What if we were stationed in an anti-choice state?
Photo: NBC News
On June 24th, the shocking Supreme Court decision to overturn a decades-old precedent on abortion sent American citizens into a frenzy of speculation about the future of family planning. While family planning for males, females, and nonbinary individuals within military families is a top issue, according to the 2021 Blue Star Families Military Family Lifestyle Survey, the overturning of Roe V. Wade leaves a fair amount of questions unanswered—especially for those who move around the country and the world often and depend on the federal government for medical care.
For service members, their families, and their spouses, ceding decisions around reproductive care to the state level instead of guaranteeing rights at the federal level means many additional degrees of confusion.
“We have concerns about the future implications of this ruling,” said Liz, a military spouse who wished only to be referred to by her first name. “We are a same-sex couple who have undergone fertility treatment through Walter Reed Medical Center for myself and a non-military clinic for my spouse due to our location at the time. Will our rights change as far as our frozen embryos are concerned?”
Roe V. Wade was the 1973 landmark case that allowed women to choose freely to have an abortion in the United States. The 7-2 decision struck down many state and federal abortion laws and caused massive debate for the last 49 years. While the case centered around abortion legality, it also set a precedent for families across the country to make their own decisions about family planning and contraception.
When Roe V. Wade was enacted, family planning didn’t get easier for military-affiliated families. As stated in the Blue Star Families Survey, “the military lifestyle introduces unique challenges to family building, including unpredictable separations between partners, disruptions to treatment due to relocation or deployment, and challenges accessing care due to the location of duty stations and lack of coverage for potential treatments.”
On top of the roadblocks mentioned above, two-thirds of military-connected family respondents (67%) reported in the BSF survey face other challenges with family building, including a lack of medical coverage for fertility-related treatments, miscarriages, stillbirth, low testosterone, hormonal imbalance, erectile dysfunction, and sexual dysfunction.
The question now is: without the protection of Roe V. Wade, what does the future of family planning look like for military families?
The Hyde Amendment, passed in 1976, curtails the Pentagon’s capability to provide federal funding for abortions unless the patient’s life is at risk. Currently, Tricare—the health care program for uniformed service members, retirees, and their families—only covers abortions in cases of rape or incest or if the mother’s life is at risk.
Tricare covers only what it deems medically necessary reproductive services and is only supplementary if natural fertilization is used. At this time, Tricare does not cover artificial insemination, donor bank costs, reversal of tubal ligation or vasectomy unless medically necessary, erectile dysfunction care, and non-coital reproductive procedures such as in vitro fertilization (IVF) or zygote transfers.
Liz says she’s concerned about how challenging family planning will become in the future regarding the IVF process and how the military has to adhere to said laws, particularly in states with so-called “trigger laws.” These laws effectively outlawed abortions, including in cases of rape and incest in some states. Military families hardly get a say in where they are stationed, so there has been no shortage of concerns.
“I don’t know if I would want to carry to term, but my personal belief is that it isn’t something that should be forced onto anyone,” said Liz.
Another military spouse, who we will call Spouse K, said, “I think family planning will take a huge step backward for military families. In 2015 I had a dilation and curettage (D&C) for a pregnancy that ended at 11 weeks. What if we were stationed in an anti-choice state? The government would have more say in what happened to me than medical professionals. Would Tricare cover the cost of care when traveling to another state?”
On top of Spouse K’s concerns, she has experienced a rollercoaster of appointments to remove an intrauterine device, or IUD, and receive birth control pills that ultimately sent her postpartum depression in a whirlwind. After waiting weeks to get the help she needed, she eventually took out the IUD herself.
“This was my first experience knowing what I wanted for my body, but being stuck in a system that is operating over-capacity,” said Spouse K. “The feeling of having something in my body that I didn’t want there and not having control was gut-wrenching, to say the least.”
Spouse K’s partner had a vasectomy after the turbulent time she had with birth control. “He goes to [Flight Medicine], so they’re very prompt at seeing him whenever he needs anything,” said Spouse K. “Urology was the department we had to wait on. Men’s options are straightforward: Abstain, condoms, or vasectomy.”
The Pentagon has reassured military families that the overturn will not affect their healthcare access at military treatment facilities.
President Joe Biden signed an executive order on July 8, 2022 protecting access to reproductive care, including the seamless support for healthcare in DoD facilities. Biden and House Democrats strive to convince Congress to reinstate Roe V. Wade as a federal law. For now, all military families can do is hope for a clear solution.