Move Forward: 

• Judge Matthew Kacsmaryk, a notoriously anti-abortion federal judge out of the Northern District of Texas, has ruled that three Republican states can move forward with their challenge to the legality of the abortion pill mifepristone. Last year, the U.S. Supreme Court threw out the original lawsuit brought by The Alliance for Hippocratic Medicine, finding that the group of anti-abortion doctors and groups lacked constitutional standing to bring their claim, as they were unable to show any injury caused by FDA’s actions. Prior to the Court’s decision, Kansas, Idaho, and Missouri joined the lawsuit in the Northern District, arguing that their states’ interests were harmed by the accessibility of mifepristone. Although the original plaintiffs voluntarily dropped the suit in light of the Supreme Court’s ruling, Judge Kacsmaryk has issued a striking ruling allowing the three states to file an amended complaint and continue the lawsuit in a Texas-based federal court. The continuation of the lawsuit in this way conflicts with decades of well-established precedent regarding jurisdiction, venue, and standing. 

• Abortion Rights Enshrined in Maryland: 

• In November, voters in Maryland passed an abortion rights amendment enshrining the right into the state constitution. Last week, Maryland Governor Wes Moore signed a proclamation officially amending the constitution. Although abortion was already protected by statute in the state, a constitutional amendment provides more permanent and immovable protections. 

• States Take Legislative and Executive Action That Would Limit Abortion Rights: 

• Indiana: Indiana Governor Mike Braun has signed an executive order that strengthens the requirement that pregnancy terminations be documented and individually reported to the state’s Department of Health. Currently, the Indiana DOH reports quarterly aggregated data on abortion. However, anti-abortion groups and lawmakers want to make each individual report public, raising concerns about the ability to reverse-engineer that information to identify abortion patients, as so few abortions are being performed in the state. 

• Indiana, North Dakota, Oklahoma, and South Carolina Introduce Legislation to Prosecute Abortion Patients: At least four states have introduced legislation allowing abortion patients to be prosecuted for homicide. Although abortion restrictions have long involved penalties for abortion providers, the prosecution of the patients themselves has traditionally been a line that anti-abortion actors are unwilling to cross. However, with the national political climate surrounding abortion growing more extreme and an abortion-hostile federal administration in power, state legislators are showing an appetite for more severe and punitive legislation. In addition to these homicide bills, several states have also introduced bills shoring up the idea of fetal personhood. 

• Abortion Trafficking in Mississippi: A Mississippi bill would make it a felony to assist a minor out of state for an abortion. This proposed legislation follows on the heels of Idaho and Tennessee’s similar ‘abortion trafficking’ laws, both of which are currently blocked in whole or in part. 

• Nebraska Restrictions on Medication Abortion: In Nebraska, legislation has been introduced that would make it significantly more difficult to obtain a medication abortion. Under the proposed law, patients would be subjected to a number of non-medically standard requirements, including in-person visits both before and after receiving the medication, and onerous testing and documentation requirements.  

• Trump Administration’s Executive Orders Take Aim at Bodily Autonomy, LGBTQ+ Rights, and Abortion Access: 

• The first two weeks of the second Trump Administration saw a flurry of executive orders, a large swath of which take aim at lgbtq+ rights, health equity and access, and bodily autonomy generally. Although many of these orders will be, or already have been, challenged in court, they reflect a clear federal agenda of rolling back civil rights protections and placing the authority over individual liberties in the hands of the executive branch. 
  
  One of the most striking executive orders declares, in contravention of reality, that there are only two sexes and that sex and gender are unchangeable and immutable, effectively denying the existence of trans and gender-diverse people. The order also contained (scientifically inaccurate) fetal personhood language by defining a woman or a man as a person belonging, at conception, to the sex that produces the large reproductive cell and small reproductive cell, respectively. Following this order redefining sex and gender, the administration also handed down directives banning trans people from serving in the military and attempting to revoke federal funding for any gender-affirming care for people under the age of 19. 
  
  In addition to attempting to roll back rights for LGBTQ+ people, the new administration also issued several orders targeting DEI programs, threatening to enforce a harsh anti-DEI agenda against both the public and private sectors. 
  
  Although the Administration has not yet taken a direct shot at eliminating abortion rights, it has signaled its hostility to reproductive freedom in other crucial ways. One Executive Order, signed on January 24th, orders strict enforcement of the Hyde Amendment, the law prohibiting federal funding from being used for abortion. Additionally, The Administration has reinstated the ‘Mexico City Policy,’ otherwise known as the Global Gag Rule, whereby NGOs that receive funding from the U.S. must certify that they do not promote or provide abortion care. 

Trend & Policy Watch:

• Government Website Offering Reproductive Health Information Taken Offline: 

  • The government-run website Reproductiverights.org appears to have been taken offline in the first week of the Trump Administration. The website was created in 2022 and included information about access to birth control, insurance coverage for preventative healthcare, including HIV and cancer screening, and the legal status of abortion across the states. 

•  Social Media Platforms Censor Access to Abortion Pill Information: 

• Social media platforms Instagram and Facebook are facing scrutiny for censoring, suspending, or blocking posts and profiles related to medication abortion access. For example, Aid Access, a prominent abortion pill provider’s page, was suspended, making it unsearchable even by those who follow them. Hey Jane, Women Help Women and Just the Pill faced similar obstacles. Although Meta stated that the profiles and posts were targeted for violating community standards regarding guns, drugs, and other restricted goods, abortion pills are FDA-approved, commonly used, and entirely legal in many states across the country, and it is unclear how provision of information about the drugs would violate any stated policy. 

• Recent Data Indicates that Support for Access to Medication Abortion is Growing: 

• New data from the Journal of the American Medical Association (JAMA) shows that support for access to medication abortion is growing. A sample of women aged 15 to 49 were surveyed in 2021, before the Dobbs decision, and again in mid-2023; results showed 6% increased support for both access to abortion pills prior to pregnancy, to be taken in the event of a pregnancy, and over-the-counter no-prescription access to the medication. 

• Anti-Abortion Activists Look to Men to Report Their Partners’ Abortions:

• In the years following the Dobbs decision, anti-abortion activists have failed to stem the flow of abortion pills to pregnant people in ban-states. It now appears that the groups are ramping up a strategy of encouraging women’s partners to report them for abortions. According to John Seago, the president of Texas Right to Life, “The strategy right now is to tell dads that if you’re the father of a child victim of an abortion, you have legal rights, there may be a way to hold these people accountable.” Reportedly, the group will use a social media advertising campaign to reach these men. Already, Texas Attorney General Ken Paxton has filed a lawsuit against a New York doctor based on a report from a “biological father” of his partner’s abortion. 

• New Mexico Supreme Court Decision May Tee Up Supreme Court Challenge: 

• In our last Digest, we reported on the New Mexico Supreme Court’s ruling striking down local abortion bans in the state. These local bans rely on an erroneous interpretation of the Comstock Act to attempt to block the sending or receipt of abortion pills through the mail, even in states like New Mexico, where abortion is legal under state law. The ruling from New Mexico’s highest court may allow anti-abortion activists to bring the issue of whether and how Comstock should be enforced to the U.S. Supreme Court, where it could find a favorable audience with the conservative majority. 

• State Department Halts Issuance of New Passports for Trans Americans:

• The U.S. State Department under Marco Rubio has stopped issuing new or renewed passports for transgender Americans seeking to change their gender marker on their documentation. For those who have already submitted their passport application, this means that their critical documents – including their previous passport and birth certificate – are in the possession of the State Department without a clear path for return. Without guidance from the Administration, thousands of Americans are now left in legal limbo, including those who are currently traveling. This action comes in direct response to the new Administration’s Executive Order denying the existence of transgender people and seeking to effect a near-total erasure of their rights and protections.