6 Tips for Being Trans Inclusive in Your Conversations About Reproductive Rights

Trans immigration rights activist Jennicet Gutiérrez waving a trans pride flag.

by KC Clements, cross posted with permission from Unapologetic Feminism

On January 21, 2017, millions of people around the world participated in The Women’s March. A Facebook event that quickly went viral, the march was a powerful display of resistance and solidarity that coalesced around a number of issues, including reproductive rights and fighting back against sexual assault.

But for many transgender people, the march was a painful reminder of the limits of the mainstream feminist movement. The sea of pink pussy hats had once again made it abundantly clear who is centered our reproductive and women’s rights discourse: white, cisgender women. The incessant chants and signs about pussies, uteruses, and ovaries actively excluded trans women and femmes from a conversation that they so desperately need to be a part of. The focus on the pinkness of these particular body parts presumed a white subject, failing to truly encompass the beautiful racial diversity of woman- and femmehood.

And, the conflation of womanhood with having those particular body parts left folks like myself who were assigned female at birth (AFAB) but do not identify as women in a strange position. Having those body parts does not automatically mean a person is a woman, nor does it mean a person is in need of the protections the feminist movement seeks to provide; indeed, many AFAB trans people like myself navigate the world with male privilege. Still, the issue of being able to access abortions applies to some of us who have functioning reproductive organs. The tension between needing to be included in the conversation about abortion access while also needing to examine our participation in systemic patriarchy made the march feel like a moment of cognitive dissonance.

While many of the cisgender (and particularly white) folks in my social networks celebrated the march, I watched as my trans and gender non-conforming friends not only expressed their anger but also worked hard to remind one another that we are valid, we are seen. I watched as my friends who are trans women and femme once again endured the painful sting of a feminism that refuses to hold and center them.

And I wondered what it would have looked like if these same people who had mobilized in such exceptional numbers had been up in arms about the murders of 27 trans people in 2016. Or about the estrogen shortage that left many trans women and femmes without life-affirming hormones for several months.

What became clear to me is that even those cisgender people who are beginning to develop more of a trans consciousness simply haven’t taken the time or done the research to understand how we fit into the conversation about reproductive health, abortion, and what our unique needs are. Although speakers like Janet Mock, Laverne Cox, and Angela Davis emphasized the need for a trans-inclusive intersectional movement, the pushback against trans critiques of the march remained.

In thinking about how to make this conversation trans-inclusive, I find it useful to apply the framework of reproductive justice to these conversations in place of reproductive rights. Reproductive justice is a concept that was developed by a caucus of Black feminists during a pro-choice conference in 1994. They contend that the long history of a single-issue focus on abortion has failed to produce true justice in the realm of reproductive health, particularly for poor folks, people of color, and other marginalized groups. Instead, they argue that when we attend to the broader socioeconomic barriers that prevent people from having access to reproductive health care, abortion, and the funds and services necessary to raise a child, we are able to develop a much more nuanced movement that can hold a diversity of experiences.

Operating with this framework in mind, I think it’s important for cisgender people who wish to make their discussions of reproductive health, abortion, and parenting more trans-inclusive to gain a better sense of how trans people fit into this movement. The following, though hardly exhaustive, are some helpful suggestions:

 

1. Stop Equating Genitals with Gender and Sex

One thing the Women’s March made clear was that many cisgender people still seem to believe that a person’s genitals define their gender and sex. However, the mere existence of trans and intersex people is enough evidence to debunk this myth. People of any genital configuration can and do identify across the gender spectrum. To presume otherwise is to fall victim to the concept of biological essentialism, one of the very same things the feminist movement is trying to resist. To put it more simply, feminism rejects the idea that being assigned female at birth means anything about how you should be treated in the world. What trans folks need cis people to understand is that we are the gender and, importantly, the sex we say we are, regardless of whether we wish to have or have had genital surgery. Ways to resist this problematic assumption are working to remove language from your vocabulary that associates having particular body parts with being a certain gender. This can look like considering whether when you say the word women, what you actually mean is something more specific like “people with uteruses” or “people who menstruate.”  It can look like not saying you like penises when what you mean to say is you’re attracted to men. Language is an important tool for creating change as well as enacting harm. Making this shift can ensure that trans people are included in your activism, your advocacy, and your everyday lives.

 

2. Understand That Reproductive Justice Is About Much More Than Just Abortion Access

While the major battle of the last several decades from a reproductive rights standpoint has been an individual’s right to access abortion, true reproductive justice is about so much more. It’s about the right to have access to safe, stigma-free reproductive health care and STI testing. It’s about the right to have a child if you wish and be able to raise that child with adequate housing, funds, transportation, and health care. It’s about vulnerable populations, like the trans community and especially trans women of color, being able to live free from discrimination and violence, including intimate partner violence. It’s about recognizing the long history of violence and forced sterilization propagated against women of color that has been justified by a pro-birth control and pro-abortion agenda that centers white cisgender women.  When we develop a more robust sense of what true reproductive justice might look like, we can see more clearly that the fight for trans justice, for racial justice, for economic justice, for disability justice is always already the fight for reproductive justice.

 

3. Learn About Reproductive Issues That Are Unique to Trans People

Trans people have specific issues when it comes to our reproductive health. For instance, for those of us who do choose to pursue hormone replacement therapy, we face potentially sterilizing effects to our reproductive organs. In most cases, testosterone causes the ovaries to cease function and bleeding to stop, while the use of estrogen and testosterone blockers reduces or eliminates sperm. While it is possible to reverse these effects by ceasing hormone replacement therapy, in some cases, sterilization can be permanent. Banking sperm or eggs is an option for folks who wish to have genetically related children at some point in their lives. But, for most trans people, these services are prohibitively expensive. Freezing eggs can cost upwards of $10,000, while annual storage fees for sperm banking can cost up to $500.

In addition, many of us face barriers to receiving the care we need simply because we are transgender. Finding trans-competent doctors especially outside of major metropolitan areas can be a challenge. Having to navigate the gender dysphoria that may arise from reproductive health visits with a discriminatory provider can lead many of us to simply avoid getting the care we need. According to the 2015 U.S. Trans Survey, 33% of trans people had a negative experience with a health care provider in the year prior. Even when we can access affirming care, insurance and health costs can create further barriers. For instance, last year, my insurance company rejected a claim to cover a pap smear I’d had because my identification documents list me as male. After several months of jumping through bureaucratic hoops, I was able to have the decision reversed, but this is not the case for many people.

Lastly, trans people in the U.S. and abroad continue to be subject to forced sterilization in order to have access to documents that reflect our gender. In as many as half of U.S. states, in order for a person to legally change their gender marker on their driver’s license, they must have undergone some type of surgery on their genitals or reproductive organs, which would functionally render them sterile. California, the District of Columbia, Iowa, New York City, New York State, Oregon, Vermont, and Washington are the only districts that have removed the surgical requirement for amending one’s birth certificate. For all other states that even allow a person to change their birth certificate, the surgical requirement remains.

 

4. Recognize That Sex Work Is Work

 

The 2015 U.S. Trans Survey reports that 12% of trans people have been involved in sex work at some point in their lifetimes. These numbers are significantly higher for Black (42%), Indigenous (28%), multiracial (27%), Latina (23%), and Asian (22%) trans women.  However, the Women’s March organizers fell short on the issue of sex workers’ rights, vacillating between supporting sex workers and treating all sex work as exploited labor. As trans activist Janet Mock so pointedly noted in her address to the D.C. Women’s March, collective liberation must include the “sex worker fighting to make her living safely.” Anti-sex work feminists need to understand that while this is a viable source of income, especially for trans people who face discrimination in finding employment, we must fight for sex workers to be able to do their work safely. For sex workers, being able to access affordable STI screenings, condoms and birth control, and even access to abortions is fundamental to the work. Sex work is a trans, feminist issue, and indeed, many of our fiercest and most crucial activist leaders past and present—such as Sylvia Rivera, Janet Mock, and Monica Jones—are or have been sex workers.

 

5. Familiarize Yourself with All of the Services Planned Parenthood Provides

One of the major concerns that the Women’s March addressed was the Trump administration’s threat to defund Planned Parenthood (PP). A lot of people tend to associate PP with abortion access, but PP provides a number of services, particularly to low-income folks. Over the past few years, PP has begun to offer services to trans people, including providing safe access to hormones, assisting with gender marker changes, and providing the letters of reference necessary for some trans-related surgeries. The defunding of PP could have particularly devastating effects for many trans people who have gotten the care they couldn’t find elsewhere, especially those outside of major metropolitan areas.  It is also important to note that these threats to defund PP are an issue of economic justice and health care access as well.  What the administration intends to do, in fact, is to restrict access to Planned Parenthood to those who are insured by public health care programs such as Medicaid and Title X. Eighty-seven percent of PP’s funding comes from Medicaid reimbursements for services rendered. Thus, the fight to keep PP up and running is also the fight to ensure that low-income people can continue to receive affordable, safe reproductive health care.

 

6. Remember That Trans People Can and Do Have Children

This is perhaps the most pertinent point where trans identity and reproductive justice intersect. It is important for us to not only concern ourselves with how trans people can have access to reproductive health services and abortion just like everyone else but also make sure that those trans people who do wish to have children, whether genetically linked or adopted, are able to do so without their children experiencing discrimination and violence because one or both of their parents is trans.

Ultimately, the movement for reproductive justice and the movement for trans justice are organized around the same basic principle: that all people deserve self-determination and bodily autonomy—the right to make choices about what we do with our own bodies. In shifting the paradigm from the single issue of cis women’s access to abortion to a movement for bodily autonomy that includes and centers trans people (especially trans women and especially trans women of color), we can center an intersectional movement that is able to address the root socioeconomic issues that prevent all of us from true reproductive justice as opposed to only addressing those issues that impact people with the most privilege.