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Even though it was expected, it was no less devastating.

A U.S. Supreme Court ruling to overturn Roe v. Wade is widely anticipated in 2022, but seeing the words in black and white in the leaked draft decision by Justice Samuel Alito made it chillingly real.

And as with everything, the impacts will not be equally felt. Those most at the margins and with the least resources will pay the highest price.

You might think that states like Washington, with strong abortion rights protections, are immune to the consequences of the end of Roe, but that would be untrue.

According to a report by Seattle Times journalist Alison Saldanha, the Guttmacher Institute, which supports abortion rights, estimates a 385% increase in the number of people coming for out-of-state abortions in Washington if a total ban in 26 states goes into effect. It’s likely that many who would seek abortion care in Washington would be coming from Idaho, one of 13 states to pass a so-called “trigger law” that bans abortion if Roe is overturned. Guttmacher estimates that 26 states are certain or likely to ban abortion if it is left to the states.

Even with our strong abortion protections in Washington, access to reproductive health services has already been threatened through religious control of hospital systems, according to Kaiser Health News. Over 40% of the state’s hospital beds are now controlled by Catholic organizations that can limit certain types of reproductive health care. This could become more acute if Roe is overturned.

This is just one of many insidious ways access to abortion can be chipped away, even in states with broad protections.

The impact of a repeal of Roe could extend far beyond reproductive rights. As columnist Jonathan Capehart wrote last week in The Washington Post, the ripple effects could be devastating for people like him who have benefited from marriage equality, for example.

Capehart noted that Alito’s distinction of preserving only what is “deeply rooted” in our nation’s history and tradition would threaten a lot of rights we now have. “Even if the final ruling in the next month or two isn’t as radical as the draft opinion, what Alito put forth is a clear warning to LGBTQ Americans that our rights could be stripped next,” he wrote.

This is not political theater or histrionics. These rights are already being attacked now. Efforts to restrict trans rights, for example, are already well underway. Republicans in Alabama last month passed laws restricting gender-affirming care for transgender people under the age of 19, for just one example.

It seems we are going backward.

One way we can try to hold some of the hard-fought ground on these issues is to see our lens and see the ways in which racial and economic justice intersect with reproductive rights. We have to care about bodily autonomy for everyone all the time, not just when cisgender white women are affected.

Reproductive justice asks that we respect the “human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities,” as the reproductive justice organization SisterSong frames it.

Abortion access alone does not solve the underlying conditions that leave Black women over three times more likely to die during pregnancy, for example. Abortion access alone does not address racial gaps in access to health care or contraception. The whole health care system regularly fails people of color and gender-diverse people – including access to reproductive care. We must use a comprehensive approach versus a single-issue one.

Another tool we have not used is harnessing the energy and resources of the cisgender, heterosexual men who are responsible for the vast majority of pregnancies. How are men stepping up to shoulder the labor to protect reproductive rights? How are they using their voices and influence to effect change?

Whatever the court ultimately decides, the battle for reproductive choice is already being waged state by state. We have some dark days ahead if we want to hold on to the rights many of us have taken for granted.

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