During his televised town-hall, Democratic presidential nominee Joe Biden was asked what he would do to preserve the rights and protect LGBTQ+ Americans. He answered that there should be “zero discrimination” against transgender people, and he also recognized that “too many transgender women of color are being murdered.”
The issue of transgender rights has entered this national conversation, and to have a presidential nominee state outright that the lives of trans people matter is significant progress. However, it is also essential to recognize that violence against the trans community does not only take the form of overt transphobic statements and actions.
There is a history of violence and exclusion of non-binary and trans people in the healthcare system that have lead many of them to avoid receiving the necessary healthcare they need. These exclusionary concepts are still perpetuated today with the continued belief that only women can get pregnant. Non-binary, trans-masculine, and gender-nonconforming people could all potentially become pregnant and seek abortion care.
One study published this year focused on general healthcare avoidance in transgender populations. The data was taken from the 2015 U.S. Transgender Survey and found that “transgender men demonstrated increased odds of avoiding healthcare due to possible mistreatment,” even after controlling for covariates.
The paper also recognized that concealing one’s gender identity has been a form of survival for many transgender people while being perceived as gender-conforming is a privilege that results in lower healthcare avoidance. This data is clear in demonstrating that people who are transgender or perceived as gender non-conforming are at an increased risk of avoiding getting the proper healthcare they need due to institutional mistreatment and discrimination. This risk is even higher for transgender or gender non-conforming people of color.
Transgender stigma continues to be a barrier to accessing proper healthcare in general. Aside from stigma, finding reproductive healthcare, including access to safe abortions, is exceedingly limited for transgender and non-binary people. One study from 2017 acquired data from 1,069 facilities that provide abortion care outside of a hospital setting. Of those 1,069 clinics, 122 reported providing transgender-specific health services. Data from this study also suggests that only an estimated 23% of all nonhospital facilities providing abortion care in the United States provide transgender-specific care.
The literature on transgender healthcare access demonstrated that not only are transgender people at a higher risk of avoiding healthcare because of systemic mistreatment and discrimination, but access to transgender-specific abortion care is incredibly limited.
These figures combined clearly show a need to increase access to abortion care and expand access to inclusive care. Healthcare facilities that provide abortion care and general healthcare to transgender people should do self-assessments of their policies in place and make it a priority to practice an inclusive language with their patients. Healthcare professionals should also continually be learning terminology around different transgender identities and practicing proper pronoun usage.
Though the discourse around trans rights has entered a national light that can inform policies at the federal level, healthcare professionals, particularly reproductive health professionals, also have a responsibility to combat cis-heteronormativity in their practice.