Long distance travel, deepening inequality, fear of persecution: The current landscape for transgender and gender-expansive abortion seekers

Transgender and gender-expansive (TGE) people face an increasingly hostile political climate in the United States (US), likely compounding existing barriers to abortion and broader health care. This brief presents findings from a focus group discussion among individuals who support transgender and gender-expansive individuals in accessing abortion care or health care to better understand the unique needs of transgender and gender-expansive people seeking abortion in the current political climate. Participants described how multiple intersecting barriers, including a lack of gender-affirming providers, insufficient provider knowledge, financial hardship, and unmet basic needs like food and housing are further intensified by political attacks on both abortion and gender-affirming care. They stressed that addressing these barriers alone would not solve the general lack of safety experienced by TGE people in their day-to-day lives. We propose a multi-pronged approach to ensure that TGE people can access adequate and safe abortion and gender-affirming care, regardless of their financial situation, that includes: 1) bolstering existing gender-affirming services, 2) expanding research and education on TGE health care needs, 3) expanding funding for abortion and gender-affirming care-related travel and services, and 4) improving self-managed abortion and DIY resources.