DIFFERENCES IN TYPES OF CHALLENGES EXPERIENCED BY SEXUAL MINORITY AND HETEROSEXUAL PATIENTS SEEKING ABORTION CARE

Objectives

Although sexual minorities are equally or more likely to need an abortion as heterosexual women, little research examines their experiences seeking abortion care. This study examines differences in challenges faced by sexual minority and heterosexual patients seeking abortion.

Methods

We analyzed survey data from 1,833 individuals who sought an abortion at 25 clinics in the Midwest from April 2020 to April 2022. We examined the types and number of challenges related to seeking abortion overall, and by sexual identity (sexual minority vs. heterosexual). We conducted negative binomial regression to quantify differences in number of challenges by sexual identity, controlling for factors commonly associated with challenges seeking abortion.

Results

A fifth of participants identified as a sexual minority (19%). Most participants, regardless of sexual identity, faced at least one challenge (90%), with sexual minority participants experiencing a mean of 3.8 challenges compared to 3.0 for heterosexual participants (p<0.001). Sexual minorities were more likely than heterosexual participants to face nearly every challenge presented, including cost (73% vs. 64%; p<0.01), transportation (19% vs. 12%; p<0.001), emotional burden (40% vs. 29%; p<0.001), and keeping the pregnancy/abortion secret (40% vs. 31%; p<0.01). Controlling for other factors, sexual minorities faced significantly more challenges than heterosexual participants (aIRR=1.20; p<0.001).

Conclusions

Sexual minorities may need additional and tailored support when seeking an abortion, including financial, logistical, and emotional support specific to their circumstances. Addressing inequalities within society, as well as within reproductive healthcare, will help ensure that abortion is accessible to all, including those who identify as sexual minorities.