Advice Sexuality

Get Real! I Might Not Be Ready for What Other People Will Say if I Start Having Sex

Heather Corinna

Feeling interested in sex with a partner, but unsure and fearful about what other folks might think or say about it? Here's some help in figuring if you're up to that part of a sexual life.

Published in partnership with Scarleteen.

Aliciapash asks:

I truly think I’m ready for sex, I’m comfortable with myself and my partner and am not at all nervous for losing my virginity. I’m only 16 but people say that different people are ready at different times right? and I think I’m ready now, I’ve ticked off all of the checkpoints on your “am I ready” checklist but there is one problem. I’m worried about if people will judge me for it. My question is should I stop doing what I want out of fear of how others will see my action?

Heather Corinna replies:

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

People do say that people are ready for sex—and not just the first time, either—at different times, different ages, and in different situations. And that’s absolutely right.

Whether we do or don’t want any kind of sex at any given time, with any given person, in any given situation, and also feel emotionally, physically, and practically ready for it is a very individual thing. That’s the case whether we’re talking about the very first time we do something sexual or the 501st. Some people certainly have the idea that whatever they think is right for them must be the only right choice or set of choices for everyone else, but no one who thinks that is correct or is probably really thinking about anyone but themselves. People are diverse, as are our sexualities: one size, or choice, most definitely does not fit all when it comes to human sexuality.

There’s ultimately no right answer to what you’re asking here; it’s just a matter of you figuring out how you feel about the opinions of others about your sexual choices, and how up to handling those opinions you feel right now.

There’s no choice you or anyone else can make here to avoid judgment from everyone. Some folks may judge you, or have negative opinions or feelings, if you do engage in sex. Others will if you don’t. Some people might get all judgypants if you have one kind of sex versus another, have sex at this age or that one, or engage in sex in one kind of relationship but not in another. Some people will have opinions, feelings, or judgments about your sexual choices they share with you or others, while others may have thoughts or feelings about your sexual choices they choose to keep to themselves.

I know how hard other people’s opinions about our sexual lives and choices can hit us sometimes and how vulnerable a person can feel when potentially facing that. I wish I could give people worried about judgments one specific choice they could make and feel good about where they were guaranteed no judgments from anyone, but people’s feelings and opinions about people’s sex lives are just much too varied, and some people lack the etiquette to keep their opinions about the sexual lives of others to themselves unless asked for them. There isn’t any one choice that can free us from the possible judgment of others.

That said, there are a few core things you can think about and talk about to sort this out.

1) Your right to privacy

Who does and doesn’t know about your sexual choices is mostly up to you. For the most part, you get to choose who you tell about your sexual life and who you don’t. If you aren’t literally having sex in front of people, or announcing sex you have engaged in to the world at large—or somewhere, like Facebook, where it can easily get to a bigger audience than you intended it to—the world at large will usually not know about it. You also have rights to privacy with things like sexual healthcare, so, for instance, if you ask your healthcare provider for birth control, or go to get STI screenings, they are typically required to keep that information confidential.

Obviously, the part of this where you don’t have control is with who someone you choose to tell chooses to then tell, or with who a sexual partner chooses to tell, and who they, in turn, choose to tell. You certainly could draft up a legal contract with your partner or anyone you tell requiring non-disclosure, but that’s a LOT more formal than most people, and probably you, tend to want to be with their sex lives. (Plus, your average person doesn’t usually have a notary handy at sexytimes.)

You can choose to only tell people about your sexual choices who are required by law (like health-care providers or counselors) to protect your privacy, or who you know you can trust to both be supportive of your choices and to keep what you share with them to themselves. Being selective in who you share information about your sexual life with, all by itself, offers you a lot of emotional insulation and protection when it comes to judgments. If you think someone you might tell isn’t someone you’re sure won’t blab about it to everyone, then don’t let that person have that information to spread around in the first place.

This also brings us to…

2) Your trust with your partner

Is your partner someone you trust to respect what you want and need around privacy? If you’ve gone through that checklist and come out all aces, it sounds like they are, but I figured I’d check.

You two can negotiate who you each want to tell about any sex you engage in or other parts of your sex life. You can make real agreements around that: it’s always okay to ask a sexual partner to be respectful about our privacy, and to keep information about our private sexual lives pretty private, sharing that information only, for example, with their doctor, parents, or a close friend. And it’s okay to veto someone a partner wants to tell who, for example, you know has gossiped to others about someone else’s sexual life in the past. If you two negotiate who you each want to tell with each other, do you feel you can trust this person to honor those agreements?

How about trust with your partner in terms of having your back in the case that anyone either of you tell, or who finds out, does make judgments you need some support with? If you’re not sure, that’s something else you can talk about together in advance, working out a plan for a unified front if you need one, and gathering some ideas about ways you can support each other well if and when you have to face any judgment.

3) Your community

The people who you or your partner would tell or think you might tell about your sexual choices: Who are these people? What are they like? Are they people you feel you can trust to be supportive of you, whether or not they agree with or approve of your choices? After all, we don’t have to agree with the sexual choices of a friend or someone in our family in order to be in their corner. We can have our own feelings and still choose not to be judgmental.

Who are the people you know have your back, who you can always call on or turn to for support when you need it? If you’re coming up blank with that, or your partner is the only person you can think of, then it might be that before you take this step, you need to identify some more of those folks. Dealing with judgments is a whole lot harder and scarier when we have to go it mostly or totally alone, and a whole lot easier and less scary when we have people in our lives who support us and our decisions and who can help us process and deal with the judgments of others.

Is there anyone in your community, be it your smaller community, like your friends and family, or your larger community, like your neighborhood or school, you’re really, really scared about with this? With the latter, like I said, you can usually control them even getting this information. However, with someone like a parent, sibling, or best friend, they either will often find out just because they’re close to you, or not telling them may be more uncomfortable than telling them. If you’re afraid of the judgment of someone like that, someone whose opinion you care about, and who you have a close relationship with, my best advice is to get in front of this, rather than having to deal with it from behind.

Talk to a person like that in advance of your choice if you can, voicing your worries about their judgments and seeing what you can do to work things out with them now instead of later, when you’ll probably be feeling a lot more vulnerable. That way, too, if you care about what they think—and you probably do—and value their opinion, you can also perhaps get feedback from them you might even find useful in making your own choices. You can also ask for their support even if they don’t agree with your choices, and they’ll often be more likely to give it because they felt heard and valued, and less likely to put judgment on you.

Of course, if any of your fears in this are fears of judgment that might or likely will result in anything like being kicked out of your house or physical, verbal, or emotional abuseif your safety is at risk—then that’s a very different situation. In that case, our advice is generally not to put yourself in danger in order to pursue sex: I just don’t think even great sex will tend to be worth that. Instead, I advise waiting until you can be in an environment where you don’t have to choose between your safety and your sex life.

4) Your own resilience

We don’t always feel emotionally able to deal with certain things well. Sometimes, we’ll feel like we can take on the whole world, and other times, we’ll feel like we might crumble at even the smallest thing going wrong, or the smallest slight. We might lock our keys into our house by accident one day and think trying to break into our own place is hilarious, while if it happens on another day, we might fall into such a huge, quivering, blubbering mass of tears we can’t even get up off the sidewalk to try and figure out what to do.

Only you can know how resilient you feel you might be about the judgments of others and how capable you feel now and in the near future of dealing with them. If you feel like you really can’t handle any judgments, or just don’t want to be open to being judged for choosing to engage in sex at all, then for now, the best choice is probably to hold off so you don’t even take that risk. On the other hand, if you do feel able to deal with those opinions—especially if you’re being very selective about who’s even told about this in the first place, have good support in place, and feel confident and strong about your own decisions—even if you would obviously rather everyone was 100 percent supportive, and engaging in sex is something you and your partner otherwise are feeling great about moving into, you probably will be able to get through it.

Sex is such a loaded thing for so many people. When we’re talking about sex and young people, it tends to get even more loaded. There’s a lot of bias against young people and their ability to capably make sexual decisions, including from people who are, themselves, young people. A lot of people also talk and communicate about sex and sexuality very poorly, which isn’t a shocker, since our world at large tends to lack those skills and enable crappy communication about it. So, we do all tend to have some resilience when it comes to people’s opinions in order to enjoy our sexual lives and to conduct them based on what we want and feel right about, based on what others want and feel is best. Sometimes we’ll feel able to do that. Sometimes we won’t. We obviously can’t look into a crystal ball and know for sure how people will react, so not only is there some guesswork involved about what people will say, there’s also guesswork involved about how we’ll feel if and when they do say something. The best we can do with this is be as realistic and real as possible in assessing ourselves and where we’re at, and how strong with it—and our own choices—we do or don’t feel.

It’s entirely possible I might have left you in the same place with my answer as you were in when you asked your question, where you just have to make a call on if this particular set of risks is one that seems worth it to you—if this set of risks does or doesn’t outweigh the potential benefits of choosing to have whatever sex it is you want to have.

If I did leave you in that exact same place, I’m sorry that I wasn’t of more help. However, if you really have already evaluated all of this, then all that really is left for you to do is to make a decision for yourself.

Certainly, if you find you feel really torn about this, or very uncertain, even after considering all of this some more, even with agreements you feel confident you’ll both honor around privacy and people around you you know you can count on to be supportive, then it might be that you’re not at this choice just yet. If you’re feeling really, really scared about this, I’d honor those feelings and not hurl yourself into something you just don’t think you can handle (or where even if judgment doesn’t happen, the fear of it is so big it makes what might otherwise be a great sexual experience into something you feel fearful about). In other words, it might be that the best choice for you to make right now is to put sex on hold until you do feel less conflicted about this issue, or less scared around it—until you have some more talks with your partner, or with friends or family, or just have some more time to gather any inner strength you think you might need to weather any judgment that could come your way.

I’m going to give you a few links below that might give you some extra help or food for thought around this. Hopefully, if what I’ve said here wasn’t what you needed to help you make your mind up around this, something in the links below might do the trick.

Whatever you choose, I hope you know that when it comes to our sexual choices, the only truly important feelings, thoughts, and values to consider are our own and those of whoever else is directly involved in those choices—whoever it is we are or might be engaging in sex with. If everyone in the world had positive opinions about sexual choices that you didn’t feel positive about at all, those would probably still be the wrong sexual choices for you. And if everyone else in the whole world had negative opinions about what you and yours felt were your best sexual choices—even though that would seriously never happen, with any sexual choices—that wouldn’t make what you two felt was the rightest thing for you the wrong thing.

It usually takes time for any of us to develop a sense of self-confidence about our own choices in life, be they sexual choices or any other kind. And the newer we are to making any given choices, the more insecure we’ll tend to be about them and the more vulnerable with the judgments of others about them we’ll tend to feel.

The very best we can usually do when we’re new to all of this is first make sure a sexual situation is generally emotionally safe for us overall. We can then also ask for the opinions and input of people we trust, whose opinions we value—people who know us well, and who we know have our best interest at heart—and then we just trust ourselves, which is something we can do when we’ve done whatever we can do to be very informed and consider our choices carefully, when we’ve done all we can to assure that our partners or potential partners have been clear and true about what they want, can handle, and can do, and when we have consulted our gut feelings to be sure we’re doing something that we really want and feel good about. It sounds like you’ve been thinking this through pretty carefully, so I’m not seeing anything that says to me that you can’t trust your own choices here.

Lastly, I want to make sure you also know that you’re not responsible for what other people think or why they think what they do about your sexual life. Your choices don’t create their opinions, after all; those belong to them and are about them. No sexual choice you or anyone else is going to make is going to be something everyone approves of, no matter what you do or don’t do. All you can do is what you know and feel is best and right for you and yours, act with integrity, own your own choices, stand by them, and ask the people that you know care about you and think well of you no matter what to do the same. And maybe, just in case you need it, practice flipping the bird with a finely-honed, leave-me-alone, up-yours glare.

Here are those links, sent along with my very best to you, and my confidence you’ll make your own right choices, whatever they are:

Commentary Sexual Health

Don’t Forget the Boys: Pregnancy and STI Prevention Efforts Must Include Young Men Too

Martha Kempner

Though boys and young men are often an afterthought in discussions about reproductive and sexual health, two recent studies make the case that they are in need of such knowledge and that it may predict when and how they will parent.

It’s easy to understand why so many programs and resources to prevent teen pregnancy and sexually transmitted infections (STIs) focus on cisgender young women: They are the ones who tend to get pregnant.

But we cannot forget that young boys and men also feel the consequences of early parenthood or an STI.

I was recently reminded of the need to include boys in sexual education (and our tendency not to) by two recent studies, both published in the Journal of Adolescent Health. The first examined young men’s knowledge about emergency contraception. The second study found that early fatherhood as well as nonresident fatherhood (fathers who do not live with their children) can be predicted by asking about attitudes toward pregnancy, contraception, and risky sexual behavior. Taken together, the new research sends a powerful message about the cost of missed opportunities to educate boys.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

The first study was conducted at an adolescent medicine clinic in Aurora, Colorado. Young men ages 13 to 24 who visited the clinic between August and October 2014 were given a computerized survey about their sexual behavior, their attitudes toward pregnancy, and their knowledge of contraception. Most of the young men who took the survey (75 percent) had already been sexually active, and 84 percent felt it was important to prevent pregnancy. About two-thirds reported having spoken to a health-care provider about birth control other than condoms, and about three-quarters of sexually active respondents said they had spoken to their partner about birth control as well.

Yet, only 42 percent said that they knew anything about emergency contraception (EC), the only method of birth control that can be taken after intercourse. Though not meant to serve as long-term method of contraception, it can be very effective at preventing pregnancy if taken within five days of unprotected sex. Advance knowledge of EC can help ensure that young people understand the importance of using the method as soon as possible and know where to find it.

Still, the researchers were positive about the results. Study co-author Dr. Paritosh Kaul, an associate professor of pediatrics at the University of Colorado School of Medicine, told Kaiser Health News that he was “pleasantly surprised” by the proportion of boys and young men who had heard about EC: “That’s two-fifths of the boys, and … we don’t talk to boys about emergency contraception that often. The boys are listening, and health-care providers need to talk to the boys.”

Even though I tend to be a glass half-empty kind of person, I like Dr. Kaul’s optimistic take on the study results. If health-care providers are broadly neglecting to talk to young men about EC, yet about 40 percent of the young men in this first study knew about it anyway, imagine how many might know if we made a concerted effort.

The study itself was too small to be generalizable (only 93 young men participated), but it had some other interesting findings. Young men who knew about EC were more likely to have discussed contraception with both their health-care providers and their partners. While this may be an indication of where they learned about EC in the first place, it also suggests that conversations about one aspect of sexual health can spur additional ones. This can only serve to make young people (both young men and their partners) better informed and better prepared.

Which brings us to our next study, in which researchers found that better-informed young men were less likely to become teen or nonresident fathers.

For this study, the research team wanted to determine whether young men’s knowledge and attitudes about sexual health during adolescence could predict their future role as a father. To do so, they used data from the National Longitudinal Study of Adolescent Health (known as Add Health), which followed a nationally representative sample of young people for more than 20 years from adolescence into adulthood.

The researchers looked at data from 10,253 young men who had completed surveys about risky sexual behavior, attitudes toward pregnancy, and birth control self-efficacy in the first waves of Add Health, which began in 1994. The surveys asked young men to respond to statements such as: “If you had sexual intercourse, your friends would respect you more;” “It wouldn’t be all that bad if you got someone pregnant at this time in your life;” and “Using birth control interferes with sexual enjoyment.”

Researchers then looked at 2008 and 2009 data to see if these young men had become fathers, at what age this had occurred, and whether they were living with their children. Finally, they analyzed the data to determine if young men’s attitudes and beliefs during adolescence could have predicted their fatherhood status later in life.

After controlling for demographic variables, they found that young men who were less concerned about having risky sex during adolescence were 30 percent more likely to become nonresident fathers. Similarly, young men who felt it wouldn’t be so bad if they got a young woman pregnant had a 20 percent greater chance of becoming a nonresident father. In contrast, those young men who better understood how birth control works and how effective it can be were 28 percent less likely to become a nonresident father.9:45]

Though not all nonresident fathers’ children are the result of unplanned pregnancies, the risky sexual behavior scale has the most obvious connection to fatherhood in general—if you’re not averse to sexual risk, you may be more likely to cause an unintended pregnancy.

The other two findings, however, suggest that this risk doesn’t start with behavior. It starts with the attitudes and knowledge that shape that behavior. For example, the results of the birth control self-efficacy scale suggest that young people who think they are capable of preventing pregnancy with contraception are ultimately less likely to be involved in an unintended pregnancy.

This seems like good news to me. It shows that young men are primed for interventions such as a formal sexuality education program or, as the previous study suggested, talks with a health-care provider.

Such programs and discussion are much needed; comprehensive sexual education, when it’s available at all, often focuses on pregnancy and STI prevention for young women, who are frequently seen as bearing the burden of risky teen sexual behavior. To be fair, teen pregnancy prevention programs have always suffered for inadequate funding, not to mention decades of political battles that sent much of this funding to ineffective abstinence-only-until-marriage programs. Researchers and organizations have been forced to limit their scope, which means that very few evidence-based pregnancy prevention interventions have been developed specifically for young men.

Acknowledging this deficit, the Centers for Disease Control and Prevention and the Office of Adolescent Health have recently begun funding organizations to design or research interventions for young men ages 15 to 24. They supported three five-year projects, including a Texas program that will help young men in juvenile justice facilities reflect on how gender norms influence intimate relationships, gender-based violence, substance abuse, STIs, and teen pregnancy.

The availability of this funding and the programs it is supporting are a great start. I hope this funding will solidify interest in targeting young men for prevention and provide insight into how best to do so—because we really can’t afford to forget about the boys.

Analysis Human Rights

For Undocumented People Seeking Health Care, ‘The Barriers Can Seem Endless’

Tina Vasquez

“The fear that accessing [health] services will get you deported is very real in undocumented communities,” said Alma Leyva, a research coordinator at the UCLA Labor Center’s Dream Resource Center.

While attending UC San Diego (UCSD), Ireri Lora used her school ID at the university’s medical school to access birth control and other services.

Lora, who was undocumented then, told ​Rewire​, “Sometimes you would see border patrol agents walking around or parked in their trucks, but they were always parked directly in front of the main hospital entrance. They would take people straight from the hospital [to a border patrol station], and they wanted us to see them do that.”

This behavior wasn’t unique to the UCSD hospital, Lora said. An acquaintance whose family members worked for border patrol in San Diego had told her that federal agents would drive around the perimeter of hospitals and park outside of them, presumably to intimidate non-citizens.

Every time Lora had to get her birth control prescription filled, she would make sure multiple people in her life knew where she was going so that if trouble arose, they would answer her call immediately.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

California is often referred to as one of the best states for reproductive rights in the country, and for good reason. NARAL Pro-Choice America gives California an A+ on choice-related laws, and the state legislature is actively trying to expand access to care.

There are, however, California residents for whom none of this matters.

The reasons vary, but what is true across the board is that the more your identity is layered by race, gender, sexuality, and immigration status and the further your income falls below the federal poverty line, the less access you will have to sexual and reproductive health-care services—even in California. There are community-based groups working to fill this gap, but resources are in short supply for those fighting to expand access to undocumented people.

Stifled by Fear of Deportation

In August 2015, when Blanca Borrego, an undocumented mother of three, was arrested by sheriff’s deputies at her gynecologist appointment in Atascocita, Texas, some in the media rightly expressed outrage. But undocumented communities knew it wasn’t an isolated incident and that immigrants are detained and deported for seeking care all the time. Borrego was yet another example confirming some of their biggest fears.

“The fear that accessing [health] services will get you deported is very real in undocumented communities and what happened to Blanca [Borrego] isn’t at all unusual, so it’s not an unfounded fear,” said Alma Leyva, a research coordinator at the UCLA Labor Center’s Dream Resource Center, a national source for research, education, and policy on immigration issues. “She was insured and had been in the country for a long time. A lot of people think, ‘If that could happen to her, why couldn’t it happen to me?'” Leyva told Rewire.

Nearly three years ago, the Dream Resource Center sought to document the experiences of immigrant youth and their families in navigating California’s health-care system as part of its 2013 Healthy California Survey Project. From June 2013 to August 2013, a research team comprised of 37 immigrant youth surveyed 550 undocumented and “DACA-mented” young people. What resulted was Undocumented and Uninsured, the first statewide research project by and about immigrant youth on health access.

As the report explains, while Deferred Action for Childhood Arrivals (DACA) recipients under the age of 21 are eligible for Medi-Cal—the state’s free or low-cost health coverage for children and adults with limited income and resources—that doesn’t resolve a primary reason undocumented people and DACA recipients do not seek care: fear.

National policies contribute to high numbers of deportations and increase immigrant communities’ mistrust, such as the Priority Enforcement Program (PEP), which requires that all fingerprints of arrested persons taken by local law enforcement be sent to ICE to check against immigration databases, and Section 287(g) of the Immigration and Nationality Act, which allows DHS to “deputize selected state and local law enforcement officers to perform the functions of federal immigration agents.”

According to the Undocumented and Uninsured:

The police and Immigration and Customs Enforcement (ICE) are not only in immigrant neighborhoods but also in the minds of undocumented people, triggering constant anticipation of harm and hypervigilant behavior. Emerging research indicates that immigrant youth experience feelings of shame, anger, despair, marginalization, and uncertainty stemming from discrimination, anti-immigrant sentiment, xenophobia, fear of deportation, and institutional barriers. Daily economic uncertainties elevate the risk of anxiety, depression, and vulnerability to mental illness for immigrant youth. Emotional traumas manifest in poor physical and mental health, which often goes untreated.

Leyva told Rewire that she has heard stories “where an undocumented youth was asked by a doctor to relay really complicated medical jargon to their mom as she was giving birth. They were so afraid they wouldn’t translate the information properly that it would be dangerous to their mom,” she said.

“There is anxiety around simple check-ups and fear around obtaining resources to get healthier. We’ve come to believe that this is just the price of being undocumented in this country, and that’s not OK. We too deserve the right to not just survive, but to live full, healthy lives. Health care is a right, not a luxury,” Leyva said.

Dire Circumstances in Rural California

Lora became a legal permanent resident in 2015, but while living in San Diego as an undocumented college student she said her “biggest fear” was a scenario like what happened to Borrego in Texas. In 2009, while working on college campuses and connecting with undocumented families, Lora learned that it was a universal fear among undocumented women.

“When I asked the moms [I worked with] if any of them, about 20 in all, had visited any particular clinics, they all shared that they were scared to because they heard border patrol patrolled the area or that vans waited outside to get people who were leaving the clinic, especially if the clinic was one that primarily served the Latino community. Fortunately, none of the mothers I ever worked with had been stopped by border patrol for seeking services, but that environment made them too scared to go to a clinic,” Lora said.

By that time, she and a friend had started a program where they brought different workshops onto campus based on the expressed needs of the community. Overwhelmingly, Lora said, undocumented mothers requested workshops about sexual education and birth control.

Lora worked with local community clinics from the Barrio Logan area of San Diego to do biweekly workshops in Spanish about sexual health. That experience led her to ACCESS, an Oakland-based organization “founded in 1993 by clinic escorts who were moved to action after witnessing the many barriers women were facing—especially young or poor women—to actually obtain an abortion.” ACCESS further explains on its website that the organization combines direct services, community education, and policy advocacy to promote reproductive options and access to quality health care for California women. It is one of the only organizations in California that helps to provide abortion access to undocumented women while also using a reproductive justice framework created by women of color for women of color.

Lora, who is now on ACCESS’ board of directors, began working with the organization as a healthline intern. The healthline, as Lora explained, empowers callers by giving them all of the information they need to advocate for themselves. It was at this time Lora learned of the very specific barriers undocumented women living in rural areas face.

“They always voiced fears about visiting any government agency to get Medi-Cal or a clinic like Planned Parenthood because they thought they’d be deported or profiled for showing a foreign ID,” Lora said.

Vanessa Gonzalez-Plumhoff, Planned Parenthood’s director of Latino outreach and engagement, made it clear that the health-care provider would not put a patient in harm’s way. She told Rewire that Planned Parenthood is serious about addressing the needs of the undocumented community, asserting that Planned Parenthood will provide health care no matter what, regardless of immigration, citizenship, or income status.

The reason why the services provided to undocumented women may differ by location, Gonzalez-Plumhoff said, is because of the legislative, political, and financial climate of a particular area. As reproductive health care continues to be attacked, it limits what services are made available from clinic to clinic.

Unlike most states, California allows low-income women to obtain public funds for abortion and also provides them with co-pay-free family planning services. Abortions are legal up to viability and California’s AB 154, which took effect in January 2014, increased the number of abortion providers in the state. The law authorized nurse practitioners, certified nurse midwives, and physician assistants to perform vacuum aspiration abortion, which previously only doctors were allowed to do.

But, like in most states, there are districts in California where abortion providers are nonexistent. According to the LA Times, UC San Francisco’s Bixby Center for Global Reproductive Health is largely responsible for the passage of AB 154, but just a handful of the clinicians trained under the six-year study are practicing in remote corners of California. Schools like the UC San Francisco School of Nursing are developing new training programs, but at this point, half of California’s 58 counties currently have no readily available provider. And even when new programs roll out in rural communities, they will only benefit women seeking abortions during the first trimester, leaving out a segment of the population at risk of fetal anomalies or later pregnancy complications.

The process of obtaining an abortion as an undocumented woman living in a rural area is complicated. Lora said these women often work in the fields and live in migrant camps, which makes obtaining the passport that some clinics require as a valid form of ID challenging—and that’s mostly because of the lack of transportation, which Lora said is a “huge barrier” for undocumented women seeking such identification.

In addition, these women often have to travel to reach one of the few clinics providing later abortion care in the state.

“A lot of clinics near women in rural areas only offer abortion until the first trimester,” Lora said. “By the time they’re referred to us, they’re often beyond that point, so they have to get transferred to a clinic that’s even farther away. Transportation comes up again and again.”

This is where ACCESS’ “practical support program” comes in. The organization helps callers navigate paying for care, leveraging over $200,000 of coverage per year for medical procedures. Also, with support from its network of volunteers around the state and the organization’s pool of funds, ACCESS provides around $25,000 annually to help with transportation, housing, meals, child care, medical costs, and doula support.

One of the toughest cases Lora ever handled on the Spanish healthline was an undocumented rape survivor who lived in a rural area. Her family didn’t know of the rape or the resulting pregnancy. By the time ACCESS could walk her through all of the steps, she was in her 20th week. Following the multi-week process, which included acquiring an appointment and bus tickets, she then had to come up with a lie to tell her family as to where she was going for two days.

“The information is not accessible and the barriers can seem endless. That’s why it’s especially upsetting to me when ACCESS constantly hears this misconception that people in California—and women of color in particular—purposefully wait until the last minute to get abortions. It’s simply not true. Most of the women I’ve spoken to were very clear that they wanted to terminate their pregnancies early on, but they were forced to wait weeks because of limited access to information, limited access to clinics, and because of transportation barriers and language barriers,” Lora said. “If abortion was as accessible in California as they paint it to be, all women who wanted to terminate their pregnancies would be able to do it in a week.” 

Community Groups Are Working to Replace Fear With Trust 

There is no telling how many women ACCESS has helped, but what is clear is the ripple effect of the progress the group is making. ACCESS alumna La Loba Loca, who identifies herself as a queer, machona, brown South American migrant, formed Autonomous Communities for Reproductive and Abortion Support (ACRAS) three years ago. La Loba Loca’s collective, comprised of mostly queer people of color, provides free and low-cost abortion support to Angelenos. Her personal project, Serpiente Birth & Spectrum Services, supports individuals and families during life transitions through bilingual full-spectrum companionship and doula work. 

La Loba Loca takes a multifaceted approach to her companion work, coupling an academic framework with traditional knowledge gained through personal research and non-Western education, which she calls “abuelita knowledge.”

“I got into birth work because of abortion. To me, there’s no place people can go that will holistically support them getting an abortion,” La Loba Loca said. “I want to normalize abortion as just another aspect of reproductive health and remind people of the ways our grandmothers took care of their health and well-being outside of the medical industrial complex. It’s medicine and knowledge that is generational and that shouldn’t be lost.”

Above all else, ACRAS works to share knowledge and resources within communities. La Loba Loca has tirelessly compiled documents about abortion and reproductive health for the purpose of being used by undocumented people who don’t have easy access to clinics and hospitals. “The idea was also to include people in the collective who have historically been left out of these conversations or who have been denied the same kind of access to reproductive justice as other people,” she said.

La Loba Loca has been a major proponent of queer and trans people of color receiving the proper training to be both birth and abortion companions. The language used around reproductive justice isn’t inclusive, she said, and it can make queer and trans people of color afraid to discuss their bodies and their needs and afraid to access services.

“I’m hearing a lot of queer and trans people try to figure that out, just because accessing abortion as a queer or trans person can be difficult or when you do obtain one, it can be dehumanizing,” she said. “Right now, there are queer and trans people doing reproductive justice work, but it’s very isolating and frustrating to never receive the funding that’s needed to provide education for and about different bodies.”

To La Loba Loca, the answer to the lack of access and the poor treatment that undocumented people and other low-income communities of color often receive at clinics and hospitals is not working to change these systems, but rather using community-based resources to find ways around the structural hurdles. Roxana, an ACRAS member who requested that Rewire not use her last name, said that the road to sexual and reproductive justice has been built on the backs of women of color and the long history of institutions being harmful to communities of color who are already vulnerable is not something that can easily be overcome.

“I think of the Latinas in L.A. who were coerced into sterilization in the 1970s and how that distrust lingers in the community,” Roxana said. “The trauma stays, and it continues to be a barrier that scares people from going to an institution that historically been violent to people who look like them. It’s only harder when you’re undocumented.”

Like Lora, Roxana realized through her work that immigrant communities, Latino communities, and undocumented communities are all in need of sexual and reproductive health information that is in their language and that comes from people they trust.

At an ACRAS workshop around reproductive justice, according to Roxana, the age of attendees ranged from 15 to 65. A woman specifically asked if it was OK that her teenage daughter was there because she wanted her to have the information that she never did. ACRAS workshops bring a LGBTQ lens and the mother and her daughter were eager to learn about reproductive health for different communities and learn about gender and sexual identities that go beyond the binary. Roxana said the interest is there; it’s just a matter of providing it in a way that’s accessible.

“We’re having real conversations about real experiences and for me, as a person who does this work, it’s very political and very personally meaningful. It’s heart work; it comes from the heart,” Roxana said, growing emotional. “I want to go beyond ‘your body, your choice.’ I’m not really into that, especially because for a lot of us, what happens to our bodies isn’t a choice. For me, it’s more like ‘I got your back.’ ACCESS and collectives like ACRAS serve a very important purpose in our communities. We’re creating alternatives to a system that wasn’t meant for us and we’re providing access to people whose existence was never even considered. We have each other’s backs.”

CORRECTION: This piece has been updated to clarify ACCESS’ funding for “practical support.”