Skip to main content

Reproductive Health Access Problematic for Undocumented, Transgender Population

The Multnomah County Board of Commissioners provides a forum for voices who say even in a state known for legal access to reproductive health, many from underserved communities face other access barriers.
March 30, 2016

Carima Guzman was born in Columbia but lives in Oregon working with Latina survivors of sexual assault. She told the commissioners about the difficulties women without health insurance face navigating the system to get birth control or STI treatment.

Emily Lai grew up in Taiwan and came to Portland to attend Reed College and now works with youth at Momentum Alliance. “I have herpes,” she told the commissioners and, at one point in her life, could not afford the $150 fee – about 15 percent of her monthly income at the time -- to get tested.

“I know that many of us don’t get tested for STIs due to the cost, silence and shame around it,” said Lai said, who urged commissioners to support STI testing for everyone regardless of age or documentation status.

Mariotta Gary-Smith, a board member at Western States Center -- a nonprofit working for racial, gender and economic justice – is lucky her mother educated her about comprehensive health services. That conversation ended up helping her while working at a reproductive health clinic in college. It was “the hardest experience I can remember” with many young women of color not knowing they could make “decisions as they see fit,” she said. “Autonomy is the key value in reproductive justice.”

Surveys indicate more than half of Multnomah County pregnancies are unplanned -- with the highest rates for the young, unmarried, less educated and women of color, Tricia Tillman, the county’s public health director, told the commissioners.

Only seven out of 10 new moms in Multnomah County receive adequate care during pregnancy, leaving 15 percent of babies born with health issues that make it more likely they will die before they reach the first year of their life from sudden infant death syndrome, birth defects, pre-term births and low birth weights.

A countywide data equity project hopes to provide more accurate reporting based on race and ethnicity with the first ever data collected on sexual orientations, said Kim Toevs, HIV/STD program director for Multnomah County.

Also, she said a new federal grant will address racial disparities in teen pregnancy prevention in middle and high schools this fall.

The Building Reproductive Autonomy and Voices for Equity coalition brought commissioners pages of stories from people who couldn’t share their stories in person.

A transgender man who needed an abortion, for example, was reluctant to disclose for fear of losing his job.

The testimony “is pushing government to make better decisions for those who need the services,” said Commission Chair Deborah Kafoury. “It’s given me a lot of food for thought.”