Last year at this time, anxiety was high among many of my friends and I. A leaked document from the Supreme Court indicated that they were about to make access to abortion difficult to impossible for American women. The language in the document was shocking.

And then it happened. The ruling came out with pretty much the same language as the leaked document. At least we had time to prepare? That felt like small comfort.

There are a lot of ways this ruling intersects with my life, but what I focused on was being a pastor and how I could support women and girls in my community. In my life, I’ve known women who have terminated their pregnancies for a range of reasons and it was hard to contemplate how their peers in this new landscape of reproductive health care options would fare. My first instinct was to purchase Plan B, the emergency contraceptive that prevents pregnancy after unprotected sex. After talking to some sister clergy I decided to keep it in my desk in my office at the church. It didn’t seem like a big help, but it is something.

I had hard talks with my daughter who is going on 16. More than half of high schoolers are sexually active and she already knows peers who have been raped, so this was not a theoretical conversation.

One of my clergy sisters gave me a “b” charm – “b” for Plan B – that I wore every day from the time I received it through the 2023 Texas legislative session. It helped keep me focused and reminded me that I was not alone in the struggle.

And I knew that that Texas legislative session would be brutal. Even though my state had already enacted a pretty restrictive law that is cruelly vague, I hoped to at least push for clarity if not actual rights.

But that’s now how things turned out in my state. Nothing happened to make things clearer on the issue of abortion. Instead we started worrying about other Plan Bs. The governor and the legislature targeted transwomen, transmen, and especially trans youth. They wanted to ban sports for trans students, ban gender affirming health care, ban books, define drag performances as sexually oriented, and replace school counselors with untrained religious chaplains. And that is what they did.

For some Texans this is leading to their own version of a Plan B, or even a Plan C. Families with trans youth who had been receiving or intended to receive gender affirming care contemplated moving out of the state. These heartbreaking cases are actually the lucky ones, they could afford to leave or send their children out of state for school. For most, that is not an option. Some trans adults are also moving or wish they could – it is hard to live in a state where you face persecution every day and hard when your children are exposed to that particular form of violence as well.

One of the things that has saddened me personally is the exodus of doctors from the state. You see, my dad was a pediatric endocrinologist. That is one of the specialities that provides gender affirming care to trans youth. While he was a researcher and medical school professor, he also saw patients, some of whom were intersex or had sex hormone dysfunction. I am imaging generations of his students now having to counsel young patients and their families, having to end a course of treatment that, although lifesaving, has now been made illegal.

Doctors are also making hard choices about whether to adapt their practice to new areas of endocrinology or leave the state so they can continue to provide gender affirming care. In addition to not being able to practice their field of medicine and properly treat their patients, they are being threatened. In case you don’t think this affects you, it might. Pediatric endocrinologists treat a range of conditions, from growth problems and diabetes to problems with the thyroid, pituitary, and adrenal glands. While some endocrinologists specialize in gender affirming care, some who are leaving are also taking their expertise in these other important areas with them.

Someday, I can have a fuller discussion about access to abortion care and gender affirming care. Right now I’m having a hard time getting past the fact that more and more people are being diminished, having their moral agency replaced by the judgment of a very few privileged people in power. The judgment of doctors who have years of training in medicine – including in ethics – is dismissed in favor of…what? I am not sure. Gut feelings? Personal religious conviction? A desire to be re-elected? The love of parents who invest their all into the care of their children is replaced with, based on what I heard, myth and hatefulness. In a state with alarmingly high rates of infant and maternal mortality, the focus of the Texas government seems tragically misdirected.

In the short term, I’m willing to be someone’s Plan B with regard to affirming their dignity and value as human beings.