One month ago, I had the unforgettable opportunity to lobby at Capitol Hill for a number of bills aiming to further reproductive justice. Thirty of my fellow physicians and I, all fellows with Physicians for Reproductive Health (PRH), a doctor-led organization that uses medicine and science to advance access to reproductive and sexual health care for all patients, spoke to our federal representatives and senators of our respective states. Our advocacy centered on immigration justice policies to protect patients and families, specifically advocating for the HEAL Act, Protecting Sensitive Locations Act, and the Stop Shackling and Detaining Pregnant People Act.
The framework and values of reproductive justice (RJ) are core to the way our communities can stay safe and healthy. In the 1990s, a group of Black activists, often referred to as the founding mothers of RJ, defined RJ as the human right to maintain bodily autonomy, have children, not have children, and to parent those children we have in safe and sustainable communities. As a pediatrician and adolescent medicine specialist who believes that bodily autonomy for all of us is central to building a future where we can all make informed and trusted decisions about our bodies, families, and futures, I see the intersectionality of reproductive justice within many elements of the medicine I practice every day.
Given the anti-immigrant sentiment furthered by the Trump Administration, it was critical to use our time during this lobby day to advocate for bills that would offer baseline protections for the most inequitably impacted communities accessing health care. Given the chilling effect of xenophobia, ICE activities, including detention and deportation, and misinformation and disinformation spread about immigrants in the United States, it is our duty as physicians who all care for immigrants to ensure that they have at least basic protections to ensure their human rights.
Related: 5 Key Facts About Immigrants and Medicaid
The HEAL Act (Health Equity and Access under the Law for Immigrant Families Act) would remove discriminatory barriers to accessing health care for immigrant families. It would lift the five-year ban period that federally authorized immigrants, including children and pregnant people, are required to wait before being able to enroll in health care programs, including Medicaid or Children’s Health Insurance Program. The Stop Shackling and Detaining Pregnant People’s Act is legislation that would prohibit the U.S Department of Homeland Security, ICE, and Border Protection from shackling pregnant, postpartum, and lactating people. It would also create a presumption that pregnant, birthing, and lactating people should not be detained. The Protecting Sensitive Locations Act would reinstate legal protections ensuring that places of worship, schools, and health care facilities would not be targeted by ICE agents.
These bills would not just offer theoretical protections. As I think about the realities of the patients I care for every day, I know what kind of meaningful impact these bills would have. As a pediatrician who worked in the Bronx where there is a large immigrant community, and now as an adolescent medicine specialist in upstate New York in a sanctuary city, I have provided care for patients and families with varying immigration status, all of them worthy and deserving of access to the health care they need. These bills will help continue access to primary care services, such as vaccinations for preventable diseases. These bills will also aid immigrant youth and families who are in need of sub-specialized care for sexual reproductive health, eating disorders, and gender affirming care. This spans evaluating adolescents for heavy and debilitating menstrual periods, to supporting and affirming patients in social and medical transition that aligns with their gender identity, and providing medical management for individuals who are malnourished from an eating disorder.
All people, regardless of nationality, race, gender or immigration status, should be able to receive health care. Under the current administration, ICE has entered children’s hospitals and targeted parents of sick children. I know parents do their best to protect and provide for their children, and no parent should have to decide between life-saving health care for their kid and the fear of detention or family separation. As an advocate for RJ, I cannot forget that one of the principles of the RJ framework is to be able to parent the children people choose to have in safe environments. Allowing ICE or DHS agents into spaces such as hospitals, health care facilities, schools, places of worship, or playgrounds, further decreases trust for these immigrant families and communities, and leads to further health disparities for an already marginalized community. The Protecting Sensitive Locations Act would prevent this from happening. We need policies that protect patients and their rights.
This current Administration — and some New York lawmakers — are trying to sow the theme of seeing immigrants as a threat instead of allies. There is a narrative that pins Black folks against immigrants and perpetuates negative stereotypes, that immigrants are taking away jobs, lowering wages, and unfairly taking away from our government. These are all lies that are spread to further separate and divide these communities. This narrative is focused on competition and conflict between Black Americans and immigrants, when both of these groups share a history of repression and colonization by an economic structure that seeks to make wealth and wellbeing available only to the top one percent. Both groups continue to face economic and racial disparities that limit access to healthcare, generational wealth, and stability.
While we were able to meet with many offices that day, my hope is that as we see increased violence against immigrants, cruel detention practices, family separation, and forced deportation to random countries — not of the nationality of the immigrants being deported — that legislators across the country will understand the importance of passing legislation that centers and protects the health care needs of immigrants across the country. As a physician, these bills are important — I took an oath to provide justice and fairness, and to respect autonomy for all patients.
Dr. Alexandra Fayne, a Fellow for Physicians for Reproductive Health and a board certified pediatrician, is also finishing her last year of an Adolescent Medicine fellowship. Her medical interests include providing comprehensive sexual reproductive health and education for teens and young adults.