Erin Smith, Kentucky Health Justice Network

One year post-Roe is an as-told-to series led by Prism’s Editor-at-Large Tina Vásquez, marking the milestone by featuring new and veteran advocates and organizers, abortion storytellers, providers, clinic directors, abortion fund volunteers, and reproductive justice organizers. You can read the complete series here

It means something that a lifelong Kentuckian is at the helm of the Kentucky Health Justice Network—part abortion fund, part trans health program, all around reproductive justice organization. Erin Smith was born and raised in Louisville, and while providing abortion and trans health support in Kentucky was never easy, Smith said that watching Senate Bill 150 unfold made them certain that humanity had left the state capitol. 

The law bans all gender-affirming medical care for trans youth in Kentucky—including puberty blockers and hormone therapy. The bill also forbids school districts from requiring or recommending that trans students are referred to by their pronouns, restricts which bathrooms they can use, and bans lessons at any grade level about gender identity or sexual orientation. Democratic Gov. Andy Beshear vetoed the law, though Kentucky’s Republican supermajority General Assembly overrode the veto in March. SB 150 will go into effect June 29. 

Rounding out the state’s attacks on bodily autonomy, Kentucky is also in the midst of an abortion ban, requiring Kentuckians to travel hundreds of miles to access care. The situation will only grow more dire as new restrictions go into effect across the Southeast. North Carolina, which until recently was an abortion haven in the region that offered abortion care up to 20 weeks, has a 12-week ban going into effect July 1. 

Smith recently spoke to Prism about how Kentucky’s attacks on bodily autonomy have wide-ranging implications for people in the state. Here they are, in their own words: 

As you can imagine, it’s been pretty chaotic, but we found our groove again. We’re still able to help every person who calls us, but it requires figuring out a lot more logistics now because we have to send everyone out of state. You’re talking about a hotel stay, food, a flight or gas, childcare—and everything costs more due to inflation. It’s been a hard adjustment. At the same time, we kind of had a leg up in the situation because they tried to do a ban before Dobbs. We lost abortion for two weeks, and then we had an injunction and were able to get access back for a short period before [the] Dobbs [decision] and Roe fell, and we lost abortion again. In those two weeks, we had to quickly learn how to redirect, how to handle support costs, and how to make sure we get people where they needed to be.

The issue isn’t just that we lost Roe, but that more and more states are facing restrictions as time goes on. It creates a ripple effect for Kentucky and for everyone in our region. There are new restrictions in Georgia, North Carolina, South Carolina, and Florida. It doesn’t just affect people in those states. It affects everyone in our region who relied on those states for care. Now people have to go further, and clinics are more overwhelmed. Clinics have told us they need to waitlist people, but in an environment like this, pregnancy isn’t something you can waitlist. Each state that we lose to harsh restrictions is like getting a lifeline cut. Kentuckians currently have to travel hundreds of miles for abortion care—and it’s only getting worse. 

Banning abortion in our state has also meant that we are losing doctors. Already, less than half of our 120 counties have specialists. If you’re a med school student who’s invested hundreds of thousands of dollars into your education and you want to be an OB-GYN, guess what? OB-GYNs provide abortion care, and you cannot provide that care in Kentucky. Because of this ban, we are going to lose generations of students and healthcare providers that are desperately needed here, especially in rural areas. It’s already the case that if you need a specialist, chances are you have to drive to Louisville or Lexington. The OB-GYN medical students graduating from the University of Louisville and the University of Kentucky will have no choice but to leave this state because they won’t be able to provide abortions—an essential piece of their education and practice. 

We hear from students who are upset about this, and we know of doctors who are trying to fight the state, but this is a hard state to fight in because of the GOP supermajority. We’ve had doctors call us and say, “Hey, I don’t want to get involved with my hospital’s attorneys, and I don’t really know what I can tell this patient; I don’t know what to do, so I’m referring them to you.” These are medical professionals referring their patients to a support fund because they know they can’t do their jobs to the full extent. This is a crisis, and it’s going to be felt across generations. 

There are movement spaces in the hollers of Kentucky that are actively trying to meet the needs of their community and provide resources for the folks who our government has left behind.

Another thing we need to talk about is the huge anti-trans omnibus bill, SB 150, that bans gender-affirming care for minors. The work we do is intersectional; we focus on reproductive justice and trans health because we know that trans health is a reproductive justice issue. We’re not just getting calls from people seeking abortion support services. We’re now also getting calls from people seeking gender-affirming care and trans health and support for minors. People don’t know where to go, what they can or can’t do, or what their legal options are once the law goes into effect this month. Trans youth and abortion rights are—and have been—under attack here in Kentucky. 

I am conscious of the risks that come with doing this work. A partner organization has been doxxed and, in response, they had to temporarily shut down for safety reasons. There’s a rise in clinic violence, and providers are being threatened and harassed. The line we try to walk is to be very vigilant about safety while remaining visible to our community and within the state because people need more help than ever accessing abortion care and trans health care. It really hurts when you know there is only so much you can do for people in need—and we know people are leaving our state because they don’t feel safe here. There are many people who feel that they can’t raise their families here and that their children won’t be taken care of or protected. People are well within their rights to feel that way and to leave, but my fear for my state and my home is that we will be abandoned by the people we need the most. If our state legislators continue to be openly bigoted, transphobic, anti-abortion, and homophobic, how long can Kentucky survive? 

This is why I wish the media would focus on not just who wins races in Kentucky, but the larger movement spaces that help fight against these ideologies. For example, we rejected an amendment that would have enshrined the abortion ban in our state constitution. In the GOP primary, there was a woman running for governor named Kelly Craft who spent millions on a blatantly anti-trans, racist, anti-immigrant hate campaign, and guess what? She came in third place. That says something about Kentuckians. We reject this hatred, but that’s not the perception of Kentuckians you get from the media because of people like Mitch McConnell. He’s been in the Senate my entire lifespan because of his money, power, and influence, which is why he’s able to maintain his position—not because he’s what all Kentuckians want. There are movement spaces in the hollers of Kentucky that are actively trying to meet the needs of their community and provide resources for the folks who our government has left behind. There are people who want to run for office and address the needs of the people and are frustrated that the majority of representatives only want to focus on anti-abortion and anti-trans laws. People in our state are struggling and sometimes dying without their most basic needs being met because the focus isn’t on the people—instead, it’s on the personal beliefs of those who took an oath to serve all Kentuckians. 

When the government fails the people, the people will always take care of each other.

Our elected officials were entrusted with the responsibility of representing their constituents. Instead, they are actively choosing hate and voting for laws that harm the people who entrusted them with this responsibility. When Sen. Karen Berg’s trans son died by suicide last year, she was the subject of insults and ridicule during her time of grief. She was an active, grieving parent who had to sit and listen to hateful, transphobic rhetoric and watch her fellow lawmakers vote for SB 150. That day, I felt like I was watching our humanity leave the capitol. What I saw was one of the most hurtful, disgusting, and disappointing things I’ve ever seen.

When Breonna Taylor was murdered, we had an uprising in Louisville, and there were protests across the state. We have been coming apart at the seams—and I know I’m not alone in the frustration and anger I feel. Whether it was SB 150 or anything else, my colleagues and I really just have the mindset of: “Let them do what they’re going to do so we can do what we need to do. We know it will be bad, we know it will hurt our people, we know it will be hateful. Let them do their little closed-door session or whatever they’re going to do so that we can focus on our work and fight for our people.”

Our grief is transforming from sadness and frustration to outrage. We are tired of licking our wounds and tired of representatives not giving a damn about us. Like I always say: When the government fails the people, the people will always take care of each other. My dream for Kentucky is that we will have a massive political shift. I think it’s already happening, very slowly. There is going to be more resistance here amongst the people because we’ve tried every other means—we’ve tried to be nice, we tried to follow the rules. We’ve shown up, we’ve voted, we’ve marched. I don’t know how much more they can expect us to take.

Tina Vásquez is the editor-at-large at Prism. She covers gender justice, workers' rights, and immigration. Follow her on Twitter @TheTinaVasquez.