Trans, Nonbinary People Say They Feel Excluded From Abortion Fight

(CNN) -- Mikiko Galpin still feels the impact of being sexually assaulted by someone he thought he could trust -- and the tough decisions he was forced to make after multiple pregnancy scares.

When Roe v. Wade was overturned in June, it was a sad and heavy moment for the 29-year-old transgender man. He was taken back to the first time he took a pregnancy test prior to transitioning. He recalls crying in the passenger seat of a friend's car at 2 a.m. trying to search for a pharmacy that was still open so he could buy a pregnancy test.

At the time, Galpin said he felt trapped and didn't know where to turn while navigating the complexities of a pregnancy scare resulting from a traumatic experience. An anxious Galpin feared the potential of upending his life to care for a baby at a young age.

"I just wanted to get a pregnancy test and know if I was pregnant at that point, and just feeling that complete sense of having no control over this really big part of your life," Galpin said. "I think when the decision came down, I had that same feeling of not having control over this very momentous and personal thing that myself and other people who have reproductive abilities are going to go through in the coming months and years."

Although Galpin turned out not to be pregnant, those fears about who gets to decide his reproductive rights still linger.

Amid discourse surrounding women's rights and bodily autonomy in the two months since the federal reversal of the right to an abortion, Galpin and other transgender and nonbinary advocates say their communities are often excluded from conversations about abortion care and other forms of reproductive healthcare.

With the reversal, many people across various states are navigating a series of new and intensified abortion restrictions. Yet transgender and nonbinary advocates say the difficulties their communities face in accessing abortion care are magnified.

Transgender and nonbinary people face unique barriers to abortion and reproductive care related to transphobia, including being refused medical care, being misgendered by medical providers and staff and an overall lack of knowledge among healthcare providers about transgender bodies and health, according to a 2021 study published in the journal BMJ Sexual & Reproductive Health.

Transgender people experience higher levels of poverty and unemployment relative to cisgender people, according to a study of 2014 data published in the American Journal of Public Health, and these factors have been linked to lower rates of health insurance, according to a 2011 study by the Institute of Medicine.

These barriers are further exacerbated for transgender and nonbinary people of color and low-income transgender and nonbinary individuals, advocates say.

"Often, there's not the understanding that trans men are men and that nonbinary people are nonbinary people, and the needs of both of those categories and folks who are capable of pregnancy are often overlooked," said Mickaela Bradford, the interim co-director of programs and policy at the Transgender Law Center. "So even before Roe v. Wade was overturned, folks were struggling to find reproductive care that was affirming of their gender identities, struggling to find accessible, affordable, safe reproductive care -- particularly folks who are Black, disabled, working class and living in the South."

For many transgender and nonbinary people, the reversal in June was yet another attack on their bodily autonomy amid a record year of state bills seeking to curtail LGBTQ rights, most of which target transgender and nonbinary people.

Bradford said as more transgender and nonbinary people seeking to terminate their pregnancies may need to travel to access abortion services, cost barriers and other difficulties may make these services even more inaccessible.

"You talk to any transgender person that has to travel across states, we are doubly prepared for stares, for violence, for looking for all of our escape exits at all times," Bradford said. "There's a heightened level of violence in this country against transgender people in all settings and so [the overturning of Roe] just exacerbates that."

The 2021 study also found that nearly one in five transgender and nonbinary respondents who was ever pregnant reported an attempt to terminate a pregnancy without clinical care, with methods ranging from physical trauma and substance abuse to fasting and the use of birth control or Plan B.

Juno Obedin-Maliver, an obstetrician-gynecologist who was one of the authors of the study, said she expects the prevalence of self-managed abortions among transgender and nonbinary communities to increase following the overturning of Roe and greater abortion restrictions across the country.

"Where we have structural limitations for cisgender women to access [abortions], those same structural imitations will be felt by trans and nonbinary people and exacerbated by gender discrimination in that care," Obedin-Maliver said. "So trans and nonbinary folks may be that much more likely to turn to those means, which can be dangerous, either to one's reproductive life and health or even to their overall life and health."

CNN spoke with transmasculine individuals about their experiences seeking abortions and reproductive healthcare in the past. They say it is important to include the experiences of transgender and nonbinary communities when talking about the fall of Roe v. Wade and its long-term ramifications.

Law student says accessing Plan B gave him control over his life trajectory

Galpin is now a law student at the Temple University Beasley School of Law and a former legal fellow with the National LGBTQ Task Force, a social justice non-profit that advocates for LGBTQ rights.

Following his initial pregnancy scare, Galpin found himself needing to access Plan B. He was scared to go to a pharmacy to buy the contraceptive drug because he feared judgment. He called his mom crying about the situation, and she was able to buy Plan B for him.

Galpin said he sees parallels between his experience accessing Plan B at 19 and beginning his transition at 24.

"I think the positive sides of both experiences is having that control over your body after, for a period of time, feeling like you didn't have any control or any ability to change these things," Galpin said.

The Supreme Court's reversal could open the door for courts to overturn the right to purchase and use contraception, which includes Plan B.

Galpin also sees parallels when it comes to attacks on gender-affirming care and abortion care.

"If we're talking about it from an intersectional perspective of gender affirming care and reproductive justice, we've seen these attacks directed at gender-affirming care and more widely just the transgender community dating back to the bathroom bills," he said. "These bills are primarily focused on this rhetoric of transgender people either being deemed a danger to themselves or a danger to other people. And I think similarly, the language that's used to deny abortion services also sort of relies a little bit on a rhetoric of protecting people from themselves."

A transgender healthcare advocate says their abortion was gender-affirming

Almost a decade ago, Oliver Hall, a transmasculine nonbinary person, had a self-managed abortion at 19 years old in Kentucky. After obsessively researching online about methods to induce an abortion, they ingested a combination of herbs and vitamin C.

The National Capital Poison Center recommends against "home remedies for abortion," adding that there's "no comprehensive list of herbal products that have been shown to induce an abortion or miscarriage."

Obedin-Maliver said with the Supreme Court's reversal, there may be an uptick in transgender and nonbinary people accessing non-standard or unsafe methods of abortion -- a reflection of transphobia within the healthcare system that hinders transgender and nonbinary people from receiving reproductive care under medical supervision.

Although Hall said their family would have supported their decision to get an abortion, their family wouldn't have been able to afford a surgical abortion. Furthermore, they said they didn't feel comfortable going to their local abortion clinic that included "women's surgical center" in its name. The name signaled to them that they may not get treated well in a space that seemingly only catered to women and wouldn't understand how to provide quality healthcare to transgender and nonbinary people.

"Doctors don't have a lot of knowledge about trans bodies, and that's where we might get people being misinformed about the risk of pregnancy on [hormone replacement therapy], or even people who are on estrogen or on hormone blockers are sometimes misinformed about their ability to impregnate," Hall said. "That's the result of institutional transphobia not prioritizing knowledge about trans bodies."

They recall the experience being scary because they were alone throughout the process and feared the potential of complications from the self-managed abortion that might have sent them to the hospital to navigate the very healthcare system they sought to avoid in the first place. They also said their abortion was personally a form of gender-affirming care in the sense that being pregnant would've caused intense gender dysphoria for them.

Today at 27 years old, Hall said their abortion experience influences and inspires the work they do as the trans health director of the Kentucky Health Justice Network, an organization that helps transgender and nonbinary people access various healthcare services.

Hall said the organization also has an abortion support fund that provides funding for procedures and practical support for Kentuckians seeking abortions. A Kentucky state court of appeals earlier this month reinstated the state's "trigger law" banning abortion as well as a separate law banning the procedure after roughly six weeks of pregnancy.

"On a personal level, had I not had an abortion, I definitely would not be in the position that I am in today," Hall said. "I would not be as far in life, I would not be able to be doing any of the kind of advocacy that I am doing, if I had been forced to birth a child."

A reproductive justice community organizer says his abortion allowed him to reclaim his power

In 2001, Cazembe Murphy Jackson, a transgender man, was a junior in college attending Sam Houston State University in Huntsville, Texas, when he was sexually assaulted and became pregnant. At 20 years old, he said he found out he was pregnant around the six-week mark and lacked financial and emotional support.

He said he traveled two and a half hours back home to get an abortion, which he accessed at a Planned Parenthood clinic in Austin, Texas. He said he was given abortion medication which he took at the clinic and then he went home.

Although he said he did not identify as a transgender man at the time of his abortion, he still presented in a transmasculine way and wore masculine clothing, which still led him to fear facing discrimination at the clinic.

"It wasn't the best time of my life, but I do often say that my abortion saved my life for a number of reasons," Jackson said. "It was a bad time and had I had to carry the pregnancy to term -- Black people don't survive childbirth sometimes, so I don't know if it would've taken my life in that way either."

While his abortion wasn't necessarily gender-affirming, Jackson said it allowed him to begin to get his power back after being assaulted during a time when he felt like he had no control. He said the ability to make a decision for himself was therapeutic.

Jackson said if he was seeking an abortion today, it would be challenging. In Texas, a trigger law banning abortions with few exceptions took effect Thursday.

Now at 42, Jackson lives in Atlanta working as a community organizer focused on reproductive justice, sharing his abortion story and encouraging other transgender and nonbinary people to do the same. In Georgia, there's currently a six-week abortion ban in effect.

"I think what trans people are asking for inside of the reproductive justice movement is the bare minimum," Jackson said. "Just recognize that we exist, we're here, we're a part of this movement, too. We need access to this healthcare just like everybody else. We're not actually trying to replace anyone or anything, just wanting to be included."

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