Queering SRHR: The need for a trans-specific focus within SRHR
Editor’s note: to mark pride month, Inspire has launched a series of articles called “Queering SRHR” with the goal to dive a little deeper in the various specific ways that SRHR relates to LGBTIQ people.
On the occasion of the upcoming Pride Month, the Inspire Team has launched a three-week series called “Queering SRHR” in the hope of raising awareness on current sexual and reproductive health and rights’ struggles, goals and achievements related to intersex, queer, gay, lesbian, bi and trans people. With this series, the goal is also to challenge the binary and heteronormative narratives around sexual and reproductive health and rights, and to encourage colleagues, partners and others to make SRHR discussions all-inclusive.
This is the fourth article of the “Queering SRHR” series. Here, you can read our previous articles:
“Queering SRHR: LGBTIQ Families” click here
“Queering SRHR: Homo-Bi-Trans-Phobia No More” click here
“Queering SRHR: De-pathologizing Trans-people: WHO removes transgender as mental disorder from the ICD” click here
“Queering SRHR": The need for a trans-specific focus within SRHR
The 72nd World Health Assembly (WHA), taking place from 20 – 28 May 2019 marked a historical moment for human rights, LGBTIQ rights and, in particular for the trans and gender diverse people as a whole. During this Assembly, the WHO officially adopted the 11th revision of the International Classification of Diseases (ICD-11), in which trans-identities were taken out of the list of mental disorders.
As we explained in the previous Queering SRHR article, WHO’s move to de-pathologize trans people should play a decisive role in future national and international implementation of trans rights. However, looking at the current state of trans people’s access to rights across the world, it is clear that there is a great amount of work to be done in order for trans and gender diverse people to truly enjoy the same fundamental human rights as their cisgender counterparts.
In this article discuss ways to be more inclusive of trans and gender diverse persons in SRHR work.
The need for a trans-specific focus within SRHR
Historically, human reproduction, reproductive health and reproductive practices have focused on cissexism. In its recent publication, “Gender Identity and Reproductive Autonomy”, GATE (Global Action for Trans* Equality), emphasises that the reproductive practices of transgender and gender queer people are almost invisible both in transgender studies and in reproductive health studies. “ According to GATE, reproductive health studies have “mainly focused on whether or not trans people should be offered assisted reproduction services and/or fertility preservation before starting medical transition. Also, in the context of discussions regarding procreative liberty, trans individuals have until recently been neglected in such discourse.”
Earlier this month, Alabama’s decision to impose the strictest US abortion ban (including in case of rape or incest), revived a global debate on abortion. One of the flaws attached to this discussion is that trans and non-binary people continue to be excluded from the conversation.
While giving a graduation speech at Pitzer College, actress Laverne Cox pointed out that framing the right to abortion as a (cis)-women’s rights issue, automatically erases trans men from the discussion. This particular case shows that there is an urgent need to go beyond a cisnormative binary understanding of SRHR. Only by conducting more research on trans reproductive health and taking into account the lived experiences of trans men, women and gender diverse people, the SRHR field can be truly inclusive.
When individuals, communities and advocates exclude trans men and women from conversations around pregnancy, abortion, contraception etc., they inevitably make reproductive health yet another obstacle that trans-people have to overcome.
Naomhán O’Connor, Communications Officer at GATE (Global Action for Trans* Equality) points out that stigma against trans men, coupled with misinformation and institutionalised transphobia, makes attaining safe and adequate health care incredibly difficult:
“In most social settings trans people are forced to conform to binary gender ‘norms’ that deny us the right to pursue, or express our desire for, genetic parenthood. This includes trans men/trans masculine people becoming pregnant, and trans women/trans feminine people impregnating another person.With regards to the right to not have a child, unwanted pregnancies can affect trans men and trans masculine people in a similar way to how it can affect ciswomen. However, in addition to issues with accessing abortion and accessing consented sterilization, trans people who become pregnant can face further difficulties.(...)”
The historical institutional psycho-pathologization of trans and gender diverse people combined with a general lack of focus and information about trans and gender diverse people from the SRHR community, have also resulted in little-to-no funding for research that focuses on the sexual and reproductive health of trans people.In the meantime, the small research data that is available, points out that there is an urgent need for a SRHR focus on trans and gender diverse people’s health and rights.
The Need for increased research & Information Sharing
According to the research available, trans men are reported to avoid getting pap smear tests, which could account for the higher instances of cervical cancer identified in trans male populations. In addition to this, trans men and AFAB (assigned female at birth) nonbinary people can still develop breast cancer even after top surgery and/or while taking testosterone. It is essential to note that the current research about trans men and breast cancer, is only based on case-to-case reports. There is a lack of data available around the frequency of breast cancer amongst trans men.
Another reproductive health concern is caused by both a lack of and spread of misinformation on the necessity of birth control for trans men when on hormone replacement therapy (HRT). Transmasculine persons, who can get pregnant, should be offered similar contraceptive methods as their cis female counterparts. Testosterone is not a form of birth control. Because transmasculine persons can become pregnant even while on testosterone (a teratogen), it is important for medical professionals to make sure that their patients are accurately informed on their contraceptive options. Since there are no contraindications to concomitant use of oestrogen/progesterone with testosterone, it is important to inform transmasculine persons that they can indeed make a safe use of hormonal contraceptives.
These are just some of many reproductive and sexual health concerns of trans men, women and non-binary people. In order to make SRHR inclusive of trans people, advocates, policy makers and researchers should jointly collaborate in social, cultural, legal and political settings in order to break local, national and global barriers.
We would like partners and allies in the SRHR community to take these issues on board, and to fight for all, let’s together work on queering SRHR, to make it as inclusive as possible and to go beyond the binaries.
Together let’s work on Queering SRHR!
- American College of Obstetricians and Gynecologists. Ask an ob-gyn. Contraception for Transmasculine Parents. 2019. Link.
- Hello Clue. What trans men and nonbinary people need to know about breast cancer. March 2019. Link.
- Hello Flo.Why Trans And Non-Binary People Must Be Included In The Abortion Conversation.February 2018. Link.
- Lamm, Eleonora. Gender identity and reproductive autonomy. Deconstructing sex, gender and roles. GATE. 2019. Link.
- Sexual and Reproductive Health Matters Journal. Framing Reproductive Justice in the Context of Institutionalised Transphobia globally. May 2019. Link.
- Sexual and Reproductive Health Matters. “In transition: ensuring the sexual and reproductive health and rights of transgender populations.” A roundtable discussion. August 2018. Link.
- The Huffington Post. Laverne Cox Wants To Stop The Erasure Of Trans Men In Abortion Conversations. May 2019. Link.
- Trans-Inclusive Abortion Services: A Manual For Providers on Operationalizing Trans-Inclusive Policies and Practices in an Abortion Setting. June 2018. Link
- Vice. For Trans Men Reproductive Health is Yet another Obstacle.2016.Link.