A 2020 study estimated that between 462 and 530 Transgender, non-binary and gender expansive (TGE) individuals obtained abortions in 2017, and that only 23% of abortion clinics in the US provide transgender specific care.1
TGE people experience well documented barriers when accessing healthcare including discrimination, lack of knowledge and cultural competence among providers and other medical staff, financial barriers (ie. Lack of insurance) and socioeconomic barriers (ie. Transportation, housing etc.).2,3 These barriers also likely impact TGE people’s access to abortion care.4
Because of these significant barriers and the history of discrimination against TGE individuals by the healthcare system, it is crucial that clinics, providers and staff make every effort to be trans-inclusive in their practice. Dr. A.J. Lowik’s guide to trans-inclusive abortion care provides basic education about gender affirming language, tips for abortion clinics to promote trans-inclusivity and example scenarios of microaggressions stemming from healthcare situations that can be traumatizing to TGE people. We highly recommend that providers and staff read over the entire guide as this is a complicated process with lots of nuance, but we’ve summarized some key points below.
|mirror language that the patient uses (they may have different words that they use to refer to their body parts)||Make assumptions about your patient based on their appearance (always ask their pronouns, what terms they use to refer to their body etc.)|
|Use inclusive intake paperwork (ask for pronouns, gender identity and sex assigned at birth)||Apologize repeatedly or offer explanations if you use someone’s pronouns incorrectly, instead apologize briefly, correct your mistake and move on|
|Introduce yourself with your pronouns (either verbally or with a nametag)||Make assumptions about your patient’s sexual partners, it can be helpful to ask what body parts they have instead of what their gender is as they may be trans or non-binary|
Access Dr. Lowik’s manual here:
Lowik. A. (2019). Trans-Inclusive Abortion Care: A Manual for Operationalizing Trans-Inclusive Policies and Practices in an Abortion Setting, United States. FQPN, National Abortion Federation. Retrieved online from https://www.ajlowik.com/publications#/transinclusive-abortion
Also check out this fantastic video that Dr. Lowik made with tips about both trans-inclusive reproductive and abortion care.
1. Jones RK, Witwer E, Jerman J. Transgender abortion patients and the provision of transgender-specific care at non-hospital facilities that provide abortions. Contracept X. 2020;2:100019. doi:10.1016/j.conx.2020.100019
2. Safer JD, Coleman E, Feldman J, et al. Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes. Apr 2016;23(2):168-71. doi:10.1097/MED.0000000000000227
3. Bradford J, Reisner SL, Honnold JA, Xavier J. Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study. Am J Public Health. Oct 2013;103(10):1820-9. doi:10.2105/AJPH.2012.300796
4. Moseson H, Fix L, Gerdts C, et al. Abortion attempts without clinical supervision among transgender, nonbinary and gender-expansive people in the United States. BMJ Sex Reprod Health. Jan 2022;48(e1):e22-e30. doi:10.1136/bmjsrh-2020-200966