It’s Not Just Women: How the Reproductive Health Movement Fails Trans People And How it Can be Better

by Danny Paulk

“In all of these conversations, what always gets erased is the patient.” Not woman, but patient. AJ Haynes, an employee at Hope Medical Women’s Center, said this when I first met her, and it really stuck with me. And she was right. We live in an age of highly politicized reproductive healthcare, increasingly limited access to safe abortion, and amidst fears that the Trump administration may try to overturn legal protections like Roe v. Wade entirely. The patient and questions of their individual liberty exist at the center of it all. In the conversation around reproductive health, the most forgotten patients–patients whose very identities are as stigmatized as the care they seek–have the strongest potential energy to uplift everyone affected. Instead, these individuals occupy the paradoxical position of being both centralized and marginalized. So what of the forgotten plaintiffs of the fight for abortion care? Not just women of color, LGBT+ women, and poor women, but patients who aren’t women at all?

What about the men and nonbinary people who need abortions?

Transgender people’s access to abortion is limited perhaps even more severely than cisgender women’s access to abortion. Transgender men and many nonbinary (nonbinary meaning existing outside of the gender binary of man and woman) people, who are also not women, can still experience the need for an abortion just as cisgender women do. Though there is little research into the relationship between transgender people and abortion, the number of trans people it affects is not insignificant; it is a potential issue for any person with the ability to get pregnant. Journalists Isabelle Kohn and Calvin Kusulke write, “…inadequate research, small sample sizes and a general lack of understanding about trans people in both academia and medicine makes it difficult to know exactly how often trans pregnancies result in abortion. Preliminary data from a 2018 study of 450 trans men and gender non-conforming individuals seems to suggest that of the six percent who experienced an unplanned pregnancy, 32 percent opted to terminate it…” The assumption of abortion as purely being a “woman’s issue” is problematic by itself in the sheer number of people that it potentially excludes (and incorrectly includes, in the case of trans women), but it also means that some of the most vulnerable people seeking abortions are some of the least acknowledged or protected. 

Like death by a thousand cuts, ever more restrictive anti-choice laws slowly chip away at abortion clinics by aiming to make the operation of these clinics legally and economically impossible. The Hope Medical Group for Women in Shreveport, Louisiana is a rare survivor, but that survival has been hard-won and hard-kept. A recent study revealed that Louisiana has passed 89 anti-abortion restrictions since Roe v. Wade in 1973, the most of any other state.  Just this past October, the Supreme Court agreed to hear Hope Medical’s case against a Louisiana law that would require abortion doctors to have admitting privileges at local hospitals–a difficult-to-obtain qualification that could potentially close the only other two abortion clinics in the state.  Elizabeth Nash, senior state issues manager at pro-choice organization Guttmacher Institute, says of Louisiana’s anti-abortion laws, “The history of Louisiana’s abortion restrictions are in fact a history of attempts to ban abortion, it’s not about giving care to patients. What we’re trying to say is that the legislature’s intent has been to regulate abortion out of existence. That’s been the pattern.”

 None of this history is visible from the outside. The clinic  sits at the bottom of a hill beneath a college, short and stout like a fortress braced against the wind. The building is utterly unremarkable, as if camouflaging itself from the anti-choice protestors who occasionally litter the public sidewalk. The only thing significant about the property itself is a statue of a stag, which looks regal despite one broken antler, standing tall in a metal diamond atop a pole.

Its sign faces oncoming traffic in front of the building: Hope Medical Group for Women. With the soft colors and Venus symbol on the sign inviting women in, one might wonder if the language of it doesn’t exclude others who are not women. Though, in the clinic’s defense, there has certainly been no lack of trying to make not only reproductive, but also other kinds of care, available to trans people. It also bears mentioning that the exclusion of trans people is a problem not only in the reproductive rights movement, but in the broader feminist movement as well.

The mainstream feminist movement has a history of excluding trans people, either by ignorance or intention. An extremist subset of feminists known as trans-exclusionary radical feminists or TERFs, for example, equates biological sex with gender and thus believes that transgender women are predatory men encroaching on women’s spaces, and that trans men are confused women brainwashed by patriarchy into denouncing their womanhood. Though TERFs (short for “trans-exclusionary radical feminists,” or cis feminists who do not consider trans women to be “real” women) are in the minority, the entire popular feminist movement is guilty of these same assumptions (being that woman = person with a vagina) in some form or another. 

In January 2017, thousands flooded the streets of Washington, D.C. and hundreds of cities worldwide for the now annual Women’s March wearing pink “pussy hats” and carrying picket signs laden with vulvas, uteruses, and clitori. Magdelana Smith writes for Medium, “In this simple equation between womanhood and possessing a vagina, Women’s March feminism showed its hand…A woman has a vagina; therefore, a person without a vagina is by definition not a woman and a person with a vagina can be nothing other than a woman. This is the Pussyhat equation.” After the 2017 Womens March, a trans comic artist named Sophie Labelle tweeted a comic about her experience there with the caption, “It took a lot of courage to be a woman and trans yesterday at the #WomensMarch. #Feminism can do better. #transgender.” The comic depicts herself, decked out in the obligatory pussy hat surrounded by signs with similar anatomical references, holding her own sign which reads, “Girlhood and womanhood aren’t defined by genitalia.” Though this is less an individual failing on these women’s parts and more a symptom of a system that actively encourages the exclusion of trans people, the hard fact remains: wherever messages like these exist, regardless of intent, any trans people listening cannot help but hear, “You are not safe with me.”

I’ve spent four semesters now driving past this clinic, as I attend the college at the top of that hill. The clinic rests practically in my backyard, and yet was about as far removed from my own experiences as it could be. Saturday after Saturday, I watched protestors gather on the public sidewalks with signs bearing slogans which  ranged from ostensibly well-meaning to aggressive to cruel.

When I actually visited the Hope Medical Center for Women, I can’t deny I felt intimidated. The building is made of dull brown brick and has an almost municipal aura to it, like a post office or even a police station. Vines and flowers cover the outside, including the brown privacy fence which brackets the front driveway. The combination of barrier and invitation felt like a war-weary protector, putting on a smile for her charges. I was grateful the protestors weren’t there the day I visited. In their hands, teddy bears and baby blankets became violent tools of guilt and shame. I felt like an interloper coming to the Clinic; part of me anxiously wondered if I wasn’t somehow like all of the pro-life bullies who walked around with signs reading “They kill babies here!” Though I had come here to hear an argument in favor of accessible abortion, and not against it, was I not also here to make some sort of judgement about a story that had never been my own? Even the front door of Hope, which was heavy and windowless, felt discouraging. Still, an effort had been made to maintain some levity with a humorous sign posted on its face, reading, “Please do not feed (or talk to) the protestors!” 

 Inside the clinic, employee AJ Haynes brought me to one of the counseling rooms–the state of Louisiana requires a pregnant person to receive in-person counseling at least 24 hours prior to the procedure, with the intention of discouraging them from following through–and sat down with me. She was short, with a friendly face and was bright and enthusiastic. Her personality felt almost too big for the small and dimly lit space; however, rather than feeling contradictory to the clinic atmosphere, the combination of AJ’s attitude and the clinic’s enclosed spaces just made the whole place feel warm and safe.

She didn’t mince words: “Those people outside–I don’t even like to call them protesters, because they’re not, really. They’re bullies. Their words are nonsense, so if you write a paper based on what they say, your paper is gonna be nonsense, too.” She then asked me, “What about this topic is important to you, personally?” As soon as she asked it directly, I realized the answer had been there all along. Every time I read Hope’s name or listened to almost any conversation about reproductive health at all, there was an assumption, as natural as breathing, that abortions were something that women specifically needed, to the exclusion of all others. As a trans person it had never sat right with me that trans people were so often left out of the conversation. AJ herself, at the beginning of our talk, had opened with, “What always gets erased in these conversations are the women–or the patients, actually–that actually receive abortions.” The fact that trans people faced even more limited access to abortion care than cisgender women is a conversation that anyone advocating for reproductive health should have a stake in. 

According to the documentary Reversing Roe, abortion rights in America first became a prominent conversation in the 1960s, when abortion was still largely illegal depending on state law. Young women were forced to find doctors–or, failing that, anyone–willing to perform an illegal abortion; those unlucky enough to not have connections were forced to either carry their pregnancies to term or attempted to terminate their pregnancies themselves, originating the the term “coat hanger abortion,” a reference to dangerous self-induced abortions via means such as coat hangers, knitting needles, or the swallowing of toxic chemicals. In 1965, 17% of all deaths attributed to pregnancy and childbirth were because of illegal abortions. The Center for Disease Control and Prevention also estimates that in 1972, the year before supreme court case Roe v. Wade legalized abortion nationwide, 130,000 women sought illegal or self-induced abortions, and 39 of those women died.  

In the 1960s, feminism was in its second wave, which focused on patriarchy as a systematic issue and on the differences that set women apart from men and made them unique. Second wave feminism has been heavily criticized by contemporary third-wave feminism, which recognizes the differences between men and women as not innate but learned, and considers intersectionality, or the way that women of color’s oppression differs from that of white women because of the intersection of race and gender. Though transgender people certainly existed in the 60s, their experiences were even more marginal than today, and major LGBT liberation landmarks like the Stonewall Riots, which brought national attention to a growing LGBT rights movement, wouldn’t happen until 1969. Thus, abortion become a galvanizing feminist issue that spoke not only to the literal concern about safe, legal access to abortion, but also of the fight for women’s autonomy generally. It didn’t become the highly politicized, bipartisan issue it is today until moral panic connected to the AIDS crisis in the 1980s caused Republican candidates to ally with so-called “pro-life” evangelicals. Ronald Reagan, who had formely voted in favor of freer abortion access in 1967, publicly denounced abortion (along with anything else that threatened white nuclear family values) and soared in the polls. 

Without a doubt, the staunch opposition to abortion is, aside from the supposed religious objection, an attack on cisgender women’s sexuality and right to their own bodies. However, even though the pro-life movement has its roots in misogynist sentiment, pro-life legislation and rhetoric affects every person who might ever want an abortion, and even those who don’t. Transgender women, who are not directly affected by access to abortion, are harmed by the narrative that abortion is a strictly women’s issue because it excludes them from womanhood. 

As S.E. Smith writes for Rewire.News, “Most people who will need abortions are cis women, and the long history of opposition to abortion has been deeply intertwined with sexism and misogyny. It is critical to recognize that cis women are the target here…the second critical truth is that women are not the only people who need abortions: People across the gender spectrum receive abortion care…That they are unintended victims of the war on women does not negate the fact that they, too, are fighting for their lives and autonomy.”

The burden often falls to trans people to be their own advocates, not only in their individual interactions with physicians, but in the broader discourse around abortion as well. Jack Qu’emi Gutiérrez, a nonbinary pro-choice advocate, approaches this issue through We Testify, an organization dedicated to normalizing and providing safe access to abortion by inviting people to share their stories. Jack uses gender neutral pronouns and titles. 

I interviewed Jack myself via email, and their personality was shiny and infectious; their words were a riot of language and color that bubbled out past the boundaries of the written word so that I felt like they were sitting right in front of me, talking with their hands and wielding a wickedly sharp humor and wit. All of their spoken slang and noise was transcribed faithfully to text; they type how they talk, with words like “tryna” and using CAPS lock for emphasis. My first question was a generalized, “Tell me about yourself!” Jack responded, “Currently, I’m a store manager at an erotic boutique in West Hollywood. It’s a fancy way of saying I sell dicks for a living.” They also like going out to bars and playing with their cats. “I’m just out here tryna live my best queer life.”

Jack’s work in the reproductive health movement is extensive. In their entry on the We Testify website, they write, “I had a medicinal abortion when I was 20. I was a poor undergraduate student in a crumbling relationship with poor mental health. Making the decision to have an abortion wasn’t difficult, but accessing it was.”

Jack goes on to further describe how gender dysphoria and the constant misgendering impacted their abortion experience. Gender dysphoria typically refers to the emotional distress caused by the difference in a person’s gender identity and their sex assigned at birth, but it can also exist in a social context, when there are differences between a person’s gender identity and the social expectations of gender held by the people around them. “It wasn’t just the physical and logistical aspects of having a medicinal procedure, but the emotional labor of navigating a space where I was constantly misgendered. Misgendering a trans person is an act of violence; to be repeatedly called by the wrong pronouns was almost as draining as the procedure itself. Around that same time, Florida passed legislation that required an individual to have a trans-vaginal ultrasound before undergoing their abortion. Experiencing that only set off far too many feelings of dysphoria, violation, and shame.” Misgendering, or the act of calling someone by pronouns or other gendered terms that do not align with their gender identity, is an explicit denial of that person’s understanding of themselves; essentially, to misgender someone is to suppose that you understand their gender identity better than they do. 

When I asked Jack if the staff at their clinic had been educated about transgender healthcare, they responded, “Phhhffft NOPE.” After their abortion, Jack started working more directly with clinics to improve their inclusivity, a process that wasn’t without a price for them: “I [held] meeting after meeting trying to justify why my existence as a trans person was just as valid as any cis person going to use their services.”

Jack’s work in the reproductive movement has included sharing their story, holding competency training with clinics, attending conferences, and writing articles about how clinics can be better allies to their trans patients. In our interview, they write, “It feels obvious to me that people of varying gender identities need access to reproductive healthcare, so why aren’t clinics doing what they need to ensure their safety and security?…Like, I’m accessing your facilities for healthcare! Why am I spending 80% of my appointment teaching you how to speak to me and how to respect me?” 

Trans people as the de facto educators for their health care providers is unfortunately a common phenomenon, even within spaces that might be expected to know better. Aiden, another person I interviewed, described similar hurdles with what he describes as “trans competence,” in many of his experiences with healthcare professionals. Aiden grew up in Louisiana before going to graduate school in Massachusetts. He did most of the field work for his thesis in Atlanta, Georgia, which is also where, in 2018, he got an abortion. 

Over the phone, his voice is sweet and calm; he laughs often, especially when our conversation gets tense; birds chirp in the background as he moves out onto his porch. When asked about how he might label his gender, Aiden laughs. “I identify as a feminine masculine person…who was assigned female at birth but struggles with masculinity. [laughs] Even though I am masculine, and read as such. Like, in society I’m read as a man. Like I have a beard and everything.”

Though he speaks with levity and the steady confidence of an expert now, his experience in the reproductive healthcare system was one of alienation and insecurity. “I’m laughing but I’m not really laughing…When I walked in, it was like I was a freak of nature. They couldn’t even conceptualize that someone could look like me and be able to be pregnant.” 

When he found out he was pregnant in 2018, Aiden says he was deeply afraid of what would happen, in part because of his past experiences with healthcare professionals; the endocrinologist he started hormones with, while accepting, had a very limited view of what transgender identity and transition should look like. For Aiden, this binary view of gender and transition meant he was expected to get a hysterectomy at six years into his transition, “So I sort of bought into that system, played that system, in order to get my hormones…It felt like if you wanted to be trans, if you want to be a guy, you have to get rid of your ability to get pregnant.” In many of his other experiences, his body had been treated as a sort of anomaly; one doctor, in the course of administering a Pap smear, made comments like, “This is weird, performing this on someone who looks like you.” His experience with abortion care was much the same, now with the added complications surrounding an already stigmatized procedure. 

Aiden knew about the clinic where he received his abortion beforehand, from his dissertation work. “I knew that they were trying to be trans competent, even if they got a lot wrong, so that’s where I went for everything.” But even before he was there as a patient, Aiden describes strange looks he would get from people at the clinic whenever he was there to conduct interviews. “I would go in and they would be like, ‘why is this guy here?’” On his first visit to the clinic as a patient, he was asked who he was there waiting for. 

Much like Hope Medical in Shreveport, the Feminist Health Center performs abortions on Saturdays, and so these are the days that protestors show up out front. The center employs a security guard and volunteers to ensure the safety of patients, but, having been on testosterone for six years at this point, Aiden was looked at more as a potential threat than a potential patient. “They try to maintain a level of safety for their other patients, and since at that time I was already ‘looking like a guy,’ with a full beard and everything, when I came in they had to send someone out with a badge, and they put me in through the back.” 

From start to finish, Aiden’s status as trans was treated by the clinicians as a stumbling block. “It was a shit show…[laughs] It was a shit show.” The intake forms were more geared towards nonbinary people (and not well-handled even then) and Aiden faced many microagressions in the way the clinicians treated him. “They didn’t even know what to do with me, a lot of times, and it was like…like people apologized over what was said and done, but once again I kind of felt like I was an experiment for other people. And that’s hard.” The hardest part, though, was that the clinic he went to actually has a fund to prevent specifically this issue; after the death of Robert Eads, a trans man who died of ovarian cancer after doctors in Georgia refused to treat him, money was donated to the Feminist Health Center to establish the Trans Health Initiative in his honor. Though the Trans Health Initiative does provide hormone replacement therapy (HRT) and other services to transmasculine individuals, there is clearly still a gap between the goal and the reality for trans patients like Aiden. Being honest about this gap is one of the things Aiden thinks clinics could be doing for trans patients.

“Transparency, but not confession. What I mean by this is, I chose that clinic because I thought it was going to be more trans-friendly than it was. So it kind of advertised itself as something that was more trans friendly than it was, in my experience, so that was disappointing. So if they had been just a little bit more honest, I think I would’ve had a better experience.” He mentions also the way that cis people in these situations will often confess their transphobia to him out of guilt, looking for absolution. “I think there’s a way to let patients know that you might be the first person they’re doing in a situation, and also to consider how that might make someone feel, when they’re about to have a procedure done.” 

Overall, Aiden felt more like an object to be studied than a person seeking care. The intense focus on intake forms and terminology got in the way of basic empathy, and open-ended intake forms are one of his suggestions for how clinics can better themselves for trans patients. “I’ve seen clinics get in the trap of like, trying to list every identity instead of just asking an open ended question, ‘what is your gender?’” The clinic he visited also employed a cis person in the position of “Trans Liason” for which Aiden felt a trans person might have been more naturally suited; as for cis employees, he felt there could’ve been better cultural competency training. When he suggested a more open-ended gender question on the clinic’s intake forms, they told him that they were afraid of alienating cis women, and while Aiden agreed that cis women’s safety is important, he also doesn’t feel that making spaces safe for trans people as well threatens that safety. 

So what holds clinics back from seemingly obvious solutions to these problems, starting with a basic education? I met with Merritt Rebouché, the Director of Options Counseling and Patient Advocacy at Hope Medical. In person, they’re small, with glasses, dark hair, and an air of steadfast calm and reliability. They packed with them a large white folder full of resources for me, along with their shoulder bag, modeled to look like the butt of a pair of jeans with a lucky horseshoe keychain dangling from a zipper. We sat on benches at the top of the amphitheatre. There was an art exhibit on campus: life-size metal statues of humans that came in pairs of silver and bronze. There were four total in the amphitheatre seats, and two on our row that faced each other at opposite ends. The statues echoed our conversation; they were two halves of the same coin, trying to bridge a gap. 

Merritt told me in our interview that while Hope was still in its “baby steps” as far as true accessability for trans people, they do offer abortion services to anyone who needs them, and they’re working to make that as affirming an experience as possible. They have started the process with simple things like including a place on their sign-in forms for patients to indicate their pronouns. 

When I asked them what they thought the biggest barrier to providing accessible abortion care was, they told me, “I think, in Louisiana, the biggest barrier right now is, just, we’re already having to work so hard just to stay afloat. Like, just this week there’s some legislation being pushed through that forces us to share basically identifying information about our physicians with every single patient in writing, which is not great. And not, it’s already hard for us to find additional physicians, so that’s something, that it’s already hard to find physicians willing to do this and that’s another added layer that kind of scares physicians away.” Back in 2009, an abortion doctor named George Tiller was murdered by a pro-life extremist. It’s easy to understand why legislation like this might make doctors wary. 

 As any trans person might tell you, finding trans friendly doctors even for general medical concerns can be difficult, especially in the South. In 2009, a survey by Lamba Legal found that 70% of the transgender and/or gender non-conforming people surveyed had experienced some form of discrimination in a healthcare setting; the 2015 U.S. Transgender Survey also found that a third of those surveyed who had seen a healthcare provider in the past year had had a negative experience, and 23% didn’t seek healthcare at all for fear of discrimination. Add that to the fact that doctors who perform abortions are already an extremely limited pool, that Hope is a clinic in the Deep South, that all of the physicians employed by Hope are part-time with other primary jobs, and the potential difficulties of educating doctors on how to remain conscious of trans-specific issues like genital dysphoria quickly becomes apparent. 

The fact that independent clinics like Hope have owners and administrators adds another layer of complications. Merritt explains that “…getting buy-in from administrators and from owners, helping them to understand that providing gender affirming care isn’t just like a bonus thing that we could be doing, it’s something aligns with our values and that we should be doing, and it’s also something that is needed in our communities, and I just think I’ve seen a lot of trans nonbinary friends really struggle to find health care in this area, and I think that’s so similar to the struggle that people deal with seeking abortion care. And it would be really nice if we could have a place where you could just get any reproductive health care that you need.” So at least in the case of Hope Medical, it’s less that trans healthcare is generally an afterthought, and more that all of the outside factors that already make providing abortion care hard are compounded when you consider intersections of identity. Trans healthcare isn’t the only potential service falling by the wayside amidst oppressive legislation: Hope also wants to provide STD testing and IUD implantation, but Medicaid restrictions mean that none of their clientele–mostly poor people of color from the adjacent Highland area–would be able to afford it.  

While no one is making excuses for abortion clinics who lack accessibility, in the case of independent clinics like Hope, they are already fighting with both arms behind their back. As Merritt puts it themself, “I don’t want to paint abortion clinics in a bad light or say they’re not caring or they’re not open to the whole community or they’re, like, TERFs, but there are definitely some old ideas about what it means to be a feminist and what it means to just be like an advocate for reproductive health in your community.” 

Efforts are also being made to improve things in the infrastructural layer of abortion access. Courtney Roark, an employee with Unite for Redproductive & Gender Equality (URGE), did their second year capstone project in their Masters degree with Northwest Abortion Access Fund (NWAAF) with the stated goal of finding how best the fund could provide support to trans, nonbinary, and gender non-conforming people. “I knew I wanted to work with NWAAF because I think the structure of abortion funds is really radical. They are literally these community-based networks who have stepped in and said, ‘Okay, the healthcare system and the government are not taking care of us? We’ll take care of each other then.’” Courtney, who is queer and trans themself, was most interested in working with NWAAF in this particular area. 

Courtney began their project with a literature review wherein they found that there were no research studies focused on trans and nonbinary people accessing abortion care. As Merritt mentioned, this is one consequence of existing at the intersection of stigmatized care and stigmatized identity. “I also did interviews with NWAAF’s board members and some volunteers as well as conducted a survey with NWAAF volunteers and reviewed their volunteer training materials and other materials about their organizational values. Simultaneously, I talked with reproductive health organizations that served TGNC [trans & gender non-conforming] folks, abortion providers, and TGNC folks themselves who had had abortion experiences and some who hadn’t. I compiled and analyzed all of this data to provide recommendations for NWAAF to adjust some of their practices.” 

Courtney’s recommendations to the fund were broken down into these five top-line recommendations: 

1. Being explicit about the value of providing gender-affirming support for clients, communicating this value internally to board members, staff, and volunteers, and externally to clients and partners.  

2. Working to improve the clinic environment by leveraging clinic relationships and providing clinic escort support.  

3. Intentionally recruiting TGNC volunteers, board members, and staff.  

4. Improving volunteer competency through increased support and training.  

5. Updating client intake forms and processes to be more gender-affirming. 

Courtney’s recommendations echo those of Jack and Aiden, though Courtney also reminds me that their project was not to improve clinic settings for trans people directly but rather to improve the abortion fund’s ability to support trans people. However, the similarities between recommendations (even across different types of healthcare infrastructure) show the broad applicability of even simple practices like hiring trans people and updating intake forms.  

So where do we go from here? There is a light at the end of the tunnel. Merritt told me in our interview, “That’s one of the things that was amazing about going to the Abortion Care Network conference that was in Las Vegas this year in March. Almost every person I spoke to either was already providing gender affirming services, or it was something they were thinking about and trying to learn more about, and it’s something I have been thinking about for a while but wasn’t really sure how to put into place, or how to advocate for, and I feel like speaking with those people… I was able to sort of get the tools for how to continue to advocate for those things.” Gender affirming services refers to services that would aid a transgender person in their medical transition, such as hormones or surgery. Merritt was happy to see the community working together towards a common end. “It’s sort of refreshing to see trans and nonbinary folk put at the center of this reproductive health movement, and people overall being really accepting of the fact, like, we have to work together or we’re all going to lose, we can’t just say ‘I’m going to work on abortion rights and I’m going to push for these things, but I don’t care about my trans neighbors or my genderqueer neighbors.’” 

Jack also briefly mentioned this shift, writing, “I will say I am seeing a lot of clinics begin to offer HRT and help with accessing gender affirming surgery which is amazing. I want to see other trans people running those programs.” In their suggestions for how abortion clinics can be more inclusive for trans people, Jack wrote, “Hire transgender people in your clinics to work with your transgender patients. We know ourselves better than cis people do. Quit naming your programs, clinics, groups, campaigns, etc. ‘Women’s this’ and ‘Female that’ and ‘Lady Bits Blah’ because trans people are going to look at that and immediately think we aren’t welcome into those spaces.” They also directed me to an article they wrote for Rewire News, “Six Ways to Meet the Needs of Trans and Gender Non-Conforming Patients,” which includes other directives like checking intake forms, thinking critically about the way we talk about bodies and barrier methods, offering resources, and recognizing the intersection between the fight for reproductive health and the fight for trans rights. 

All in all, it’s clear that the reproductive health movement, and the feminist movement as a whole, has a long way to go in terms of defeating cissexism and broadening its inclusivity. However, for clinics like Hope and many others, that first step has already been taken, and enthusiastically at that. When trans people don’t have to fight transphobia from within our own movements, it becomes that much easier to share our stories and create a united front–one that uplifts and fights for the rights of everyone, starting with our most vulnerable members. Though the word “Women’s” on the Hope Medical sign still looms over me every time I pass by, I can’t help but also look at the stag statue and think that it stares toward the horizon.


Danny Paulk will be a senior at Centenary College of Louisiana and is a French & English double major.

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