Respect Equality

Yes, abortion bans affect transgender and nonbinary people, too

A closer look at the intersection of reproductive and gender-affirming health care.
Abortion rights advocates gather outside the Oklahoma Capitol on Tuesday, April 5, 2022, in Oklahoma City, to protest several anti-abortion bills being considered by the GOP-led Legislature. (Sean Murphy/Associated Press)

Story at a glance

  • Efforts to restrict access to abortions and gender-affirming care have gained considerable momentum in recent months. That’s not inconsequential, an expert says.

  • The connection between trans and nonbinary people and reproductive health care often gets overlooked because that community is so often “de-sexualized,” URGE policy director Courtney Roark, who identifies as nonbinary, told Changing America.

  • For trans and nonbinary, the stigma attached to getting an abortion can be twofold. They’re also likely to be misgendered by providers with little training in trans and nonbinary healthcare.

As the Supreme Court considers a case that could overturn or undercut precedent established in Roe v. Wade, which has protected the constitutional right to abortion for nearly five decades, anti-abortion activists and lawmakers are churning out some of the nation’s most restrictive abortion legislation in rapid succession.

Florida senators earlier this month passed a bill to ban abortion after 15 weeks of pregnancy, making no exception for rape, incest or human trafficking. Florida’s Republican Gov. Ron DeSantis is expected to sign the bill into law.

Shortly after, senators in Oklahoma passed two bans, one that would outlaw abortion after six weeks of pregnancy and another after just 30 days. Another near-total abortion ban in Oklahoma was sent to the governor’s desk on Tuesday.

On March 14, Idaho Gov. Brad Little (R) signed into law legislation outlawing abortion after six weeks of pregnancy, modeled after a restrictive Texas law which took effect last year. More than a dozen other states, including Oklahoma, are seeking to pass Texas-style abortion bans, according to The Washington Post.


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At the same time, more than a dozen states are working to restrict access to gender-affirming care for transgender and nonbinary people, mostly under the age of 19. Many of these bills refer to gender-affirming care — an umbrella term capturing medications like puberty blockers and hormone therapies as well as procedures like gender-affirming surgeries — using inflammatory language like “mutilation” and “sterilization.”

That these two movements are advancing in lockstep is not irrelevant — or coincidental — Courtney Roark, Alabama policy director for the group Unite for Reproductive & Gender Equity (URGE), told Changing America.

Transgender and nonbinary people tend to be de-humanized and “de-sexualized” in media, meaning the connection between reproductive and gender-affirming health care is often missed, said Roark, who identifies as nonbinary and prefers a gender-neutral pronoun.

“Transgender people have to access reproductive health care, and that’s something that a lot of people don’t understand,” they said. “The same people who need abortions are sometimes the same people who need access to gender-affirming care.”

For some, the two can be synonymous, and getting an abortion may be important in affirming their gender identity. Clinics that offer abortions, like Planned Parenthood, seem to have picked up on the fact that their patients are not always cisgender women, and many in recent years have also begun offering other gender-affirming services like hormone therapies.

“It improves the cultural competency when they understand these are not different groups of people,” Roark said.

For many cisgender women, getting an abortion is not only incredibly emotional, but also stigmatizing. Clinics that perform abortions are often flanked by protestors.

But for transgender and nonbinary people, the stigma is twofold.

“If you’re trans or nonbinary, you could be having to interact with not only transphobic anti-abortionists, but also trans-exclusionary radical feminists,” Roark said, using a term to describe feminists who deny transgender people their full humanity. “Your world of support gets smaller.”

Getting an abortion can also be a particularly emotional experience for transgender and nonbinary people because they are more than likely to be misgendered, as medical professionals who perform abortions are not typically versed in trans or nonbinary health care.

Correcting the mistake of abortion providers or clinic administrators means running the risk of being treated poorly by staff who are not accepting of your gender identity, Roark said, though people who are not cisgender “passing” have little other options. 

Legislation seeking to restrict both abortions and gender-affirming care is also largely drafted by special interest groups, who then give the bills to lawmakers to introduce in state legislatures across the country.

“A lot of the anti-abortion bills and anti-trans bills are just copy and pasted,” Roark said. “They’re being pushed in state legislatures by people who have interests in stopping health care from happening.”

At the national level, the organizations most involved in drafting legislation to restrict gender-affirming care are the conservative groups Alliance Defending Freedom (ADF) and the Heritage Foundation, according to the Human Rights Campaign during a recent media briefing.

“That’s why these bills look so similar across the country,” Cathryn Oakley, state legislative director and senior counsel at the HRC, said during the briefing, estimating that bills seeking to restrict access to gender-affirming care vary from one another by little more than 10 percent.

That also makes it incredibly simple to reintroduce legislation. In Alabama, Roark and their team are fighting a bill that would criminalize providing or recommending gender-affirming care to minors for the third year in a row.