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Dobbs ruling may have implications for transgender people’s access to healthcare

Members of the ACLU march for reproductive justice at Champaign County's Fourth of July Parade. Some transgender people said they often feel left out of conversations about reproductive rights.

As protests continue after the repeal of Roe v. Wade – a ruling that allows states to control access to abortion – the conversation often revolves around women’s reproductive rights.

But women aren’t the only ones whose access to healthcare is impacted by the recent Supreme Court decision. Transgender and non-binary people can – and do – get pregnant, meaning they also need access to reproductive healthcare.

Transgender – or trans – people’s gender identity differs from their biological sex. Some trans people choose to medically transition, meaning they undergo treatment, like hormone therapy, puberty blockers and gender-reassignment surgery, so their sex better matches their gender identity.

Although not every transgender person chooses to medically transition, many socially transition by coming out to their friends and family, going by a different name, or dressing in ways that match their gender identity. 

​​As of March 2022, according to the Human Rights Campaign, more than 300 anti-LGBTQ bills have been proposed in courts across the U.S. Nearly half of these bills target transgender people. 

University of Illinois law professor Robin Wilson said the repeal of Roe v. Wade could limit trans people’s access to healthcare –  particularly reproductive healthcare – in the future. 

Even if a trans man needs to receive an abortion in order to survive a pregnancy, Wilson said states may still decline their request.  

In light of the recent SCOTUS ruling, Wilson said states could also begin regulating trans people’s bodily autonomy through legislation. 

“I think what it really means is that trans people – to the extent that they are trying to avail themselves of surgery or hormones – that those medical processes can be regulated just like abortion can be regulated by the states,” Wilson said.

Although Wilson said anti-transgender legislation and abortion bans probably won’t come to Illinois, she said trans people in neighboring states might be at risk. 

Marcus Moone is a trans man who has lived in Urbana his whole life. He said trans men are often left out of the conversation about reproductive healthcare, and that many protests ignore the ruling’s impact on trans people. 

“Trans men can still get pregnant and do get pregnant,” he said. “Access to healthcare as a trans person is something that is actively being legislated against, and you would think that – given all of that – the conversation about reproductive rights would be wider and more inclusive, and it is still so narrow.” 

He said it can be more difficult for trans men to realize they’re pregnant. For trans men who undergo masculinizing hormone therapy, testosterone suppresses their menstrual cycles, and in some cases, may stop them completely. 

In states with six-week abortion bans, trans men who take testosterone may be unable to tell that they’re pregnant until it’s too late to get an abortion. 

“When you’re on testosterone, usually your period goes away,” he said. “So, you would figure out later that you were pregnant, as opposed to, like, your period stopping and that sort of notifying you.”

Moone said he isn’t worried about anti-transgender bills and abortion bans coming to Illinois, though he worries about trans people’s access to healthcare in neighboring states. 

In Iowa, for example, 14 anti-transgender bills and policies were filed between 2021 and 2022. 

Sean Finn is a trans man who spent most of his life living in Marshalltown, Iowa, and he currently lives in Iowa City. Finn said accessing healthcare can be challenging as a trans man, especially because he started hormone therapy when he was 17. 

“I had to travel to Iowa City – which was a two-hour drive from where I lived – to even get the care that I needed,” Finn said. “Nobody in my hometown knew anything about trans people or their medical care, like how to prescribe hormones or what that would mean, so I had to go to Iowa City.”

Like Moone, Finn said trans people are often excluded from conversations about the repeal of Roe v. Wade.

“A lot of the public outcry is very gendered, it’s very much about women’s rights, it’s about how women are being affected by it,” he said. “I think it’s valid to talk about women’s rights and to talk about how this affects women, as long as that’s not the entirety of the conversation.”

By ignoring trans voices, Finn said the protests overlook other issues tied to the ruling.

“As a trans man, I do have to think about my reproductive rights,” he said. “Abortion is something that – while maybe unlikely in my personal case – is certainly something that I want reassurances that I would have access to if I needed it.”

Finn said he’s worried about trans youth under 18 years old who want to medically transition. 

According to a survey of 34,000 LGBTQ+ youth conducted by The Trevor Project, more than two-thirds of transgender and nonbinary respondents reported experiencing symptoms of depression. 

The study also found that half of transgender and nonbinary respondents considered suicide, and nearly 1 in 5 attempted it. 

Finn knew he was trans at 14, but couldn’t start taking hormones until he turned 17. He described that in-between period as the worst time of his life. 

“There were times when I didn’t think that I could make it until I was 18,” he said. “For trans youth to be attacked, to say, ‘That’s not an option for you until you’re 18,’ I worry about what that’s going to do to trans youth, and I worry about how many people won’t make it until they’re 18, how many people will turn to suicide because of those laws going into effect.” 

However, Finn said he has hope for the future of trans people in Iowa and across the country, especially because of the younger population’s more accepting views. 

“The future is trans,” Finn said. “That’s what I’m trying to say. So they can try all they want to pass these laws now and restrict the rights of trans people, but the only reason they’re doing it is because they’re scared. The real momentum is that trans rights are going to be stronger in the future than they are now.”

Picture of Sydney Wood

Sydney Wood

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