Roe v. Wade Is the Floor. Reproductive Justice Is the Mountaintop.

As a queer woman who grew up in North Carolina, I learned at an early age that my Blackness could be a source of great joy — but it could also pose a threat to my safety and autonomy.

In middle school, white boys laid their hands on me without my consent when I sharpened my pencil. To travel through town, I had to pass a building dedicated to Senator Jesse Helms, a champion of modern-day anti-abortion laws. It was all a daily reminder of the tight grip that whiteness had on my full liberation. I did not consent to that either.

Systemic racism is built into every facet of our society, including sexual and reproductive health. In 1973 the U.S. Supreme Court decision in Roe v. Wade affirmed the constitutional right to abortion, barring states from banning abortion before the point of fetal viability. But too many states, especially in the South, interpreted and applied the decision as strictly as they could get away with, disproportionately affecting women of color.

In the decades since, lawmakers have enacted hundreds of dangerous restrictions that have made getting an abortion nearly impossible for many poor women and women of color. In 2021 alone, over 100 anti-abortion bills that restrict or ban abortions were passed in 19 states. This summer, the Supreme Court could deliver a lethal blow to Roe v. Wade.

As devastating as that outcome would be, it’s important to keep in mind that Roe never fully protected Black women — or poor women or so many others in this country. That’s because Roe ensured the right to abortion without ensuring that people could actually get an abortion. People seeking abortions in America must consider: Do I have the money? How far is the nearest clinic, and can I get there? Can I take off work? Will I be safe walking into the clinic? For more privileged people, these questions are rarely a deterrent. But for many women of color and poor people, they are major obstacles. That’s how white supremacy works.

It didn’t help matters that almost as soon as Roe was decided, lawmakers started rolling it back. The Hyde Amendment, which first passed three years after Roe, bans coverage of abortion through federally funded programs like Medicaid. In addition, 34 states and the District of Columbia bar the use of their state Medicaid funds for abortions except in limited cases.

The Hyde Amendment has made it very difficult for many women to afford an abortion in America, and that affects women of color the most: In 2019 women of color made up a majority of women insured through Medicaid. As a result of all this, many women have had to carry unwanted pregnancies to term.

This has ripple effects on people’s lives. According to the decade-long Turnaway Study, women who seek an abortion but are unable to gain access to one are four times as likely to eventually live in poverty as women who were able to get the procedure. Their families suffer, too. Black children are three times as likely as white children to grow up in poverty and live in a food-insecure household.

On top of that, women of color in states with restrictive abortion laws often have limited access to health care generally and a lack of choices for effective birth control. Schools often have ineffective or inadequate sex education. In almost every aspect of reproductive health, women of color today are more likely to experience racism and discrimination in the U.S. health care system. We have poorer health outcomes compared with white women. Black women are three times as likely to die of pregnancy-related causes as white women. And police violence cuts short the lives of too many of the babies we do have.

These are complex problems, and they will require complex solutions. As such, we can’t afford to focus on our sexual and reproductive lives with a single-issue lens. We must consider the ways in which all social justice issues intersect and affect the way we are able to make decisions about our bodies and the creation of our futures.

One hurdle toward achieving that goal is that for decades, white-led reproductive rights organizations were the default, and the experiences of those leaders are not the same as the experiences of people of color. That’s why reproductive justice organizations — groups like SisterSong, focused on grass-roots organizing campaigns, promoting policy change and providing education for our communities — have been calling for changes in leadership and representation. We have made progress on that front, but we need to build on it.

What we need is a culture shift.

My experiences navigating my sexual identity and reproductive health inspired me to become an activist and organizer, but for many years the organizations I was part of were led by white men.

It wasn’t until much later that I learned about a group of Black women who called themselves Women of African Descent for Reproductive Justice. In 1994 it took out an ad in The Washington Post and Roll Call to proclaim to the world that our reproductive freedom cannot be boiled down to a single issue. When I was introduced to the reproductive justice movement, it was the first time I was exposed to Black women leading and owning their stories and bodies, and that was powerful.

Their work was the road map that grounded my own.

In my state, Georgia, Black women-led organizations have led the charge in pushing back against unjust laws that disproportionately affect our communities and challenge our autonomy, from voting rights to abortion access. People of color don’t have the privilege of focusing on only one issue — everything is connected. Reproductive justice has always been more than just being “pro-choice.” To be pro-choice you must have the privilege of having choices.

The fight for reproductive justice must be led by those most affected. To build collective power, we need a deeper investment in B.I.P.O.C.-led organizations. We also need to normalize sharing our abortion stories, whether we had one or held the hand of someone at a clinic. And we need to work to elect, appoint and confirm officials who are aligned with reproductive justice values. It’s not enough to just show up when an anti-abortion law reaches the Supreme Court — we need to bring that energy to our local school boards, state legislatures, attorneys general offices and every election.

It is our duty to hold everyone accountable at every level, every day, because our lives depend on it. And because Roe might soon be gone. But we can imagine a better world, one in which we have not just the minimum, but stand at the mountaintop: true reproductive justice.

Monica Simpson is the executive director of SisterSong Women of Color Reproductive Justice Collective. Her organization is the lead plaintiff in SisterSong v. Kemp, challenging a Georgia anti-abortion law.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: [email protected].

Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.