Pinterest has gone all in on artificial intelligence and users say it's destroying the site. Since 2009, the image sharing social media site has been a place for people to share their art, recipes, home renovation inspiration, corny motivational quotes, and more, but in the last year users, especially artists, say the site has gotten worse. AI-powered mods are pulling down posts and banning accounts, AI-generated art is filling feeds, and hand drawn art is labeled as AI modified.

“I feel like, increasingly, it's impossible to talk to a single human [at Pinterest],” artist and Pinterest user Tiana Oreglia told 404 Media. “Along with being filled with AI images that have been completely ruining the platform, Pinterest has implemented terrible AI moderation that the community is up in arms about. It's banning people randomly and I keep getting takedown notices for pins.”

Oreglia’s Pinterest account is where she keeps reference material for her work, including human anatomy photos. In the past few months, she’s noticed an uptick in seemingly innocuous photos of women being flagged by Pinterest’s AI moderators. Oreglia told 404 Media there’s been a clear pattern to the reference material the site has a problem with. “Female figures in particular, even if completely clothed, get taken down and I have to keep appealing those decisions,” she said. This pattern is common on many social media platforms, and predates the advent of generative AI. 

“We publish clear guidelines on adult sexual content and nudity and use a combination of AI and human review for enforcement,” Pinterest told 404 Media. “We have an appeals process where a human reviews the content and reactivates it when we’ve made a mistake.” It also confirmed that the site uses both humans and automated systems for moderation.

Oreglia shared some of the works Pinterest flagged including a photo of a muscular woman in a bikini holding knives, a painting of two clothed women in an intimate embrace, and a stock photo of a man holding a gun on a telephone that was flagged for “self-harm.” In most cases, Oreglia can appeal and get a decision reversed, but that eats up time. Time she could be spending making art.

And those appeals aren’t always approved. “The worst case scenario for this stuff is that you get your account banned,” Oreglia said.

r/Pinterest is awash in users complaining about AI-related issues on the site. “Pinterest keeps automatically adding the ‘AI modified’ tag to my Pins...every time I appeal, Pinterest reviews it and removes the AI label. But then… the same thing happens again on new Pins and new artwork. So I’m stuck in this endless loop of appealing → label removed → new Pin gets tagged again,” read a post on r/Pinterest. 

The redditor told 404 Media that this has happened three times so far and it takes between 24 to 48 hours to sort out. 

“I actively promote my work as 100% hand-drawn and ‘no AI,’” they said. “On Etsy, I clearly position my brand around original illustration. So when a Pinterest Pin is labeled ‘Hand Drawn’ but simultaneously marked as ‘AI modified,’ it creates confusion and undermines that positioning.”

Artist Min Zakuga told 404 Media that they’ve seen a lot of their art on Pinterest get labeled as “AI modified” despite being older than image generation tech. “There is no way to take their auto-labeling off, other than going through a horribly long process where you have to prove it was not AI, which still may get rejected,” she said. “Even artwork from 10-13 years ago will still be labeled by Pinterest as AI, with them knowing full well something from 10 years ago could not possibly be AI.”

Other users are tired of seeing a constant flood of AI-generated art in their feeds. “I can't even scroll through 100 pins without 95 out of them being some AI slop or theft, let alone very talented artists tend to be sucked down and are being unrecognized by the sheer amount of it,” said another post. “I don't want to triple check my sources every single time I look at a pin, but I refuse to use any of that soulless garbage. However, Pinterest has been infested. Made obsolete.”

Artist Eva Toorenent told 404 Media that she’s been able to cull most of the AI-generated content from her board, but that it took a lot of time. Whenever she saw what she thought was an AI-generated image, she told Pinterest she didn’t want to see it and eventually the algorithm learned. But, like Oreglia fighting auto-moderation and Zakuga fighting to get the “AI modified” label taken off her work, training Pinterest’s algorithm to stop serving you AI-generated images eats up precious time.

AI boosters often talk about how much time these systems will save everyone. They’re pitched as productivity boosters. Earlier this month, Pinterest laid off 15 percent of its work force as part of a push to prioritize AI. In a post on LinkedIn, one of the former employees shared part of the email CEO Bill Ready sent out after the lay offs. “We’re doubling down on an AI-forward approach—prioritizing AI-focused roles, teams, and ways of working.”

Toorenent removed all her own art from her Pinterest account after hearing the news that the site would use public pins to train Pinterest Canvas, the company’s proprietary text-to-image AI. But she has no control over other users uploading her artwork. “I have already caught a few of my images still on Pinterest that I did not upload myself…that makes me incredibly mad,” she told 404 Media. “It used to be a great way to get your work seen among other people, but it’s being used to train their internal AI.”

Oreglia told 404 Media that the flood of AI has changed her relationship to a site she once used to prize. “It's definitely affected how I search things and I'm always now very critical about where something came from... although I've always been overly pedantic about research,” she said. “It does make you do your due diligence but it sucks to constantly have to question and check if something is authentic or synthetic.”

She’s thought about leaving the platform, but feels stuck. “I just want to be able to take all my references with me. I've been on the platform for about ten years and have very carefully curated it. It's really nice to be able to just go to my page and search for something I saved instead of having to save everything to folders although I also do that,” she said. “More and more I'm trying to curate and collect physical references too but some of that can take up space I don't have so it can be difficult. Having a physical reference library just seems more and more necessary these days…artists have to be adaptable to this kind of thing these days. It's annoying but not unmanageable.”

Ready has been vocal and proud about the company’s commitment to forcing AI into every aspect of the user experience. “At Pinterest…we’re deploying AI to flip the script on social media, using it to more aggressively promote user well being rather than the alternative formula of triggering engagement by enragement,” Ready said in a January column at Fortune. “Social media platforms like Pinterest live and die by users’ willingness to share creative and original ideas.”

I'm generally skeptical about AI, mostly because we're currently living in a hype bubble about it, with stories both good and bad, everywhere.

It's clearly not going away so I decided that instead I should treat AI like any other technology that may have good or bad qualities, by evaluating it on its own merits whenever I could. I've heard enough good stories from people I know doing amazing things with AI that save them time and effort that I'm still willing to give it a try from time to time.

Lately, everyone is into AI agents and Paul Ford wrote a great piece about it that mirrors what I've heard from programmer friends also using them. I even dipped my own toes into this water last week when I asked Claude to code up an iOS app that I've had in my head for years and in less than two minutes it cranked out the swift code and files I need to dump into Xcode to test my new app out (haven't done that part yet but it definitely shows promise).

So let's try and save time with AI!

The things I'm most interested in are automations that reduce tedious things I have to do by hand, so asking AI to look up anything I've written in the past on a certain subject and find it for me, or turn a meeting transcript into an outline of things to do next on a project are both things that seem easy enough for a pattern-recognition engine to complete.

Someone at my work asked me to compile a list of a previous articles I've written over the past year that had already been edited and vetted by our in-house experts, so we could re-use them as internal documentation or in other contexts.

I thought this could be a perfect job for AI to save some time for me.

I tend to write a handful of pieces each week, so after a year of working there, I've got a couple hundred articles in my Google account. Google Doc's "last opened by you" interface means it's not easy to look up all my previous docs on a single screen, much less be able to go through them easily. It would take literal hours to open hundreds of docs by hand, read them a bit, then categorize them myself.

Claude trips and falls

I fired up Claude.ai and asked it to look at everything I authored in my Google Docs account, and produce a list of article titles that linked to the docs, all grouped into categories of related subjects.

Claude told me it didn't have access to my google account, even though I use Google sign-on as my login. Claude said I needed to install a Google plugin, and while digging around for that I figured out I was already connected to Google's API (again, from my login).

I told Claude and it apologized with a "oh right, my bad" which was 4-5 minutes wasted tracking down an already existing Google connection. Not a great sign.

So I asked Claude to dig up my old articles and found out Claude doesn't have API access to searching specific files in my Google Drive or Docs so instead it asked me to create, then copy and paste a "share link" for every single thing I've written.

I decided it was time for me to try using Google's own AI instead.

Gemini save me!

I started my first ever session with Gemini, as I figured it should have no issues dealing with Google APIs, so I asked it to compile a list of pieces I've written over the last year about disaster recovery and toss them into some categories for me.

At first it gave me a list of 17 articles spread across four or five categories. I knew this was barely scratching the surface, so from memory I started expanding my requests, asking for all the things I wrote about fires and floods in addition to the stuff it found about hurricanes.

It gathered 30 pieces and eventually over 40 titles of old content and the categories expanded to over a dozen. As I read through results, I kept thinking of more things I wasn't seeing and I'd ask it to gather additional pieces on specific subjects.

What's wild is each time I'd ask for an updated list, it would return a different number of items. Sometimes it would drop back down to 17, other times over 50 would be returned. Mostly about 30 docs I wrote would be shared in the list. Every two or three times I'd make a new request, it'd stop numbering my list and go back to plain bullet points. Then I'd ask it to reinstate the numbers.

I kept going, getting frustrated with the inconsistent output. After an hour of futzing, I eventually tailored my request to docs I'd been the original author of, that had more than a couple hundred words, and to omit any meeting transcripts, since a lot of those were brainstorm sessions with 3-4 people throwing ideas around. Gemini thought some of the ideas pitched in meetings were actual articles and some of my resulting items were things I once pitched but never wrote.

The wheels come off the bus

When I thought my list was finally looking comprehensive, I started checking each of the links to my old Google Docs. A few article titles linked to meeting transcripts. A few linked to my resume which I guess I uploaded at some point. I started seeing a couple articles I know I didn't write, like something about earthquake strapping on buildings to prevent damage, and when I'd follow the link to see what Gemini was using as a source, it was a piece I wrote on how to protect your home from prolonged freezing temperatures.

I know I'm supposed to mention errors to AI so it can fix things. So I asked Gemini why it was hallucinating an article I never wrote about earthquakes, and why it linked to an unrelated piece. I got apologies and muddled excuses. I noticed half the links to my shared Google Docs linked to a google.com search instead of a docs.google.com URL. Again I asked Gemini to be sure and link directly to actual pieces and I got more apologies.

I asked Gemini to save the list output as a new doc in my account and was told it wasn't allowed to create new files even though it's Google's Gemini in my Google account accessing my Google Docs.

Eventually, I copied and pasted the results from a few dozen Gemini outputs into one giant long document. I found about 50 unique pieces I had to categorize and share, and as I worked on those by hand, the titles continued to jog my memory about other pieces I'd written but weren't mentioned so I'd search Google Docs and add them to the list myself.

Conclusion: not good

A thing I thought might take five minutes and save me oodles of tedious work ended up taking over two hours to produce a long list, half done by hand, half by Gemini, after removing erroneous links and straight up hallucinations.

I think my request of "Hey Gemini, show me a list of all the articles I wrote over the last year and arrange them into categories by subject" is a straightforward one, and I came away from this experience surprised that Gemini shipped these features as bleeding edge AI to customers when it never really delivered for me.

I've had a few good experiences with AI actually saving me time and effort (especially around transcribing audio and video to text I can later edit/transform into stories) but in this case I can't believe we're boiling oceans and burning forests and firing everyone in the tech industry for AI systems that can't complete fairly simple tasks.

Rep. Heather Meyer debates the "bathroom bill" that passed the House Feb. 18, 2026. She says it paints a "bullseye" on trans people. (Photo by Morgan Chilson/Kansas Reflector)

TOPEKA — Kansans will soon be required to use the bathroom of their biological sex at birth in all government buildings after the House joined the Senate Wednesday to override Gov. Laura Kelly’s veto. 

House Substitute for Senate Bill 244 will go into effect immediately after paperwork is filed at the Secretary of State’s office. Along with the public facilities regulations, the bill requires Kansans to use the gender marker of their biological sex at birth on their driver’s licenses and birth certificates. It invalidates documents that were issued to transgender people previously. 

The House vote was 87 to 37, with Republican Rep. Mark Schreiber joining all Democrats present in opposing the bill. It passed the Senate on Tuesday. 

Kelly said in a statement after her veto was overridden that the bill was poorly drafted and will cost taxpayers millions of dollars to comply. 

“It is nothing short of ridiculous that the Legislature is forcing the entire state, every city and town, every school district, every public university to spend taxpayer money on a manufactured problem,” she said. “Kansans elected them to focus on education, job creation, housing, and grocery costs.”

Just four Democratic opponents were able to debate the bill before Rep. Barb Wasinger, R-Hays, made a motion of the previous question, which means all debate stops and a vote is immediately taken.

Rep. Heather Meyer, an Overland Park Democrat, said the legislation was discriminatory and “paints a bullseye” on the backs of legislative colleagues who are trans women, including Rep. Abi Boatman, D-Wichita, and former representative Stephanie Byers, a Democrat from Wichita.  

“I feel safer in a restroom with those representatives than I do or would with some people here, including women, and I’m not even joking about that,” she said. 

Rep. Alexis Simmons, D-Topeka, said she took issue with a statement that the bill codifies societal norms. 

“We used to also have a law that women were subjugated to pregnancy and marriage because that was considered the societal norm,” she said. “Societal norms also would have included slavery and Jim Crow and other horrific stains on our nation’s history.”

Rep. Lindsay Vaughn, D-Overland Park, said evidence shows that bills like SB 244 negatively impact the mental health of trans people and cause “hateful stereotypes.” 

“Attempting to legislate away the rights of people who are different from you has played out in history time and again,” she said. “So I want to ask which side of history does this body want to be on today?”

After debate was shut down, many Democratic opponents used the one-minute opportunity to explain their vote to show support for trans people and their frustration with the bill. 

Rep. Carolyn Caiharr, R-Edwardsville, supported the bill and voted to overturn the veto. 

“Our young women deserve to have restrooms and locker rooms where they can undress without men in the room. This bill protects girls and women, the ones feminists used to claim to stand for,” she said. 

Along with opposing the bill, several Democrats talked about the fact that debate was cut short Wednesday, and that the process allowed no public input on the bathroom restrictions. 

“Statesmanship requires the willingness to listen to those you disagree with, to care when you are exhausted, and to respect when you are not willing to,” said Rep. Kirk Haskins, D-Topeka. “Trans women are women. Trans men are men. They deserve our protection, even if we don’t want to listen to them.”

Rep. Lynn Melton, D-Kansas City, said lawmakers were silenced during the debate on SB 244. 

“Kansans want tax relief and affordability,” she said. “Fourteen voices were silenced today that represent thousands of people who deserve to be heard. Shame on this chamber.”

Kansas House Speaker Dan Hawkins, R-Wichita, said in a statement that SB 244 protects privacy and safety. 

“While the Governor fearmongers and muddies the water with her misleading veto message, our position remains steady: This isn’t about scoring political points, but doing what’s right for women and girls across our communities,” he said. “Kansans expect clarity, not confusion.”

Advocacy groups joined in a written statement criticizing the passage of SB 244 and raising concerns about its effects. 

“This discriminatory bill undermines our state’s strong constitutional protections against government overreach and persecution,” said Micah  Kubic, executive director of ACLU of Kansas.

Michael Poppa, executive director of Mainstream Coalition, said the legislativesupermajority was targeting an already marginalized community. 

“Kansas families are being crushed by rising housing and healthcare costs. Small businesses face workforce shortages,” he said. “Rural communities are losing hospitals and struggling with failing infrastructure. These are the issues that demand action.”

Other organizations included in the statement were Equality Kansas, Kansas Interfaith Action, Loud Light Civic Action and Planned Parenthood Great Plains Votes.

Platform Ventures, the Kansas City investment firm at the center of a firestorm over its plans to sell a massive south Kansas City warehouse to the federal government for use as an ICE detention center, announced today that it is “not moving forward” with the sale.

The announcement comes after weeks of sustained, escalating mass protests, student walkouts, a national general strike, business shutdowns, and relentless community organizing that made Kansas City a flashpoint in the national resistance to the Trump administration’s kidnapping and concentration camp machine.

Let us be absolutely clear about what happened here: the people of Kansas City forced Platform Ventures’ hand.

This was not a corporate change of heart. This was not Platform Ventures suddenly discovering a conscience after secretly negotiating to hand over a publicly subsidized, $80 million warehouse to be converted into a 7,500-bed concentration camp. Ultimately, it was a calculated business decision made under extraordinary pressure from a community that refused to be complicit in the machinery of mass incarceration and deportation.

What They Said

In a statement released February 12, Platform Ventures claimed it “chose not to move forward” because “the terms no longer met our fiduciary requirements for a timely closing.”

To be explicitly clear, they are not saying it was wrong. They are also not saying they oppose detention. They are saying the deal stopped making financial sense. The company also cited “baseless speculation, inaccurate narratives and serious threats toward leadership” as motivating the statement.

There was nothing baseless about any of it. ICE agents were physically spotted touring the warehouse on January 15. Port KC documents confirmed the plan. Jackson County Legislature Chair Manny Abarca confirmed that a DHS supervisor told him the facility would hold at least 7,500 beds and was planned to open by the end of 2026. Platform Ventures’ own previous statement confirmed “all negotiations are complete.”

The speculation was in fact confirmed by various sources, repeatedly, by the company’s own words and by the federal agents walking through the building.

What Actually Killed the Deal: The People

What Platform Ventures will not say, and what mainstream outlets may underreport, is the extraordinary, multiracial, cross-generational movement that erupted across the Kansas City metro in the last month.

Organizations like Decarcerate KC, Advocates for Immigrant Rights and Reconciliation (AIRR), the Missouri Workers Center, Stand Up KC, and dozens of other grassroots groups mobilized with a speed and ferocity that corporate Kansas City was not prepared for.

On January 15, the day ICE agents toured the warehouse, protesters were already on site. Jackson County Legislature Chair Manny Abarca drove to the site himself and was confronted by ICE officers who told him he wasn’t allowed on the publicly subsidized property. He recorded the entire interaction.

That same day, the Kansas City Council, at Mayor Quinton Lucas’ request, passed a five-year moratorium on non-municipal detention facilities within city limits.

On January 20, hundreds gathered across the metro for protests and immigrant rights trainings. Students at Staley High School in North Kansas City staged a walkout with hundreds of students marching against ICE. In Overland Park, North Kansas City, Raytown South, Grandview, Wyandotte, student protests have drawn students and adults alike. Across the country, student walkouts have become one of the most powerful expressions of resistance, with young people refusing to sit quietly while their classmates’ families are targeted.

On January 24, hundreds braved single-digit temperatures and snow to march through downtown Kansas City as part of a national shutdown. Protesters marched from Oppenstein Park directly to properties owned by Platform Ventures on Baltimore Street. Decarcerate KC’s Pateisha Royal vociferiously denounced the planned concentration camp. The Missouri Workers Center’s Terrence Wise said what so many were feeling: “I’m a father of three, and I cannot accept that ICE just last night kidnapped a 2-year-old, whisking her off to the sort of detention facility they want to build here.”

Dozens of Kansas City businesses closed their doors or donated proceeds to AIRR KC and other immigration defense organizations in an unprecedented show of economic solidarity.

Port KC voted to sever all ties with Platform Ventures on February 9.

Leavenworth saw over 100 protesters rally against the separate CoreCivic detention center proposal. Representatives Emanuel Cleaver and Sharice Davids sent letters to DHS denouncing the planned operation.

The walls closed in from every direction because the people closed them.

It’s Cause to Celebrate. It’s Also Cause to Organize.

Platform Ventures’ statement is carefully worded. They said they are “not actively engaged” with the U.S. government or “any other prospective purchaser” for the I-49 property. They did not say they would never sell. They did not say the federal government has abandoned its plans for a mega-detention facility in the Kansas City metro. They did not say they oppose the caging of immigrants.

The CoreCivic facility in Leavenworth is still moving forward. ICE arrests in the Kansas City metro have surged in Missouri and nearly tripled in Kansas from January to October 2025. Masked federal agents are still roving our streets. The $45 billion allocated for ICE detention in the “Big Beautiful Bill” is still law. The administration is still targeting our neighbors.

What happened here is a victory, and it belongs to every single person who showed up in the cold, who walked out of class, who closed their shop, who marched to Platform Ventures’ front door, who trained their neighbors on their constitutional rights, who made phone calls, who refused to look away.

But a victory and a conclusion are two different things.

The fight for Kansas City continues. The fight against the carceral state continues. The fight for our immigrant neighbors, our unhoused neighbors, our Black and brown communities targeted by every arm of the state continues.

Platform Ventures backed down because organized people are more powerful than organized money. Remember that. And stay in the streets.

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This is a developing story. The Kansas City Defender will continue to provide updates.

Resources: If you or someone you know needs immigration legal assistance, contact AIRR KC (Advocates for Immigrant Rights and Reconciliation). Know your rights: you have the right to remain silent, the right to refuse entry without a judicial warrant, and the right to an attorney.

The post BREAKING: Platform Ventures Backs Down From ICE Detention Center Sale After Weeks of Mass Organizing and Protest appeared first on The Kansas City Defender.

When Elie Liakopoulos discovered she was pregnant, she knew immediately that she wanted to have an abortion. A surgical abortion to be specific — a prior distressing miscarriage experience made her wary of taking the abortion pill at home, since both miscarriage and medication abortion are managed using mifepristone. She lived in Portland, Oregon, where abortion access is legally protected by the state. She assumed that meant the hardest part of the process would be scheduling the appointment. She called the Lilith Clinic — an independent abortion provider in the city — completed the intake process and set her date. 

Then, a phone call changed the course of her plans.

“They returned my phone call to tell me that they wouldn’t be able to perform the abortion. I had no idea at that time that you could be turned away from an abortion at any size for any reason,” Liakopoulos said. “They just said that they had a limit for BMI.”

Body mass index (BMI) is a screening tool to estimate a patient’s body fat. Patients over a certain BMI seeking surgical abortions can face substantial limits and delays (medical abortions however, are not impacted by BMI). Those barriers can lead to a scramble to find alternative care, leaving patients with lingering frustration, physical discomfort and emotional distress.

The Lilith Clinic said that while they could not comment directly about Liakopoulos’s experience, citing health privacy laws, its policy was to “assess each patient from an anesthesia perspective, as well as a gynecological perspective, as to their eligibility for a safe outpatient procedure,” and to refer them to a hospital if they felt that was needed.

For Liakopoulos, the denial meant she would have to remain pregnant  longer, pushing her into the 12th week of her first trimester.  

“My first trimester was marred with horrific morning sickness that lasted all day,” Liakopoulos said. “Having to deal with another week and a half of not being able to eat anything or smell anything was really horrible.”

She eventually secured care at Planned Parenthood Columbia Willamette, a northeast Portland location. But there, her body size also shaped her experience.

“They did not sedate me the way they told me they would, nor did they manage my pain the way it was managed during my last abortion procedure,” Liakopoulos said. “They said this was because my neck was larger than 19 inches around and because my BMI is high.”

Planned Parenthood Columbia Willamette does not comment on individual patient experiences, but a spokesperson did say “anesthesia and sedation policies are based on evidence‑based medical standards and designed to ensure patient safety. Clinicians assess each patient’s health needs, including factors such as BMI.”

Her prior surgical abortion at a similar gestational stage had been painful but brief. This time, she said, she was sobbing. The difference in sedation meant she could feel much of the procedure.

“My abortion was noticeably much worse, materially, much worse, because of my BMI,” she said. “The difference three years of getting a little fatter made.”

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Size as proxy

There are no comprehensive statistics on how often patients are denied surgical abortions because of BMI or body size. Obesity is typically defined in medical research as a BMI of 30 or higher, but studies consistently show abortion is safe across weight categories. With medical abortions, BMI does not impact dosing or successful outcomes. 

“There’s nothing physiologically that should keep you from being able to perform these safe procedures or medications,” said Dr. Noora Siddiqui, a family medicine physician in Philadelphia and a fellow with Physicians for Reproductive Health. 

She added, “Strictly from a clinical standpoint, there is no difference in outcomes for someone over a BMI of 30 and someone under a BMI of 30.”

Recent research backs that up. A 2025 study published in the journal Obstetrics and Gynecology found that obesity was not associated with increased risk of complications from surgical abortion, even when accounting for age, gestational age and prior cesarean delivery. 

An earlier 2019 study in Perspectives on Sexual and Reproductive Health found that complication rates did not differ by BMI, yet patients with higher BMIs were more likely to be referred out of clinics, often resulting in delays and higher out-of-pocket costs.

Yet BMI limits act as a proxy for other concerns. Clinics may turn away obese patients seeking abortions because of a lack of training or equipment, experts said. 

“The history behind BMI was based on White, Scandinavian, European men,” she said. “It wasn’t made for guiding medical management.”

Siddiqui cited anesthesia as an example. Some anesthesia providers rely on insurance policies or older risk models that treat BMI as a disqualifier, even when evidence shows moderate sedation is safe. 

“If the person providing sedation is not educated or trained in caring for people with higher weights, that feeds into bias,” Siddiqui said.

Another common reason is equipment.

“That could be the bed that somebody lays on or the chairs that they are expected to sit in,” said Megan Daniel, senior director of programs at the Chicago Abortion Fund, the largest abortion fund in the country. “Whether or not the literal physical structure of the clinic is made to accommodate their physical body.”

Siddiqui said BMI cutoffs are not without consequences. 

“When we use these numbers to prevent folks from getting essential, safe, time sensitive care, we’re causing delays,” she said. “We’re causing increasing costs like travel, child care, loss of work or income.

Lexis Dotson-Dufault had an abortion years ago in Massachusetts while in college. Access was straightforward, even if emotionally difficult. Medicaid covered the cost. The clinic visit itself, she said, was the easiest part.

Years later, living in California and working in reproductive justice, Lexis found out she was pregnant again.

“I knew immediately that I wanted a surgical abortion,” she said. “I just wanted quick, in and out, done.”

She scheduled an appointment at FPA Women’s Health in Long Beach, where she had previously gone for routine care. She took time off work and flew her best friend in from across the country because she would need someone to drive her home after sedation.

During the appointment, after the ultrasound, a nurse returned to the room.

“She was like, we can’t do it today,” Dotson-Dufault said. “We have a visiting doctor, and they’re not comfortable with doing a surgical abortion on you because of your BMI.”

When Dotson-Dufault asked whether the regular doctor could perform the procedure later, the nurse left and returned again.

“She just hands me a bunch of different papers with different hospitals on it,” Dotson-Dufault said. “I immediately black out. I’m like, what are you handing me?”

She said she was later told the denial was not about the visiting physician, but rather that it was part of their policy.

When asked for comment, FPA women’s health pointed to their guidelines listed on their website which says that individuals with a BMI above 60 are considered high risk and will be referred to hospitals for their safety. Dotson-Dufault says that at the time, her BMI was 53.

“I wasn’t expecting it with abortion care, because abortion is just so low risk, so safe,” Dotson-Dufault said. “All you looked at was my weight and said, ‘That’s not OK.’”

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Barriers to care

Abortion services are one area where size-based barriers surface, but not the only one.

“The fatter I’ve gotten, the worse my care has gotten,” Liakopoulos said. “My fatness does not signify anything related to my health.”

Christina Hughes, a size-inclusive doula who runs their company Big Fat Pregnancy out of Seattle, said these experiences mirror what many fat patients encounter throughout pregnancy and reproductive care.

“We start at a disadvantage from chairs squeezing into us, gowns not being big enough, tables not fitting our bodies,” she said. “We’re physically uncomfortable and mentally being perceived as not enough.”

They added that fear and shame shape how patients experience care.

“When we’re scared that our body can’t do it, can’t have a baby, can’t be a parent, we are already physiologically signaling to our body that we can’t do this,” they said.

That fear can make it harder for patients to ask questions or advocate for themselves when denied care. 

Abortion funds help connect patients with providers and coordinate care. Some are working to act as a buffer for patients by identifying clinic restrictions ahead of time. Daniel said the Chicago Abortion Fund surveys clinics about BMI limits, equipment constraints and sedation policies so callers are directed to providers who can meet their needs. She said that among the dozens of clinics surveyed, a handful explicitly said they had restrictions about who they could serve.

“Everything that we do is guided by our callers,” Daniel said. “We want to make sure that the place they’re going to get abortion care is truly the best fit for them.”

Siddiqui said broader change requires provider education and accountability.

“There should be more provider education around this, and more research done for all body sizes,” she said. “Safe, accessible, effective reproductive care.”

Liakopoulos said what she wants is simpler.

“I just want fat people to be included. Fat people make up more than a third of this country. If all of us are being treated more poorly simply because our bodies are larger, that’s obviously a systemic problem,” she said. “If for abortion access, you have to kick a few fatties off the medical table, I think in the grand scheme, I think people think that’s worth it. And you know, being in that statistical margin is not a fun place to be.”