Women and femme-identifying people around the world are on the frontlines of climate change, often hurt first and worst by its impacts, and in the battle to curb and adapt to it. A review of peer-reviewed research published Monday in The Lancet Planetary Health found gender-based violence is a recurring phenomena during and after disasters fueled by climate change, including assault, intimate partner violence, and trafficking.

The extraction and transportation of fossil fuels is also closely linked to increases in gender-based violence, especially targeted at indigenous women and trans people, who are also disproportionately harmed by the impacts of climate change. Extreme heat, just one climate impact, is especially dangerous for pregnant people, as is the case in Jacobabad, Pakistan, which hit 122°F last month.

“Heat is a super big deal for pregnant” people, Cecilia Sorensen, of Columbia University, told Reuters. “We’re not associating health impacts on women and often times it’s because we’re not collecting data on it,” she said. “And often women in poverty are not seeking medical care.”

Fighting back

Legacy, mostly-white, environmental groups, and the traditional “environmental movement” overall, have neglected environmental concerns of communities of color. Women of color, however, are fighting for environmental justice while concurrently pushing to make the movement look more like the people hurt worst by pollution and climate change.

“The issue with the environmental movement for so many years has been a lack of diversity and a lack of shared lenses around environmental racism,” Deseree Fontenot, who grew up with asthma in Los Angelean sprawl, told Women’s Health. “We don’t see ourselves in that movement, but we do see ourselves in the places which we’ve had to make home over and over again, places that are deeply affected by processes like extraction, or the forceful removal of natural resources from their rightful place at a scale, pace, and intensity that ecosystems cannot recover from or regenerate.” (Disasters: Business Insider; Heat: Reuters; Fighting back: Women’s Health)