M. Florine Démosthène, “Forgiveness and Love,” 2019
In 2011, Joaquín Carcaño was raped and became pregnant while serving with the Peace Corps in Peru. It was illegal for him to obtain an abortion there and the Peace Corps’s health insurance didn’t cover the procedure. So not only did Carcaño have to leave the country to get care, but he also had to find a way to pay for it. A few years later, after ending his service early, he lobbied Congress in support of a bill that sought to extend health coverage for abortion for Peace Corps volunteers in cases of rape or incest, or if the pregnant person’s life was in danger. (The government eventually extended abortion care to the Peace Corps through an appropriations bill.)
A few years later, Carcaño, then living in North Carolina, again found his body’s needs rejected by the state when North Carolina passed HB2, which prohibited trans people from using public restrooms that aligned with their gender identity. For Carcaño, a state employee at the time, the law meant that he could not use the restroom while at work. Once again, he fought back against government discrimination, becoming the lead plaintiff in a challenge to the law.
As Carcaño’s experience makes abundantly clear, if anyone knows what it’s like to have their body targeted by multiple forms of governmental regulation, it’s trans people. “Our bodies,” Carcaño told me, “have been targets of shame and secrets and objectification long before we ever had the words to properly name it.” Both invisible and hypervisible, trans bodies occupy a uniquely scrutinized and demonized place in public and medical discourse. And as a result, trans people have developed strategies for resisting governmental attempts to criminalize health care. There are lessons here for the abortion-rights movement if we create space to build, struggle, and organize together.
Trans people are all too often posited as a distraction from cis women’s fights for justice. But that counterfactual narrative risks ceding power to fascists who exploit our internal divisions to consolidate control over all of our bodies. For the political right, policing what we can and cannot do with our bodies, including whether and how we identify within and outside of sex binaries, is linked to a goal of limiting material and conceptual freedom altogether. Our opponents recognize that our collective subjugation is necessary for the political project they envision; but we, on the left, have not been as effective in recognizing that our collective resistance is necessary for ours. And this exposes not just an anxiety about trans people and bodies, but ultimately, the anxiety of white-led reproductive rights movements about fully challenging existing structures of power.
In 2015, The Nation ran a piece by Katha Pollitt asking, “Who Has Abortions?” The piece did not go on to talk about the many people, navigating diverse experiences, who get abortions. Instead, Pollitt argued that focusing on those experiences would only distract attention from the people who really mattered in the abortion debate: cis women. “We can, and should, support trans men and other gender-non-conforming people. But we can do that without rendering invisible half of humanity and 99.999 percent of those who get pregnant,” she wrote. Forget that people like Carcaño had literally expanded abortion access for women, sharing his story to ensure that his trauma would not be repeated. Pollitt’s piece, and many others like it, demonstrate one of the greatest failures of gender justice movements over the past few decades: Rather than build solidarity across experience, when under threat, those most closely aligned with power punch down.
Now, eight years since Pollitt’s piece, the Supreme Court has shown a brazen disregard for precedent and overturned Roe v. Wade. Hundreds of bills have been introduced in state legislatures to restrict or criminalize abortion. Many of the same groups that advocated these bills are also pushing for laws that restrict health care for trans people — in particular, gender-affirming care for those under 18. The material consequences of these political realities are staggering, and yet, article after article continues to explore the “controversy” over how to talk about gender and abortion.
An NBC News piece following the court’s decision in Dobbs began:
In perhaps one of the most absurd of these articles, Pamela Paul wrote a column in The New York Times, soon after Roe fell, with the headline “The Far Right and Far Left Agree on One Thing: Women Don’t Count.” According to Paul, “women don’t count” when their access to abortion is criminalized (by the right) or when trans people are included in conversations about abortion or spaces for women (by the left). And again, in September of 2022, CNN recycled the same narrative, in a piece that explored this supposed conflict: “The language we use to talk about pregnancy and abortion is changing. But not everyone welcomes the shift.”
Meanwhile, Paul continues to find a way to insert some gratuitous trans antagonism into her regular column at The Times, a consistent feature of the paper of record’s editorial contributions. And Katha Pollitt kicked off 2023 with a letter to the editor in The Times questioning an op-ed that explored the possibility that Louisa May Alcott was a transgender man. Suggesting that the very possibility that there were, in fact, trans men in history is somehow “erasing” women, Pollitt wrote: “It’s sad that we seem to be going backward by seeing women longing for masculine freedoms and advantages as evidence that they are really men!” There is a difference between “longing for masculine freedoms” — whatever that means, since there weren’t many freedoms enjoyed by Black men, for example, in the 19th century — and feeling and knowing oneself to not be a woman. What Pollitt is really saying is that recognizing the existence of trans masculine people through history is somehow a threat to (white) womanhood.
Ultimately, if there is a “heated debate,” it is largely because it has been reified by the barrage of articles claiming that the real post-Roe question is how to talk about abortion, not how to ensure people have access to it. With the Supreme Court essentially greenlighting draconian abortion bans in nearly 50 percent of the country and signaling that many more civil rights precedents may soon be under threat, it is troubling how much time we spend debating the “harms” of inclusive language. Rather than asking how the many communities affected by the court’s decision in Dobbs and statewide attacks on reproductive rights can build the largest possible networks of organizers and care providers, we are allowing ourselves to be pitted against one another. And this isn’t just confined to the pages of legacy media publications. Even in liberal policy and legal advocacy spaces, there is a degree of hand-wringing over language that wrongly presumes the real threat to cis women’s bodily autonomy is an expansive notion of sexed bodies and not the ever-encroaching threat of fascism.
Positioning trans people and cis women as distinct and opposed political constituencies has not only harmed trans and cis people, but also limits our ability to build creative, robust, and effective movements. It has reduced the entirety of the conversation about a reproductive justice movement that includes the experiences of trans people to a facile debate over the use of the term “pregnant people” instead of “pregnant women.” The fact that some men and non-binary people get pregnant and have abortions has so fundamentally disrupted people’s understanding of sexed bodies that figuring out how to incorporate this fact into advocacy discourse has derailed our solidarity and movement-building at a critical time.
It is true that most men cannot get pregnant. It is also true that bans on abortion and restrictions on reproductive autonomy are intended in large part to maintain power over the bodies and labor of women. But neither of these realities changes the fact that there remains a maligned and marginalized group of people who are not women, some of whom are men, who can and do get pregnant and need access to abortion.
The purpose of broadening the lens through which we name and understand the impact of reproductive violence is not to erase or diminish the experiences of cisgender women. Including men who are trans and non-binary people in the conversation about pregnancy and abortion is both factually accurate and a necessary part of creating more space for trans masculine people to have access to health care that they need. Of course, the language we use has political consequences, but ultimately, this is about so much more than semantics. It is about how — and whether — we truly can learn from each other and build meaningful and transformative movements and care networks. And ultimately, a world in which we embrace more expansive notions of what our bodies can do will serve to protect, not undermine, the health and safety of cis women.
I am less interested in the question of whether we talk about pregnant people or pregnant women and far more interested in building a blueprint for how we work together to collectively control access to and distribution of the health care that trans people and women want and need. This means creating the resources to defy unjust laws, disseminate life-saving information, and collectivize the care that we need. For example, trans people with access to hormones have long shared those hormones, as well as the syringes used to administer them and information about how to safely do so with those who are unable to get care from doctors. Trans masculine people like me have vital insight to share about what it means to organize for, demand, and get access to criminalized, stigmatized health care. We have existed at the intersection of multiple forms of health denial and our bodies have been deemed illegible and disposable by society many times over.
In the past 15 years, I have needed gender-affirming hormone therapy, birth control, PrEP, PEP, Plan B, and emergency gynecological care. I have gone to hospitals, doctors’ offices, and other institutional sites of care — only to be ridiculed, rejected, and reminded that it is often safer and more healing to turn to my community for the treatment I need. Carcaño has had similar experiences. “I had to fight to justify PrEP and STI tests to medical providers who refused to process the entirety of my body,” he told me, “and have been publicly and vocally questioned about testosterone and estrogen prescriptions alike by pharmacists, at times leaving without my prescription filled.”
Trans people understand what it means to navigate health institutions that pathologize and criminalize before they protect and heal. And because of this, we know first-hand how to self-administer and monitor treatment. We have been turned away from providers because they are repulsed by our bodies or certain that we do not need the care that our bodies demand. They fail to understand what it means to be a man who can become pregnant because they have heard time and again that only women can become pregnant; it is easier to dismiss us than see and care for the body existing right before them.
This is not just about whether a trans man feels safe getting an abortion when he needs it, as vital as that is. This is about whether a post-Roe reproductive rights movement can recognize that there are lessons to be learned beyond the experiences of cis women and get out of its own way. This is about which political projects those who claim an interest in reproductive autonomy will ultimately privilege — either the political projects that destabilize power or those that align with it.
Chase Strangio is a lawyer and trans activist.