The effect of homophobia and transphobia on universal access to reproductive health

Today is IDAHO, otherwise known as ‘The International Day Against Homophobia and Transphobia’. We decided to blog about the relevance of reproductive rights to people of all (or no) genders and sexualities, and some of the problems those who identify as LGBT* can face in accessing sexual and reproductive health services and relevant information.

Why are reproductive rights important for people of all genders and sexualities?

When I tell people I work on a project which educates young people on pregnancy options they’ve asked if we only visit girls’ schools, and have expressed skepticism at the usefulness of covering this topic at a workshop for LGBT* youth. At EFC we believe everyone has a stake in understanding how reproduction works, and how people can be supported to make decisions about sex, contraception and pregnancy that are right for them. Here are some thoughts on why this is a subject which breaks though cisgendered/heterosexual ‘norms’:

-    Most people with a womb have at least the capability to get pregnant at some point in their lives. Even those who don’t choose to have vaginal intercourse can become pregnant, for example through sperm accidentally coming into contact with the vagina through non-penetrative intercourse, or as a result of rape.
-    Research has shown that young people who identify as gay, lesbian and bisexual may in fact be at a higher risk of unplanned pregnancy than their heterosexual peers. Stigma surrounding sexuality can lead some young people to ‘prove’ heterosexuality through sexual contact with a partner of the ‘opposite’ sex.
-    As Thomas Beatie has shown with his high-profile pregnancies, trans men and transmasculine people can and do become pregnant and may require specific information on this process.
-    Those who are unable to conceive in what is often seen as the ‘natural’ or ‘traditional’ way, may decide to access services which allow them to become pregnant (e.g. IVF) or to become parents through other means (adoption, fostering and surrogacy).
-    People who cannot themselves become pregnant may have close contact with those who do, whether it be a partner, family member or friend.
-    Many of the individuals and groups which seek to restrict abortion access also argue against LGBT* rights – for example, anti-choice group SPUC is currently running a campaign against equal marriage and has claimed that ‘making homosexual couples the legal parents of children is not in the best interests of children’.

What are some of the barriers for people who are LGBT* in accessing reproductive health services?

Outright stigma, and homo/trans/biphobia is a clear barrier for equal access to services. The stories gathered by #transdocfail showed systematically poor treatment of trans* people in health services, likely to be reflected in consultations relating to sexual and reproductive health. Media outrage and sensationalised headlines relating to LGBT* parenting are unlikely to make those who identify as such eager to access support and services. And as well as stigma, there may be legal restrictions to reproductive rights – the Swedish government has only just vowed to remove a statute which requires all transgender people to be sterilised in order to have their gender recognised legally.

Beyond direct objection to equal reproductive rights, there is also often a lack of tailored resources and information for those who are lesbian, gay, bisexual and/or transgender. In our own work we are trying to address this by using language that is inclusive, and thinking of ways to address gaps in resource provision, making links between the reproductive rights and LGBT* rights movements where possible. Thankfully, some progress is being made – we’ve listed some useful resources below but please do add your own comments and suggestions.

Useful resources

• A brilliant book for talking to children about ‘where babies come from’ which doesn’t make assumptions about gender and sexuality
• The Terrence Higgins Trust has produced sexual health resources for trans men and trans women 
• Stonewall’s ‘A Pregnant Pause’ provides advice ‘for lesbians on how to get pregnant’ 
• 9 Facts about Trans Sexual and Reproductive Health (U.S resource) 
• The Transcending Anatomy blog has specific information on pregnancy
• Blog from Abortion Gang entitled ‘Why queer justice and reproductive justice movements should work together’

‘Men have wombs too'

There were some great banners at the pro-choice demo on Saturday: see our photos of them here on Flickr. But one which stood out was a simple sign proclaiming that ‘men have wombs too’. Today’s blog attempts to unpick this slogan and look deeper at the intersections between pregnancy, sex and gender.

When most people talk about pregnancy they tend to focus on a female-born, female identified ‘woman’, generally assuming that this pregnancy has occurred because of penetrative sex between a ‘cis man’ and a ‘cis woman’ (see Scarleteen and Bish for a full explanation of ‘gender’ terms). These two people are also often assumed to be straight (see previous LGB blog for more on pregnancy and sexuality). Whilst this may indeed be the case the majority of the time, at EFC we think it’s really important to acknowledge the fact that some ‘men have wombs too’. But what exactly does this mean?

When delivering our Talk About Choice sessions in schools, more than once I have had young people ask me ‘if men can get pregnant’. There’s generally a titter, and somebody will reference a TV show in which they’ve seen a ‘pregnant man’ to back up their point. What these young people are generally referring to are trans men who have conceived and given birth. That is, someone who was born into a body typically read as ‘female’ but whose gender identity is male. Not all those who feel this discrepancy between their assigned sex and their lived gender will undergo full surgery (commonly known as ‘a sex change’ in the media) but some may choose to take hormones to affect secondary gender characteristics such as facial hair and a deeper voice, or may have a mastectomy and/or hysterectomy.

Some trans men retain their female reproductive organs and are able to conceive and carry a pregnancy to term, although they may have an outwardly masculine appearance. Thomas Beattie is an example of a trans man who has ‘gone public’ with his pregnancies although of course many more trans men become pregnant without such media attention. Trans men of course may choose to terminate a pregnancy, hence the banner which called out for the right to choose for all those who can become pregnant, male or female.

We believe it’s important for young people to acknowledge and understand the implications of sex, gender and sexuality with respect to pregnancy and are keen to address the diversity of those who are affected by pregnancy, abortion and childbirth.

Lesbian women and gay men don’t need information about pregnancy and abortion

Every Monday EFC busts myths and takes names, cutting through the misinformation, disinformation, and straight up nonsense to bring you the facts

Pregnancy isn’t just something which affects people who identify as heterosexual. Those who identify as lesbian, gay or bisexual can also experience pregnancy, whether planned or unplanned. In fact, a Canadian study of LGB youth found that they were more likely than their heterosexual peers to report having been pregnant or having caused a pregnancy.

Behaviour doesn’t always follow on logically from identity. As the young advocates on Youth Resource point out, ‘self-identifying as lesbian or gay does not mean that someone will never have sex with a member of the other sex.’ A lesbian woman or gay man may choose to have sex with someone of the opposite sex in order to become pregnant/cause pregnancy; they may feel under pressure to do so; or they may, at that point in their lives, find themselves sexually attracted to someone of the opposite sex. ‘People who are questioning their sexual orientation may experiment in an effort to determine their sexual identity’ or to present themselves to others as heterosexual. Of course all women can become pregnant as a result of rape.

It’s important not to make assumptions about someone’s sexual activity or reproductive health based on their sexual identity or preference.

Anyone who finds themselves pregnant, however they identify, deserves honest, impartial information and advice about their options. Since 1 in 3 women in this country will have an abortion during their reproductive lives it’s really something we all need to know about.