New polling reveals that Asian Americans, Native Hawaiians and Pacific Islanders (AANHPI) strongly support abortion, though stigma and lack of research focused on the community hinders them, as they are behind their peers in accessing reproductive health services. According to Cedars-Sinai published in March, Asian American women have the lowest rate of breast and cervical cancer screening of any ethnic group.

About 8 in 10 AANHPI think that abortion should be legal in all or most cases, and three-quarters believe that Congress should pass a law to guarantee legal abortion access in the U.S. In comparison, 64% of U.S. adults overall said that abortion should be legal in all or most cases last year, according to polling by AAPI Data and The Associated Press-NORC Center for Public Affairs Research in March.

Because so many AAPI adults are immigrants or first-generation, they view abortion as a right, says Varun Nikore, executive director of AAPI Victory Alliance, a progressive political advocacy organization, told the Associated Press in March. About 57% of Asian Americans and 71% of adults were born in another country, according to Pew Research Center.

“I think it has to do with some sort of home country attitudes that are sort of pervasive, but also the strong feeling we’ve had rights and we’ve had access to health care, and now we don’t want to lose something that we had. And it could be that we also came to this country to have better access to health care than we did before,” Nikore said.

Though strongly in support of the right to bodily autonomy, AANHPI individuals face numerous disparities in accessing abortion care and reproductive health services.

A 2023 survey by the National Asian Pacific American Women’s Forum (NAPAWF) and Ibis Reproductive Health showed that almost half of AANHPI respondents said that they did not know where to access medication abortion if they needed it.

There are several contributing factors to these disparities, one being the model minority stereotype, says Katrina Heyrana, MD, PhD,an OB-GYN in the division of Family Planning, Department of Obstetrics and Gynecology at Cedars-Sinai and second-generation Filipina.

“The fallacy of a model minority is that every Asian who comes to the United States is the same and none of them need anything because they’re successful,” said Heyrana. “And so it leads to an incuriosity from the medical field and from a policy standpoint, because they think that Asian people don’t need anything because they see us all as the same person.”

Heyrana said that stigma and silence around sex in Asian communities prevents people from seeking reproductive health services, and these influences begin early on.

“Asian adolescents are some of the least likely to be well-informed about sexual health, so things like HIV transmission and different forms of contraception and to feel comfortable disclosing their health needs to medical professionals compared to their white peers,” she said. “And that’s just like sort of a tip of the iceberg.”

Disparities fall through the cracks when lumping AANHPI groups together

In a May 2023 interview with Ms. Magazine, Dr. Sophia Yen, clinical associate professor at Stanford Medical School and CEO and co-founder of online birth control delivery company Pandia Health, also pointed to the importance of recognizing differences within AANHPI communities.

“Disparities exist because first, we didn’t do the research. Socioeconomic status also comes into play with the racial disparities, because someone may live surrounded by gunfire, cloistered with five people in one room making noise or has a mother working two or three jobs—the immigrant experience… It’s important to realize that not everyone is the same,” she said.

Though we do not know the true scope of these disparities because of the lack of data available, the numbers available regarding AANHPI gynecological health is alarming.

Analysis of the National Cancer Database published in January shows that Asians face over 3 times higher rates of uterine cancer than white individuals, with Indians and Pakistanis at greater risk of morbidity and Filipinos more likely to be diagnosed with advanced cancer.

Asian American identity in the U.S. is robust and non monolithic, as experiences vary greatly between the communities who fall under the umbrella term. For example, both U.S. and foreign born Asians overall are less likely than Americans to live in poverty, according to Pew, but many Asian subgroups actually experience high poverty rates. 25% of Mongolians in the U.S. face poverty, while only 6% of Indians do.

Heyrana told Reckon that the way AANHPI communities are lumped together is a disservice to their individual needs and experiences because they vary greatly.

“When we talk about Asians, and we talk about Native Hawaiians and Pacific Islanders, we consider them in aggregate which is terrible because it’s a conglomeration of over 50 different ethnicities,” she said. “And so when you really look at the different ethnicities that comprise the Asian and the NHPI groups, you’ll find that they also have a lot of like individual disparities that are ignored when you consider them in aggregate.”

She said that this type of grouping especially impacts Native Hawaiians and Pacific Islanders, who are often neglected in data collection.

“Research and the involvement of Native Hawaiians and other Pacific Islanders in reproductive health research is almost zero. And like any of the data that’s actually available is all aggregated data,” she said.

Native Hawaiians and Pacific Islanders face disparities in sexual health, with high HIV rates, almost three times higher rates of gonorrhea syphilis than whites, per the Centers for Disease Control and Prevention in January.

Heyrana said that she sees different entry points to overcoming the effects of cultural stigma such as using non-stigmatizing words, allowing patients to be covered during intimate exams, and ensuring that translators speak the correct language and dialects.

According to the Chinese Language Institute, there are 10 varieties of Chinese.

“[This] is a surprisingly huge problem even in [Los Angeles], making sure that the Chinese interpreter speaks the right dialect, the right time Chinese, because having that sort of comfort and having that sort of like cultural congruence grew is super important when it comes to explaining what is going to happen for the patient,” she said.

She encouraged researchers to partner with community leaders and organizations to better serve

“It has to come from the community itself. My community has this history of people, Catholic white people coming in and just telling us what to do. That’s not it, that’s not going to work,” Heyrana told Reckon.