June 30, 2022

The American Art Therapy Association (AATA) is writing in response to the US Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization that eliminates the constitutional right for individuals to access abortion services and rejects nearly a half century precedent. No matter where one stands on this issue, the Court’s ruling will have immediate and far-reaching impacts. Reproductive choice is a personal decision. Taking away the right to exercise bodily autonomy in making life-changing decisions—and placing decision-making authority with lawmakers rather than health care providers—will have profound mental and physical health consequences impacting families and communities, especially those most disadvantaged in society.

A person’s ability to determine when and if they have a child should not be tied to their socioeconomic or financial standing. Evidence-based research demonstrates that people who are denied abortion services are more likely to experience higher levels of anxiety, lower rates of life satisfaction and lower self-esteem compared with those who are able to obtain abortion services. Furthermore, the loss of access to safe, legal abortion may limit people’s ability to effectively participate within society, including in the workforce, and affect their education attainment and future earning prospects. And in the short term, without access to safe abortion services by medical professionals, people may make medically risky choices, including self-induced abortions.

Approximately 25% of women will have an abortion in their lifetime—and the vast majority (6 in 10) are already mothers. However, the impact of this Supreme Court decision will fall disproportionately on people who already face obstacles accessing health care, including Black, Indigenous, and other People of Color (BIPOC), Latinos, people with disabilities, people living in rural areas, young people, nonbinary and trans people, undocumented people, people in violent relationships, those without financial resources, and even our nation’s military service members.

When fundamental rights to health care are attacked or taken away—whether overturning the right to access abortion services or creating new laws making it illegal for parents to seek gender-affirming care for their children—targeted groups may feel uncertain, anxious, hopeless, or worse. It may trigger other past traumas, especially among historically marginalized communities. For example, compared with the general population, transgender people experience more chronic health conditions and experience higher rates of a variety of health problems. Barriers to accessing general and gender-affirming care for trans and sexual minorities are increasing. Each of these factors not only erode the mental health of already vulnerable communities but lead to drastic increases in suicide.

As mental health professionals, art therapists care for the overall mental health and well-being of the clients and communities they serve. They witness first-hand the mental health consequences of the medical and health crises women and sexual and gender minorities in particular are already experiencing. For example, American women have the highest rate of maternal deaths among high-income countries, while Black women are nearly three times more likely to die from pregnancy-related complications than white women. When compared with their own mothers, American women today are 50% more likely to die in childbirth. And suicide is a major cause of death during the postpartum period.

We want to take this opportunity to remind our colleagues, as they engage with their clients, and as they process the Supreme Court opinion, to navigate conversations with curiosity, respect for a range of perspectives and points of view, ethically and mindfully, separating facts from personal beliefs or emotions—regardless of their own personal opinions about abortion. Mental health professionals, including art therapists, have the professional and ethical obligation to their clients to support them through life’s challenges and informed decision-making, including reproductive choices, to help them thrive. Conversely, clients seeking support should not have to doubt the confidentiality and integrity of their relationships with their therapists.

AATA stands in support with our art therapist and student members, other mental health professions, and the clients and communities we serve in the aftermath of this Supreme Court decision, even as we cannot yet fully understand its long reaching mental health ramifications. Our agency lies also in being civically engaged and participating in our nation’s democratic processes and seek ways to continue to advocate for the health and well-being of current and future generations.   


History of Abortion Access in the United States

According to the Supreme Court’s decision, if a right isn’t explicitly mentioned in the Constitution, it must be “‘deeply rooted in this Nation’s history and tradition’ and ‘implicit in the concept of ordered liberty’” to qualify for constitutional protection. But according to historians, “that view of history is the subject of great dispute.”

Here are some points to consider as context regarding the history of reproductive choice in the United States:

  • Abortion was frequently practiced in North America during the period from 1600 to 1900. From 1776 until the mid-1800s abortion was viewed as socially unacceptable; however, abortions were not illegal in most states.
  • The history of abortion bans in the US have been rooted in patriarchy and white supremacy, particularly for Black women. Enslaved Black women did not have control their own bodies and were prohibited from obtaining abortions.
  • By the late 1800s, recent immigration, the growth of cities, and the end of slavery flamed nativist fears that white Americans were not having enough children, prompting some prominent physicians to argue that white women should have children for the “future destiny of the nation.”
  • Legislative movements to ban abortions began during the Civil War, and continued until 1910, when abortion became banned in states across the country.
  • The 1873 Comstock Act, named after the U.S. Postal Inspector at the time, made it illegal to send “obscene” materials—including information about abortion or contraception—through the mail or across state lines.
  • As more women looked for birth control options, advocates like birth control pioneer Margaret Sanger said that she was inspired to make teaching women about contraceptives her career after treating a woman who died from a self-induced abortion—a practice she called a “disgrace to a civilized community.”
  • It wasn’t until the 1970s that states began loosening existing birth control and abortion laws. At the time, many states prohibited the sale of birth control to unmarried women.
  • In a six-year period in the 1970s, following the passage of the Family Planning Services and Population Research Act, physicians sterilized approximately 25% of Native American women of childbearing age. Some of these procedures were performed under pressure or duress, or without the women’s knowledge or understanding. The law subsidized sterilizations for patients who received their health care through the Indian Health Service and for Medicaid patients, and Black and Latina women were also targets of coercive sterilization in these years.
  • In 1973, the Supreme Court established the legal right to access abortion nationwide with its landmark decision in the Roe v. Wade
  • Laws restricting access to abortion continued to target Black and other communities of color, even after the Roe decision. For example, the Hyde Amendment, which bans using federal money to cover almost all abortions in Medicaid and other programs, disproportionately affects Black and Latino communities, and restricts abortion funding under the Indian Health Service.
  • Over the years, language similar to that in the Hyde Amendment has been incorporated into a range of other federal programs that provide or pay for health services to women including: the military’s TRICARE program, federal prisons, the Peace Corps, and the Federal Employees Health Benefits Program. The Affordable Care Act (ACA) also included a provision that applied similar abortion coverage limitations to plans that are sold through the Marketplace for women who receive federal income-based subsidies to purchase private health insurance.

Note: In this post, we use the term “women” to align with the data sources referenced, but we acknowledge not all people who seek abortion identify as women.