Dr. Ghazaleh Moayedi, Pegasus Health Justice Center

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

If you know anything about the reproductive justice movement in Texas—or how reproductive injustice functions in the state—chances are you’re familiar with Dr. Ghazaleh Moayedi. The board-certified OB-GYN and complex family specialist has devoted much of her life and career to abortion rights in Texas. She’s worked in clinics, advocated for abortion funds, provided abortion care, cared for birthing people, and recently launched her private practice, the community health resource Pegasus Health Justice Center. A large part of the work she does with Pegasus focuses on education. Moayedi traverses the country—often for free—providing abortion education and training to medical students and universities. The work isn’t entirely sustainable, but that is not an unfamiliar feeling to an abortion provider and reproductive justice advocate from Texas. 

For many people across the U.S., the Dobbs decision was a defining turning point. For abortion rights advocates in Texas, the turning point was Senate Bill 8. Enacted in September 2021, the law banned abortions after about six weeks and put enforcement in the hands of civilians, allowing them to obtain rewards of at least $10,000 for successfully bringing lawsuits against anyone who aided or abetted abortion care beyond the ban. After the fall of Roe, that six-week ban turned into a total ban.

Since the passage of SB 8, Moayedi has been faced with two options: only provide abortion care out-of-state, or leave Texas. For now, the full-spectrum OB-GYN remains firmly planted in Texas. 

In a recent phone call, Moayedi told Prism that the last several years have provided a brutal re-education in American democracy and the lengths Texas lawmakers will go to deny people human rights. Here she is, in her own words: 

I went to medical school and became an OB-GYN specifically to be an abortion doctor in Texas. I dreamed of not only expanding health care access for my community, but also education and training opportunities for other Texans. The Dobbs decision completely changed the course of my work and the trajectory of my career. Even though the writing has been on the wall for years and worsening bans were just constantly looming over our heads here in Texas, it’s still been an overwhelmingly challenging few years—both as an abortion provider and a Texan. 

For me personally, COVID-19 was the real eye-opener into the lengths anti-abortion politicians will go to. I’ve been working in the abortion care field in Texas since 2004—while not as a physician, I was working at abortion clinics and doing abortion funding advocacy. I’m not naive to the realities of practicing, working, and advocating in Texas. But the idea that in 2020, the governor could use a legitimate public health emergency to restrict the constitutional right to abortion and shut down clinics was one of those crystallizing, defining moments. Like, “Oh, the rules really don’t matter. The Constitution doesn’t matter. The Supreme Court doesn’t matter. They’re going to do what they want to do, no matter what. They have a plan, and they’re not going to follow the rules.” 

We knew this was going to happen, but also … we didn’t know it would be this bad. There was no way to know all of the elements of surprise—the legal maneuvering and the duplicitousness that would get us here. What was especially frustrating to me were the months leading up to SB 8. 

At the time, advocates and providers across the state were having all of these meetings, and in one of those meetings, a colleague essentially said, “Don’t worry, we still have the Constitution.” This was not a malicious or unintelligent person; this was someone who is excellent in their own right. But again, it was one of those defining realizations that there are very different realities that exist across the pro-abortion movement. There’s the reality of people who have an inherent sense of their rights and protections under the Constitution, and those people don’t actually understand the reality faced by people for whom those rights and protections have never really existed. 

We go there, we bare ourselves, we experience harm, we subject ourselves to harm, and nothing happens.

I go by Ghazal in English, but I intentionally pronounced my name in Farsi in that moment. I said, “Ghazaleh Moayedi doesn’t have the same constitutional rights in every part of this country that you all do.” The notion that we should find comfort in the Constitution isn’t a very comforting thought for a lot of people. It’s certainly not a comfort for me as someone who essentially has my citizenship through the 14th Amendment called into question every single time we have a Republican primary—and I’m not even close to the most systematically marginalized or structurally oppressed in this country.

The last few years have just made me realize how tenuous everything is. I testified in Congress regarding SB 8. It was an amazing opportunity to have that kind of access and to speak for my community, but I also walked away from it feeling like, “Is this the process we’ve been relying on to save us?” It was kind of devastating to witness what actually happens in Congress and what that process actually entails. We had the meeting; everyone said their things, and anti-abortion extremists hurled insults and vitriol at me and at people who shared their abortion stories. And the culmination of our testimony was … nothing. We said what we had to say; I guess that’s important? But is this the process we’re upholding? We go there, we bare ourselves, we experience harm, we subject ourselves to harm, and nothing happens. It’s just political theater. All of this has shifted my understanding of democracy—and this is as someone who has always been questioning and critical of this thing we call American democracy.

Depending on the day, risk and threat with my work are either low-level or high-level on my mind. Every single thing I do, every single media person I speak to, every piece of information I put into the world for public consumption, I think: How can this be weaponized against me? How could this jeopardize my medical license? How could it endanger my family? Could this lead to someone finding out where I am? Could this lead to me losing my job? Will this lead to them harming my kid? When I’m deep in the pain and anxiety spiral, I might even wonder if I need to leave the country. 

I try not to look at it, but there’s this website that I won’t name—let’s call it the abortion doctor kill website—and it’s basically a hit list. I usually don’t look at it, but today it came up in a search when I was trying to find an article I’d written. It’s not usually something I would engage with or even think about on a daily basis, but it’s not lost on me that there’s a website that monitors every single thing I do and then collates it and aggregates it and puts it on a website to intentionally threaten me. When I think about it, that’s when it becomes very real that any piece of information could potentially be used to target and harass me and other providers. 

After the Dobbs decision, there was a moment when I wondered if we needed to move out of state. I even told my friends I thought I was going to leave Texas. I started to look at job opportunities in other states, and I thought about where we could move and be happy. It took me a few months to emotionally move through that process, but in the end, I sat down and really pushed myself to think about what I was really afraid of. Certainly, it’s the state coming after me and claiming I wasn’t complying with the law. But I have a brilliant legal team, and I am complying with the law, so what else was it? Was it the rise of violent extremists who could seek me out and harm me? They’re not entirely separate from the government entities I’m legally afraid of. 

 Texas is where I have roots. This is where I can authentically advocate for what I know is right. This is where I can be the most impactful, so this is where I’m staying. For now.

The answer occurred to me one day when I asked my husband, “Where am I going to escape white supremacist violence? Where can we be safe from that?” I realized that nowhere in our country is safe. Freedom from white supremacist violence doesn’t exist anywhere. No place I go will protect us from this larger, systemic, festering problem that our country has yet to confront in a meaningful way. The other part of it was that I thought ahead to 2024. There’s a good chance Donald Trump could be president again. There’s a chance of a national abortion ban. So, am I going to uproot my family, move somewhere else—to a community I don’t understand or that I’m not from? Then what? As a Texan, I’m allowed to say that sometimes it feels really bad to live here, but guess what? The rest of the country isn’t better than us. Texas isn’t the only place in America where people don’t have human rights. That’s an entire U.S. problem. Texas is where I have roots. This is where I can authentically advocate for what I know is right. This is where I can be the most impactful, so this is where I’m staying. For now.

This is why I have sort of a gut reaction when people use that concerned voice and say, “What can we do for Texans? How can we help you all?” Help is great, but my advice is for people to think about what they’re doing in their own community to advance equity, justice, and human rights. Because every single community in the U.S. has the problems that Texas has.

A lot of people also want to hear how different and bad things are in Texas, but very few people ask us what’s been sustainable. I’m committed to doing this work in whatever form I can do it. After SB 8, I personally stopped practicing abortion provision in Texas and transitioned to offering abortion care out-of-state. Once the Dobbs decision came down, I even temporarily stopped traveling to other states to provide abortion care because it wasn’t clear at the time if I could be targeted for that. I joined the lawsuit with abortion funds in Texas that eventually allowed me to resume providing out-of-state care. If I want to keep providing the care that I’m highly trained and specialized in, I have to travel or move. That’s still a hard pill to swallow. 

My other work, outside of direct abortion care, hasn’t really changed. I joke—though I don’t know if it’s really a joke—that free speech is still legal in Texas, so I still teach medical students, public health graduate students, OB-GYN residents, and family medicine residents. I’ve spent the last couple of years doing lectures for law students and, more broadly, providing education on abortion provision, abortion access, and abortion advocacy in Texas. I have this lecture I used to give about the evidence-based provision of medication abortion that was contextualized to teach students the laws here in Texas: how to comply with the laws, and what the evidence is. It was kind of a depressing lecture. It was like, “Here’s all the evidence. Here’s the evidence you’re not allowed to use. Here’s the best practice. Here’s the best practice you’re not allowed to use.” I can’t even give that lecture now. I have to go back and edit the hell out of this educational content I developed for Texans. With certain topics, I can’t even teach students how to practice in Texas, other than saying, “You’re not allowed to do this. Here’s what would happen if you lived in another state that allowed you to practice evidence-based medicine.” 

The non-abortion work I do has also mostly stayed the same, like taking care of birthing people as an OB-GYN hospitalist. It only gets really tricky around pregnancy complications. Before, I was the person my colleagues would call when they needed to know where in the state to send a patient with a specific complication. Now it’s more like, “This patient has this complication; what state do you think I can send her to?” The work is the same, but there’s been a real morbid shift in the conversations physicians and healthcare providers have about how best to take care of pregnant people in Texas. 

I always urge people to remember that just because someone is a physician doesn’t mean they’re well-versed in their state’s laws or know how to advocate for their patients. I still get calls from doctors who are like, “I just diagnosed a fetus with a horrible anomaly, can you do the abortion?” The answer is no. I can’t do the abortion. It doesn’t matter how bad the fetal diagnosis is. It doesn’t matter if the fetus is definitely going to die. It doesn’t matter if every single organ is outside of its body. There isn’t an exception. 

It bothers me the way that outsiders talk about Texas as it relates to “safety,” as if other states are safe places for all pregnant people. The subtext of concerns over safety are actually concerns over white women’s safety. For example, many OB-GYNs have urged The American Board of Obstetrics and Gynecology to consider leaving their headquarters in Dallas because Texas was “unsafe” for pregnant OB-GYNs to travel to. But where is the safe place in this country for pregnant people? Where is the safe place for Black physicians to become certified OB-GYNs? 

I just hope that we can spark something in young people so that they fight to successfully regain abortion rights in the future.

Yes, it’s scary to be here sometimes, but millions of people live here, and the shit you’re afraid of was happening before Dobbs. If a person came to Dallas with a pregnancy complication that the local hospital wouldn’t handle before Dobbs, guess what? Before SB 8, hospitals in Texas refused to intervene with pregnancy complications because hospitals overinterpret anti-abortion laws, meaning that people had pregnancy complications and didn’t get emergency care. So great, move your headquarters to another city, but make sure there isn’t a Catholic institution nearby that would refuse care. And make sure no one on staff at the nearby hospital is racist and the hospital has solved medical racism, and that Black and brown people don’t have significantly worse outcomes too. I almost can’t believe the mental gymnastics people do to address “safety,” especially when it involves the South. It makes me think of how [the American College of Obstetricians and Gynecologists] moved their annual meeting from New Orleans to Baltimore over safety concerns. You don’t agree with New Orleans’ abortion laws, but tell me: Is Baltimore categorically better for the treatment of pregnant people? Is it a safe place for Black physicians? Did moving the meeting actually prevent violence? [During the organization’s annual meeting, a man physically assaulted an OB-GYN on a panel, alleging that years prior, the OB-GYN sexually assaulted his wife. A video of the incident circulated online.] 

I know it’s important to be hopeful, but I have to be honest and say I don’t always feel that way. 

I say this with a rock in my stomach, but I don’t think we’ll get abortion rights back in my lifetime. That doesn’t mean I’m going to stop doing this work. I’m going to keep talking about abortion and educating people. I’m going to keep challenging folks to think critically and analyze the way we provide medical care in our roles as physicians and community advocates. But I don’t think it’s going to be my generation that gets abortion back. I just hope that we can spark something in young people so that they fight to successfully regain abortion rights in the future.

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