When Genevieve Postlethwait’s water broke in her sleep one July morning, she knew something was wrong. At 17 weeks pregnant, it was too soon for this to be normal. That afternoon at her OB-GYN’s office, Genevieve and her husband saw their daughter’s moving shape on an ultrasound screen. But she looked different — opaque, hard to see, almost “squished,” the 35-year-old recalled. The ultrasound tech was “clearly rattled and didn’t know what to say.” Over the next several hours, Genevieve learned her daughter would not continue developing without that fluid, and now she was at serious risk of severe infection, too. Even though there was still a fetal heartbeat, her pregnancy was no longer viable. But because of the OB-GYN’s own religious beliefs — and because of Kentucky’s restrictive abortion bans, the expectant couple later came to understand — their doctor would not surgically remove the fetus, and she could not recommend where Genevieve could go to get an abortion, even though it is widely considered the standard of care in this scenario. “Her plan of action was to send us home and drink lots of water,” Genevieve said. Less than a week later, at a loss for options that felt safe from the Paducah hospital where Genevieve had hoped to give birth to a healthy baby for the first time, the couple instead drove roughly 70 miles to an Illinois clinic and charged $1,100 to a credit card to end her pregnancy. Genevieve’s situation is not unusual in Kentucky. Five OB-GYNs and high-risk maternal fetal medicine doctors across central and southern Kentucky told the Herald-Leader that the commonwealth’s near-total abortion bans and their vaguely defined exceptions do not permit doctors to legally provide the standard of care to patients like Genevieve. All said their ability to safely treat pregnant patients who require a medically indicated abortion has been compromised by state statute. Nearly all have referred patients out of state for these procedures, fearful of performing them in violation of the law and being charged with a felony. Kentucky’s abortion bans have routinely prevented doctors from providing the standard of care since they were enacted in 2022, according to interviews for this story and previous Herald-Leader stories. But lawmakers still haven’t taken steps to remediate the law’s impact in this way, either by considerably rolling back the ban, removing or lessening its criminal penalty or by adding more exceptions.

State Rep. Daniel Grossberg offered a dancer at a Louisville strip club $5,000 to have sex with him about two weeks before he was banned for life for inappropriately touching another club dancer, the Herald-Leader has learned. The Louisville Democrat has been ensnared in a growing controversy throughout the summer linked to his harassing, sexually charged texts and interactions with young women. Numerous Democrats around the commonwealth have called for his resignation, and one of his accusers said in a column published Thursday Grossberg is a potential risk to unsuspecting women. Six sources at Foxys Gentlemens Club say the married 45-year-old Grossberg was a familiar figure at the club. In fact, he had been kicked out at least twice because of drinking too much and grabbing the dancers. But he crossed the line when he moved a dancer’s underwear and tried to touch her genitals as she was performing on stage. “He was calling girls all kinds of names,” Foxys’ co-owner Milford Renfrow told the Herald-Leader. “Disrespecting the girls and grabbing them.” After a club manager escorted Grossberg from the club to its parking lot off Berry Boulevard, he tried to use his status as a state legislator to get back in. When that failed, he warned he could close down the 24-year-old strip club. “’You don’t know who I am,’” the club’s manager recalls Grossberg telling him. The freshman legislator also said he “could shut this place down.” The manager who kicked Grossberg out that night said he was not swayed by Grossberg’s threats. “I don’t care if you’re Donald Trump. I don’t care who you are,” the manager said he responded. “You can’t treat girls like this.” To tell this story, the Herald-Leader conducted 13 interviews at Foxys over the past two weeks after receiving a tip from an anonymous exotic dancer that Grossberg was publicly harassing and acting inappropriately at a different Louisville club. This story is based on independent interviews with Renfrow, as well as the club manager, two bartenders, two dancers and one of the dancer’s close friends who was told of Grossberg’s solicitation the night it happened.

Three more women have come forward to the Herald-Leader detailing specific instances of alleged sexual harassment by state Rep. Daniel Grossberg, even as state officials continue to investigate previous allegations of improper interactions. The three women, all involved in Kentucky’s political scene in Frankfort, contacted the newspaper after its initial July 30 story where other women said the Louisville Democrat had sent them unwanted “creepy” and “weird” text messages they said crossed ethical lines. That same story confirmed the state’s Legislative Research Commission was investigating Grossberg’s behavior. The most recent allegations include inappropriate, harassing or sexually-tinged text or direct social media messages. One of the women described feeling sexually harassed by Grossberg in the summer of 2023, in his statehouse office after a legislative meeting. Late Monday night, when presented with details of the three women’s accounts, Grossberg denied the claims, but also apologized to those he’s made “uncomfortable.” “I deny any allegations of sexual harassment or abuse of office,” he emailed to the Herald-Leader. “I sincerely apologize to anyone who felt uncomfortable because of something I said or wrote.” The women’s ages range from 26 to 28. Grossberg, 45, is married. He represents about 46,000 Louisville residents in the 30th House District. The Herald-Leader has granted the women anonymity due to the intimate nature of the allegations against Grossberg and their fears of retaliation. To ensure the veracity of their stories, reporters reviewed 68 time-stamped texts or direct messages sent by Grossberg via X, formerly Twitter. Reporters also reviewed another 63 text messages the women sent to friends and family detailing how his behavior triggered worries for their safety. The Herald-Leader also spoke to some of the people to whom these women confided at the time to corroborate their stories. Their accounts paint a portrait of a rookie representative in Frankfort, running unopposed in November’s election, who wields his power and influence to target ambitious young women whose careers intersect with politics.

Kentucky Gov. Andy Beshear demanded state Rep. Daniel Grossberg to resign Friday, less than four hours after the Herald-Leader reported Grossberg has been permanently banned from a Louisville strip club for accosting a dancer and, weeks earlier, soliciting another for prostitution. “I want to, once again, state clearly and unequivocally that Rep. Grossberg should resign,” Beshear said at a hastily called 9:30 a.m. news conference in Frankfort. Beshear described Grossberg’s alleged conduct as wrong, and said no one should face harassment in their place of work — or the Kentucky Capitol. “You cannot be a state representative and engage in this type of conduct,” he added. “No human being should engage in this type of conduct.” Lt. Gov. Jacqueline Coleman also promptly called for Grossberg to resign on Friday morning. “Enough is enough. Women and girls in Kentucky deserve better and so do Rep. Grossberg’s constituents,” she said. “He has had ample opportunity to do the right thing by stepping aside, and if I were him, I’d take it sooner rather than later.” Neither the governor nor his lieutenant governor have authority under Kentucky’s constitution to remove a legislator from office. But as the state’s two top-ranking Democrats, they have incredible influence in the direction of the party and those Democrats in office. Kentucky Democratic Party Chair Colmon Elridge joined in the calls, part of a wave of angry calls for Grossberg’s resignation.

State Rep. Daniel Grossberg has responded to several allegations made against him — many of which were not previously public — in a lengthy press release from his attorney Friday morning. Grossberg’s attorney, Anna Whites, wrote that there is “no evidence” presented in a complaint filed to the Kentucky Legislative Ethics Commission by House Democratic Leadership that any messages he’s sent constitute sexual harassment. “The only text that discusses inappropriate communications is a reference by a (third) party to that third party hearing rumors about inappropriate communication from other unnamed third parties at some unnamed time,” Whites wrote. “Rumors have no place in a fact-based hearing.” The Herald-Leader had previously reported on an investigation into Grossberg and messages that three different women working in and around politics in Frankfort received from him that they deemed “creepy” and inappropriate. In those messages, the 45-year-old Louisville Democrat commented on their appearance very late into the night. Whites wrote that House Democratic Leadership included a “copy of a newspaper article” in their discussion of Grossberg’s messages. “The communications complained of in that article, particularly taken in the context of the ongoing messages between the recipients both prior to and after the ones cited in the newspaper story, do not constitute sexual harassment,” Whites wrote. Grossberg has “steadfastly” denied any impropriety since he was first contacted by the Herald-Leader about his messages to women.

State Rep. Daniel Grossberg, who is being investigated for alleged inappropriate conduct toward women, wrote a satirical advice column in college two decades ago under the name “Sketchy Dan,” where he recommended that “lonely,” “horny” and “creepy” young men aggressively pursue women on campus, even if the women weren’t interested. The column and its title, in Grinnell College’s school’s humor newspaper, were a play on Grossberg’s public reputation for making women uncomfortable around campus, and he doled out advice to fake letter-writers who claimed to have similar experiences. Readers wrote in letters to the editor published in the campus newspaper that Grossberg made people uncomfortable, and they debated whether his “sketchy” reputation was fair. In one of the letters included in a Grossberg column, a writer named “Creepy in Clark” asked: “Dear Sketchy, I think the girls in my hall are scared of me; they always think I’m hitting on them. You have some experience in this area. What do you suggest?” Grossberg, as “Sketchy Dan,” replied: “Hold a floor meeting where you threaten to sue anyone who calls you creepy for slander, and proceed to ask each one out individually for a romantic reconciliation dinner at Rube’s Steak House, followed by an erotic foot massage.” The column, saved in the school’s digitized archives and reviewed by the Herald-Leader, sparked a minor controversy in November 2003 at the Iowa college, where Grossberg was a sophomore. The column resurfaced this week after Kentucky’s Legislative Research Commission, the administrative arm of the legislature, last week launched an investigation into texts Grossberg sent several women who work with lawmakers, commenting on their appearances. The state probe came after the Herald-Leader reported three women received texts from Grossberg that were “creepy” or “weird” and made them feel uneasy. In response, the Kentucky House Democratic Caucus has temporarily suspended Grossberg from its membership and called for a separate investigation by the Legislative Ethics Commission. The 45-year-old Grossberg has denied any impropriety.

Rep. Daniel Grossberg is under investigation by the state’s Legislative Research Commission for inappropriate interactions with women, the Herald-Leader confirmed Tuesday evening. Four sources have independently shared their stories and details of the state’s investigation with the Herald-Leader. Three of the sources are women who said they have been contacted within the past two weeks by Legislative Research Commission staffers, including lawyers. On Wednesday, House Democratic leaders called for an official ethics investigation into Grossberg’s conduct. As part of the Legislative Research Commission investigation, the three woman have been asked about specific actions, questionable behavior and text messages sent by Grossberg, a first-term Democrat from Louisville. The women shared text messages with the Herald-Leader from Grossberg they described as “weird” or “creepy.” They often came late at night, and Grossberg remarked on their physical looks. He complimented one for her “exotic” appearance, and described how “beautiful” another one was. On Tuesday evening, Grossberg denied any wrongdoing. “I never, in my work, approached or crossed a line in my professional communications. Any claim that private texts on my personal cell phone are work related have no merit. I steadfastly deny any impropriety,” Grossberg said in a statement released by his Frankfort lawyer, Anna Whites. All of the text messages were reviewed in their entirety by the Herald-Leader to ensure their authenticity. Grossberg, 45, is married. A fourth source in Frankfort, with direct knowledge of the allegations and investigation, also confirmed the Legislative Research Commission is looking into Grossberg’s conduct. The Herald-Leader is not identifying the sources because of the nature of the allegations and the sexually charged text messages the newspaper has reviewed with the three women. The three contacted by state investigators work for nonprofit advocacy organizations or lobbying firms and are not state employees. However, they interact routinely with legislators, including Grossberg, in Frankfort and are afraid of potential personal and professional retribution, they said. Less than 90 minutes after the first version of this story posted on kentucky.com, a spokesperson for House Democrats released a statement saying they’ve asked Grossberg to step away from the caucus during the investigation.

Almost a year to the day after Rep. Lindsey Burke gave birth to twins — one dead, the other alive — she walked out of a legislative committee meeting in Frankfort. Burke, one of three Kentucky Democrats who walked out that day, was protesting a bill she said shamed the choice to abort a nonviable pregnancy. Burke herself made that choice in October 2022 when she and her husband ended a pregnancy they’d planned for and wanted in order to protect the life of their second child. For her family, Burke was exacting what control she had over an otherwise impossible situation. The decision to walk out of the committee meeting March 7 in response to Republican Rep. Nancy Tate’s House Bill 467, the “Love Them Both Part II Act,” was one she saw similarly: Exacting a sense of control over a situation in which she had little. Republicans hold a veto-proof majority in both legislative chambers, rendering Democrats virtually powerless. Burke knew that this committee — made up of four Democrats and 15 Republicans — was going to advance the bill regardless of her act of protest or the will of her Lexington constituents. In the hallway outside the committee room, Burke told a gaggle of reporters the bill was “an insult to grieving parents everywhere.” Burke underwent her first IVF egg retrieval in late 2021, right around the time she put her name in to run for public office. But it ended eight weeks later in a miscarriage. The medical landscape for her second egg retrieval — and the full range of care she could need should something go wrong — looked very different than the first a few months earlier. It was July 2022. Just a few weeks earlier, Roe v. Wade, which for 50 years prevented states from banning abortion entirely, had been overturned by the U.S. Supreme Court. This historic ruling gave states free regulatory rein over abortion laws. In Kentucky, two abortion bans simultaneously took effect: a trigger law banning abortion except in medical emergencies, and six-week ban, or fetal heartbeat law, outlawing abortion after the first flickers of fetal cardiac activity. Burke got pregnant with twins, but early ultrasounds showed a size disparity between the two. Twin A, whom Burke had already named Ezra, had a series of birth defects and diseases, including a condition called a cystic hygroma. It’s a bulge at the base of the head and neck that often portends other serious conditions. “But then the doctor says, ‘And that’s the problem for Twin B,’” whom Burke and her husband had named Ewan. Allowing her pregnancy with Twin A, which was near 13 weeks, to continue progressing toward its inevitable end was a fine choice. But when her body miscarries, it will likely also try to expel her healthy twin, too, before the pregnancy has reached full term, forcing her into early delivery and potentially jeopardizing his health, too.

When it became clear that the only way to keep their four Northern Kentucky independent pharmacies afloat was to siphon money from their personal retirement funds, Jennifer and Erik Grove made a painful decision. It was finally time to call it quits. It was 2021, and after years of tossing solicitation letters in the trash from CVS Pharmacy and Walgreens offering to buy them out, the Groves, who owned pharmacies in Warsaw, Carrollton, Campbellsburg and Bedford, begrudgingly agreed to call a corporate chain. Like dozens of other independently-owned pharmacists across Kentucky, the Groves could not manage to consistently turn enough of a profit. It wasn’t that their stores, two of which were the only pharmacies in their counties, weren’t high-performing. Each time an independent pharmacist fills a patient’s prescription, how that pharmacy is reimbursed by insurance companies — and what amount in fees are levied for filling it — is decided by a somewhat arbitrary and complex tangle of decisions by entities outside a hometown pharmacy’s control. This lack of control and contractual obligation to pay every fee levied has paved the way for independents to be financially gouged from multiple angles: Low or break-even reimbursement rates set by insurance companies often blunts a pharmacy’s ability to make a profit on every prescription they fill. This reality is made harder to bear when factoring in the fees collected by Pharmacy Benefit Managers (PBMs), who act as a middle man between providers like Grove and insurance and drug wholesalers, and Direct and Indirect Remuneration (DIR) fees. DIR fees are collected by PBMs and governed by the Centers for Medicare and Medicaid Services. Until Jan. 1, those fees were retroactively clawed back as many as six months after a prescription was filled. Withstanding the mandate to fork over hundreds of thousands of dollars in fees, alone, borders on financially unsustainable for many independent pharmacies. That financial burden, coupled with the unpredictable timeline by which that money is collected, is what eventually drowned the Grove’s businesses, Jennifer said. Stories like this are a dime a dozen across Kentucky, according to seven independent pharmacists who spoke with the Herald-Leader and dozens more who’ve shared stories through the Kentucky Independent Pharmacists Alliance, or KIPA. In the past year, at least 67 independent pharmacies have shuttered across the commonwealth – nine in Pulaski County, alone – driven to the brink by a combination of the factors that forced the Groves to close, according to pharmacy alliance co-founder Rosemary Smith. “No one can withstand this onslaught,” said Smith, who owns six pharmacies across Eastern Kentucky with her husband, Luther.

The first pursuit by a pregnant woman in Kentucky to legally challenge the state’s near-total abortion bans — historic not just in the Bluegrass State, but nationwide — has ended less than two weeks after it began. On Dec. 8, “Jane Doe,” who was eight weeks pregnant at the time, filed a class-action lawsuit, asking a Jefferson County circuit judge to intervene on her behalf and allow her to terminate her pregnancy and permanently block Kentucky’s trigger law and six-week abortion bans from enforcement. On Monday, about a week after she learned her embryo no longer had cardiac activity, she asked the judge to dismiss her case. While the request to dismiss ends her particular case, more are predicted to follow, as attorneys with the American Civil Liberties Union of Kentucky and reproductive rights advocates mobilize to mount another legal challenge. But the short-lived nature of this case portends the unique difficulty plaintiffs face in Kentucky in trying to overturn these bans, say legal experts who spoke to the Herald-Leader. In effect, “Kentucky has made it harder than in every other state to challenge its abortion laws,” said David S. Cohen, a law professor at Drexel University who specializes in abortion policy. In February, four justices on Kentucky’s highest court agreed that health care clinics that provide abortions did not have legal standing to sue on behalf of their patients, who were and continue to be barred from accessing the medical procedure. This historic ruling meant that all future challenges to Kentucky’s restrictive abortion laws, which don’t include exceptions for rape, incest or fatal conditions that make survivable after birth impossible, would fall to the population most impacted by them: Pregnant women. The 4-3 decision last February upended longstanding precedent that had previously allowed health care providers to sue on behalf of their patients, as two dissenting justices in that ruling pointed out. But even more notably, it solidified Kentucky as an outlier, raising the bar higher than any other state for effectively contesting the state’s trigger law and six-week ban. “The Kentucky Supreme Court is the only highest court in the land that has said abortion providers cannot bring cases on behalf of their patients,” Cohen said. Instead, it has “put that burden on individual pregnant women.” Though justices said no major “hindrance” existed for pregnant women wishing to sue the state over these laws, experts said the sheer amount of time it took for a plaintiff to step forward — almost a year and a half after the bans took effect — is proof of that hindrance.

In a post-Roe v. Wade world, the GOP’s new social issue of choice is trans rights. Kentucky was one of at least 17 states during their most recent legislative sessions to enact restrictions on health care for trans people. Gov. Andy Beshear, Cameron’s opponent, vetoed the bill, but the Republican supermajority overrode him. These positions from Beshear will “alienate swing voters,” according to Cameron. “Kentuckians are fed up with left-wing nonsense. I’ll bring back commonsense values.” Though he is defending policies passed by members of his party — and appointed a champion of those laws, Henderson Republican Sen. Robby Mills, as his running mate — Cameron’s rhetoric on the campaign trail has aligned more with the party’s ideological extreme. And in a state whose Democratic governor continues to boast high approval ratings across political parties, some within the Republican party are questioning whether Cameron’s emphasis on socially divisive issues is a winning strategy for swing voters, whose support he needs. “What I think he’s attempting to do is connect himself to (the legislature’s) efforts. Whether or not that’s going to be something that moves the dial in his direction remains to be seen,” Senate Bill 150 proponent Rep. Savannah Maddox, R-Dry Ridge said. Each of the lawmakers interviewed for this story said they supported at least a portion of SB 150, even if they ultimately voted against it. But most agreed: The current political characterizations of trans-rights issues, generally, leaves little room for the nuance they believe exists for many of their constituents. Many worry what the continued othering of a marginalized group will do to their party, long-term. “I’m concerned for my party, because I worry this doesn’t portray us as compassionately as I know we are,” said Rep. Kim Moser, R-Taylor Mill. She was one of three Republicans in the House, all women, who voted against the final version of SB 150. Moser is one of 10 Republicans who spoke to the Herald-Leader for this story. Rep. Stephanie Dietz of Edgewood, a second Northern Kentucky Republican who cast a “no” vote, said of Cameron’s messaging on trans issues, “there is an audience that wants to hear that message. “But I think the majority in my district want to hear: What’s the plan to get our kids back on track with their education, what we’re going to do to increase our workforce, what are we going to do about affordable daycare?” When asked whether Dietz thinks her party will continue in its pursuit of legislating trans issues, she said, “I’m hoping this was a one-time thing.”

In a windowless room at the back of a strip-mall restaurant in Hazard, Daniel Cameron said school teachings on gender and allowing transgender girls to play girls’ sports threatened Kentucky’s true values. “We need to make sure our schools are about reading, writing and math, and they’re not incubators for liberal and progressive ideas,” the Kentucky GOP nominee hoping to unseat Gov. Andy Beshear said on a humid morning in late July. “You’ve also had a governor who has said that he’s OK with biological males playing in women’s sports,” Cameron told the crowd. “Your values are at stake in this race for governor.” Cameron, 37, repeated this message to more supporters later that day in Whitesburg. Then again in Harlan. For months, that message was ratcheted up, piped into thousands of homes via cable and YouTube campaign advertisements, paid for by political action committees supporting but not affiliated with Cameron. One such commercial begins with a person dressed in drag reading a children’s book. “The radical transgender agenda,” a narrator begins in a voiceover, conflating people in drag with being trans. “It’s bombarding our children everywhere we turn. Child sex changes with permanent consequences. That’s Andy Beshear’s Kentucky.” On the coattails of a legislative session defined by the passage of anti-trans policies, Cameron’s bid for governor has tacked far-right in hopes that leaning heavily into charged culture war issues will play well with swing voters, his campaign told the Herald-Leader. Though he has defended the same trans-targeting policies passed by his party — and appointed a champion of those laws as his running mate — Cameron’s rhetoric on the campaign trail has aligned more with the GOP’s ideological extreme. Republicans who portray being trans as sinful and biblically immoral have found refuge in his candidacy. This is leaving some in the GOP questioning whether Cameron’s choice to veer from the political middle in an attempt to unseat a relatively well-liked moderate Democratic incumbent is a winning strategy. “Do I think this is the issue that’s going to be a motivating reason to not vote for Beshear?” asked Sen. Amanda Mays Bledsoe, R-Fayette, who voted in favor of SB 150 despite having reservations about it. “It will be for some. But the economy, inflation and public safety are bigger motivators for most voters I hear from.”

From January to July of this year, reported abortions in Kentucky dropped by almost 100% compared with 2021, according to state data. Thirteen abortions were reported to the Cabinet for Health and Family Services between January and July of 2023, compared to 2,591 reported in 2021 during the same time frame — a reduction of 99.5%. The marked cliff is a direct result of Kentucky’s trigger law and six-week ban, both of which took effect after federal abortion protections were overturned in June 2022. The trigger law bans all abortions except when a pregnant person’s life is immediately threatened, and the six-week ban, or fetal heartbeat law, outlaws abortions after fetal cardiac activity develops, which is usually around six weeks gestation. The impact has been a near-total elimination of abortion, even in circumstances where the procedure is medically recommended, as the Herald-Leader has reported, including when a fetus is nonviable. That trend is mirrored across the country in more than a dozen states that have enacted similar abortion bans, according to new estimates released this week from the Guttmacher Institute, a pro-abortion rights research policy center. Though the full scope of Kentuckians traveling across state lines for reproductive health care isn’t known, organizations that help women to this end say demand is not letting up. Kentucky Health Justice Network, which offers assistance to people who need help paying for their abortion, fielded more than 500 calls from January to July of this year (421 received donations from KHJN to pay for their abortions). That breaks down to 15-20 calls a week, said Savannah Trebuna, KHJN’s abortion support fund co-director. “Before the ban, a large barrier to people seeking care at clinics was just the cost of the appointment,” Trebuna said, which can range anywhere from $600 to $1,000. In the more than year since the trigger law, donations spent on travel — what KHJN calls “direct assistance” — has increased 127%. Increasingly, “we’re seeing a large need for practical support, things like gas money or a flight, hotels and childcare expenses,” she said.

Jessica Blackburn didn’t know she was addicted to opioids until her body’s first withdrawal. It was 2004, and she was 18. For the last year, she’d swallowed oxycontin recreationally at high school parties in Betsy Lane, her Eastern Kentucky hometown. The first time her body responded to a deficit of pills, Blackburn thought she’d caught a bad case of the flu. It was her high school boyfriend who explained that her body had become dependent. “It all just kind of clicked,” Blackburn, 36, said recently by phone. After years of trying to stop, to no end, her dad told her about ibogaine, a psychedelic drug he’d read about. An alkaloid derived from the root bark of an iboga shrub native to West Central Africa, ibogaine had a burgeoning international following among war veterans who’d taken it to treat post-traumatic stress disorder. Her dad learned the drug had also long been used in some countries to treat substance use disorders. In 2008, with roughly $6,000 in cash, Blackburn traveled alone to Jalisco, Mexico. There, in a house in a small village, she took two doses of ibogaine under the watch of strangers. The only medical device present was a battery-operated blood pressure cuff. For the next 24 hours, Blackburn lay in a bed, largely immobile with ataxia, a side effect of the drug. She sweated, her heart rate slowed and accelerated, and she hallucinated vividly. “It was not a fun trip,” she said. “It was violent, like being choke-slammed by God.” She’d last taken oxycontin the day before she flew to Mexico and expected to wake up the following morning in cold sweats from withdrawal. But she didn’t. When her hallucinations stopped, she was dead-tired, but her craving for oxycontin had diminished entirely. So, too, had her withdrawals. Surreal, it felt like her brain had reverted to a pre-addiction state.

From an overflow room in the Kentucky Capitol Annex, Henry Svec, 13, listened to adults explain why kids like him needed to be protected from themselves. As lawmakers on the House Judiciary Committee heard testimony in favor of a bill to ban gender-affirming health care, Henry, who's trans, watched the meeting unfold on a projector screen from a room down the hall. Dr. Roger Hiatt, Jr., an Arkansas child and adolescent psychiatry specialist who has publicly supported bills outlawing this type of health care in other states, called transgenderism a “psychiatric disorder.” He had been invited to speak by lead bill sponsor, Waddy Republican Rep. Jennifer Decker. State law prevents parents from giving their underage children alcohol and cigarettes, she told committee members. Gender-affirming care is just as harmful, and trans kids need to be protected from adults who endorse their identity. Taught to respect his elders, Henry quietly considered what Decker, near the age of his grandmother, was saying. If adult lawmakers believed that health care affirming the gender that feels most authentic to him was wrong and harmful, it must mean his trans identity was also somehow wrong and harmful. Otherwise, why would his doctor’s care be so damaging that it warranted a law banning it? But it didn’t feel wrong or harmful to Henry, or any of the 13 families across Kentucky with a trans child the Herald-Leader has interviewed in the months since, each of whom will be directly impacted by some aspect of the new law, which goes into full effect June 29. Parents described a sense of powerlessness and fury at lawmakers for dictating to them how to parent their individual children. Many are territorial about the progress their family has made on a journey of acceptance that, for several, wasn’t an easy or linear one. Now that enforcement of the law is imminent, each is grappling with what to do to ensure their children feel supported in a state they believe is hostile to their well-being.

House Bill 470 from Rep. Jennifer Decker, R-Shelbyville is a sweeping proposal that would wholly restrict how health care providers across specialties, including mental health therapists, school counselors, psychologists, and primary care doctors, treat their underage trans patients by outlawing gender-affirming care. “What we are seeing is medical misinformation with these legislative efforts,” said Dr. Anthony Carney, a family medicine nurse practitioner for UK HealthCare. It’s a “denial and erasure” of this population’s lived experience, he said. Gender-affirming health care is “anything that helps a person live in the gender with which they identify and feel comfortable,” Dr. Amanda Fallin-Bennett said. It can be as simple as referring to a patient by their preferred name, or as involved as prescribing hormone therapy, which, for minors, is done only with informed parental consent; it’s a family decision, providers interviewed for this story said. “You can’t separate someone’s gender, or dysphoria about it, from their depression or from their joint pain or from anything else,” she said. “They all go together in what’s going to make them thrive as a human being.” The underpinnings of lawmakers’ debate over GOP-backed bills like House Bill 470 the validity of the trans identity, providers said. It’s not that more people are “deciding to be trans,” but rather, incrementally, “our culture is more accepting of trans people,” Carney said. “The decision is not to be trans — they are trans. The decision is to disclose that information to their parents, friends, their support network and me as their provider,” he said. Legislative proposals like these not only feel like a “regression,” Carney said, “it feels like retribution for being more visible and existing.”

Sitting in a fluorescent-lit room inside Baptist Health Louisville, Amy English looked for familiar shapes on the screen as an ultrasound tech probed her abdomen. Familiar with radiology in her career as a physical therapist, she has a baseline understanding of how to read ultrasounds: gray shapes usually indicate fluid, and bone shows up as white. Amy remembers seeing her baby’s arms, legs and the curve of its back. But there was no recognizable outline where the skull should be. “I couldn’t see the top of my baby’s head,” Amy said in an interview with the Herald-Leader. “I kept waiting for the tech to move the probe in a way where we could see what we should be seeing. I could tell she was searching for it, too.” Over the next few minutes, Amy remembers the room blurring as she heard her doctor use the word “acrania,” which is when a fetus matures through pregnancy without ever developing parts of its skull. It can spur anencephaly, when the brain, too, is underdeveloped and partially missing. Pregnancies with either of these conditions are nonviable. Amy’s baby, which they learned was a boy, had both. He would not survive into childhood, likely not beyond a few minutes after birth. This, alone, was devastating news. Her dismay was compounded the next day when she learned that terminating her nonviable pregnancy, even by way of an early induction — a commonplace and provider-recommended method of treatment for such a diagnosis — couldn’t happen. Even though Amy’s baby would never survive outside her womb, the pregnancy still had a fetal heartbeat — a technicality, considering the diagnosis. Coupled with the lack of immediate threat to her health, her doctors explained they couldn’t induce labor, much less give her an abortion. Kentucky laws forbade it, they said.

For nine days in late July, abortion was temporarily legal and accessible in Kentucky. The state’s two outpatient abortion providers had filed a lawsuit a month earlier in an effort to overturn the trigger law and a six-week ban, both of which took effect after federal constitutional abortion protections were dropped in late June. Both laws are still intact today. The trigger law bans abortions in all circumstances except in limited emergencies to preserve a pregnant person’s life. The six-week ban criminalizes abortion after a fetal heartbeat is detected, typically around the sixth week of pregnancy. Together, the pair of laws has nearly rid the state of legal abortions. But from July 22 to August 1, enforcement of these laws was briefly halted by an injunction handed down by Jefferson Circuit Judge Mitch Perry. It was the last stretch of time abortion was legal in Kentucky before both bans were reinstated by the Kentucky Court of Appeals, granting a request for emergency relief from Republican Attorney General Daniel Cameron. Perry’s basis for issuing a temporary injunction may foreshadow what’s to come for abortion access in Kentucky, now that voters have rejected Amendment 2, a proposal to revise the constitution to prohibit a protected right to abortion. That rejection leaves the door open for the Kentucky Supreme Court to interpret abortion as a constitutionally-protected right in Kentucky.

On a recent Saturday afternoon, on the steps of the Kentucky Capitol, Bishop John Iffert wanted to make something clear: Christians have a duty to publicly advocate on behalf of unborn fetuses ahead of the November election. “This is the one opportunity in our lifetime for the citizens of Kentucky to register your opinion on abortion and on life,” he told the few hundred people gathered for the Yes For Life rally in early October. They rallied in support of Constitutional Amendment 2 — a yes or no question on the November 8 ballot that seeks to change the wording of Kentucky’s constitution to clearly state there’s no protected right to, or state funding of, abortion. Bishop Iffert, of the Diocese of Covington, walked rally goers step by step how to access sample ballots on their phones. He then directed them to return home to their respective churches and encourage their church leaders to preach a “yes” vote to their congregations. This allowance has opened the door for Yes For Life to lean on faith leaders across Kentucky — a devoutly religious state, with 76% of residents identifying as evangelical Christian — to wade into the political fray this election cycle and preach politics from the pulpit And in such a hyper-religious state, where local priests and pastors are often as influential as local elected leaders, Yes For Life has not only tailored its message to resonate with evangelicals (vote “yes” to “protect the unborn” and to preserve the “sanctity of life”) but the campaign’s voter outreach relies heavily on the proselytizing of Christian leaders.

Less than two months after federal abortion protections ended and Kentucky’s near-total abortion ban became law, the state’s largest medical association was poised to take an unambiguous stance on abortion access for the first time in its history. In Kentucky, the termination of a pregnancy is illegal except when the life of a pregnant person is threatened. But that caveat, vaguely defined in the trigger law, has caused confusion in the medical community, as the Herald-Leader reported in August. It’s a friction playing out for many physicians in states across the country, where largely GOP-backed abortion laws disregard not only evidence-based health care, but physicians’ ethical duty to care and advocate for the wellbeing of their patients. In a state like Kentucky, where broad support of those laws is often buttressed by Christian doctrine rather than peer-reviewed research, many doctors are pinned between their ethical obligation to publicly advocate for patients, and a need to compromise and avoid alienating the political party in power that passes those laws. But the opportunity to proclaim abortion access as an essential part of health care, exclusive to the relationship between patient and medical provider, was largely sidestepped in late August during the Kentucky Medical Association’s annual meeting. When presented with multiple evidence-based proposals, KMA’s governing body chose not to adopt most of the policy changes that would’ve provided medical clarity from experts on the importance of abortion access in a state that has all but eliminated it.