Starting Early but not Getting Ahead: Clinic Choice, Time to Care, and Potential Hurdles for Queer Patients Seeking Abortion Care

Abstract Purpose We aim to describe select facets of queer peoples’ paths to abortion care, focusing on time spent at each stage of deliberation and care-seeking, along with factors influencing choice of care facility. Methods Leveraging self-administered survey data collected from 1,475 abortion-seeking respondents in Ohio, Kentucky, and West Virginia between 2020 and 2021, we used unadjusted and adjusted negative binomial regression models to examine associations between sexual orientation only (queer vs. non-queer) and the number of days between pregnancy detection and any clinic contact, between pregnancy detection and contact with chosen clinic, and between pregnancy detection and abortion. Results In the adjusted negative binomial model, we found that queer participants contacted any clinic 1.8 days sooner than non-queer participants after pregnancy detection (95% confidence interval [CI] -3.5 to -0.21 days, p = 0.03). We observed no significant difference between queer and non-queer participants in the number of days between pregnancy detection and first contact with the chosen clinic (0.93 days sooner for queer participants, 95% CI: -3.0 to 1.2 days, p = 0.38), nor in the number of days between pregnancy detection and abortion (0.65 days sooner for queer participants, 95% CI: -3.2 to 1.9 days, p = 0.62). Conclusion & Policy Implications While queer and non-queer abortion timelines appear similar overall, queer people contacted any clinic sooner after pregnancy detection than non-queer people in the sample. This pattern did not hold for time between pregnancy detection and contact with chosen clinic or abortion, where we found no differences between queer and non-queer participants. More research is necessary to understand the timing gap between first clinic contact and chosen clinic contact and how queer people navigate clinic selection, which impacts abortion timing. Understanding differences in patient access could inform future policy around care equity.