July 18, 2023
In June 2022, the U.S. Supreme Court struck down constitutional protections for abortion. One year later, 15 states enacted abortion bans, and half of states have tried. Gender-affirming care restrictions also exploded in the same period: 142 bills were introduced across the U.S. in 2023, 20 states have already banned gender-affirming care for youth, and seven have banned it for people of all ages. These restrictions force healthcare providers to turn away patients in vast regions of the U.S., from Texas to Florida and across much of the American heartland. In turn, healthcare seekers and their families have foregone vital care or traveled far from their homes and across state lines in search of the care they need.State legislators opposed to abortion and gender-affirming care have these healthcare travelers in their crosshairs. They've reached beyond their states' jurisdictional bounds to punish residents for seeking care that is perfectly legal where it's administered. In April 2023, Idaho legislators banned the in-state leg of travel to neighboring states to obtain certain abortions–and other states are trying to follow suit. These laws have been countered by "safe harbor" legislation in states like Massachusetts (abortion care), California, New York, New Jersey, Minnesota and Washington state (gender-affirming care). But while dubious laws like Idaho's stand, they put healthcare seekers, their helpers and healthcare providers at serious risk of investigation or prosecution.Healthcare seekers' very need to travel can be used against them. Prosecutors bringing criminalized healthcare charges have relied on digital surveillance data in healthcare prosecutions. Typically, the data comes from smartphones: a person's texts, their internet search history, or their online purchase records. The Federal Trade Commission and tech companies like Google have rushed to prevent prosecutors and state officials from using phones' geolocation data to place individuals at healthcare clinics. But even when smartphone data is out of reach, travel data can be used to corroborate accusations against known healthcare travelers and to identify yet unknown healthcare seekers. License plate data, Uber and Lyft data, and even bikeshare data can be used to reveal that someone traveled to a reproductive or gender-affirming healthcare clinic.Not all forms of travel and accommodations pose the same surveillance risk, especially for individuals who are not on state officials' or prosecutors' radar. But it's nearly impossible to travel anonymously in the U.S. and to avoid leaving a digital trail of one's travels.