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How to Get an Abortion If You're Transgender

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Since the Supreme Court struck down Roe v. Wade, millions of people lost abortion rights in their states. Among them are transgender men, nonbinary people, and gender nonconforming people, who are often left out of conversations about reproductive healthcare.

But trans people can and do get abortions, despite facing unique barriers to care.

Trans people encounter discrimination when seeking all types of healthcare, ranging from misgendering to overall refusal of care. Some postpone or opt out of medical care — including abortion care — due to fears of mistreatment. A 2021 study found that nearly one in five transgender, gender-expansive, and nonbinary people who have been pregnant attempted to end a pregnancy without clinical oversight, sometimes using unsafe methods.

Despite logistical and emotional obstacles, getting a safe, legal abortion is possible for trans people. Here's how to get an abortion if you're trans:

How Do I Find a Trans-Affirming Abortion Clinic?

Amid ever-shifting legal restrictions and shuttering clinics, accessing an abortion is hard for anyone, especially trans people. In the U.S., the highest number of trans people live in the South, where some of the strictest anti-abortion laws are in place. Even if abortion is legal in your state, finding a trans-affirming abortion clinic requires scrutiny.

“If the clinic’s website is using non-gendered language to talk about their services, that’s an indicator that they’re actively working to create a space that’s safe for trans people,” said Rebecca Wang, Legal Support Counsel at If/When/How, which offers a free Repro Legal Helpline.

Some abortion clinics also offer gender-affirming care like hormone replacement therapy (HRT), and those providers likely have experience working with trans patients. If you’re not even sure where to start, you can find a list of reputable abortion clinics at AbortionFinder.org.

If abortion is not legal in your state or if you don’t feel comfortable with your local clinic options, you’ll need to travel to get an abortion.

“It is absolutely legal to travel outside of the state to seek abortion care,” Wang said. But traveling for an abortion can come with challenges.

On top of travel costs and taking time off from school or work, there’s a risk of encountering transphobia on the road amid increasing anti-trans legislation and rhetoric. Bringing a friend or partner with you can help you stay safer and feel supported.

What If I Can’t Access a Trans-Affirming Abortion Clinic?

Whether or not your clinic advertises itself as a trans-affirming space, you might experience misgendering or other forms of transphobia when seeking an abortion. Bringing a support person to your appointment or working with a trans-affirming abortion doula can help.

“An abortion doula guides you through the logistical and emotional process of getting an abortion, from making the decision to the emotions that come up afterwards,” explained Simran Singh Jain, a North Carolina-based abortion doula. Abortion doulas don’t always attend in-clinic abortion appointments with clients, but when they do, they can help make the experience less stressful.

“Then there's somebody in the room who sees you as you are, who can stop people from misgendering you and just be present for you,” Singh Jain said.

Some abortion doulas are volunteers, while others charge for their services. You can find a abortion doula by contacting your clinic or a local abortion fund via the National Network of Abortion Funds.

Medication abortion is another option for trans people who can’t travel to an abortion clinic or who want to avoid in-person interactions with medical providers. Medication abortion involves two pills — mifepristone and misoprostol — which work together to stop a pregnancy from continuing and empty the uterus.

You can have a medication abortion within the first 10 weeks of pregnancy, or within 70 days of the first day of your last period. Determining whether or not you’re in a safe window for medication abortion can be complicated for trans people who take testosterone, since hormone replacement therapy can cause people to have irregular periods or no periods at all.

“There may be exceptions, such as if someone had one-time exposure to sperm and thus knows the exact dating of their pregnancy, but in general, if someone is using testosterone, becomes pregnant, and is in need of abortion care, they should have an ultrasound for pregnancy dating,” said Dr. Halley Crissman, MD, MPH, an OB/GYN and adjunct clinical assistant professor at the University of Michigan and the Director of Gender-Affirming Care at Planned Parenthood of Michigan.

The ultrasound may be done externally over the abdomen, but depending on how far along the pregnancy is, some medical providers may require patients to have a transvaginal ultrasound, which can potentially bring up feelings of gender dysphoria for trans abortion-seekers.

Medication abortion is legal in most states if you have a prescription from a healthcare provider. Depending on your state’s laws, you may be able to see a telehealth provider and have the pills mailed to your home, or you may need to go to a clinic to get your prescription. Walgreens and CVS will dispense abortion pills at pharmacies in some states. Visit Plan C or Mayday Health to learn how you can access abortion pills.

Can I Have A Medication Abortion If I’m Taking Gender-Affirming Hormones?

“People taking testosterone for gender-affirming hormone care can safely use mifepristone and misoprostol for abortion and early pregnancy loss care,” Dr. Crissman said. If you take other medications or have any health conditions, talk to your prescriber about whether or not medication abortion is right for you.


What If I Can’t Afford an Abortion?

Job discrimination and a lack of legal protections means that trans people experience higher levels of unemployment and poverty relative to cisgender people and are less likely to have health insurance. If you’re uninsured or if your state does not allow private insurance coverage of abortion, paying for an abortion can be expensive.

Abortion funds can help you pay for your abortion, plus associated costs. Visit the National Network of Abortion Funds to find organizations that can help.

How Can I Manage Gender Dysphoria When Seeking Abortion Care?

The experience of being pregnant, navigating care that centers cis women, and dealing with the physical effects of abortion can bring up feelings of gender dysphoria. Ash Williams, a trans, North Carolina-based abortion doula and member of the Mountain Area Abortion Doula Collective, has had two abortions.

“It was hard for me to think about how I had the kind of body that made it possible for me to get pregnant,” Williams said. “Talking to people about my emotions and spending time around other trans people helped.”

If you’re experiencing dysphoria, reach out to your support network and engage in whatever practices typically help you through dysphoric moments.

Getting an abortion can feel scary when you don’t see yourself reflected in abortion narratives, but you’re not alone. There are providers and activists who want you to help you have the safe, accessible, and gender-affirming abortion that you deserve.


Originally Appeared on Teen Vogue