Moving beyond sharing your pronouns: how and why you need to be more trans inclusive in your repro work
As she was shaking my hand, a former Planned Parenthood physician said to me: “I heard you use they/them pronouns. Well, I won’t be using them. I’m too old school.”
I wish this was an isolated incident but, in my 13+ years of doing this work, this is only one example within a career-long pattern.
When I was a health center assistant in a reproductive health center, on my first day I witnessed the one out trans man on staff being bullied and called the t-slur by co-workers just for being there, trying to do his job. He was not offered support by management and ended up quitting within weeks of that day. When I started working in an educational role at a repro organization, my boss told me we already had trans-specific content in all of our educational presentations. After looking through them, I discovered it was missing. I found only one PowerPoint slide in one presentation about abortion that included trans-specific considerations. When I went to reproductive health, rights, and justice conferences, I was clearly one of very few trans attendees. I was almost always misgendered with incorrect pronouns or referred to within a group as “ladies.” Of course this was all said by folks wearing badges with pronouns listed.
From a cursory glance of the repro movement, it is clear that we have a movement of primarily cisgender women who want to be inclusive and talk the talk, but do not actively work to acknowledge or deconstruct their transphobic beliefs. Transphobia is pervasive in society and repro movements have never been exempt from it. Even so, we’ve seen an alarming trend within the movement over the past few years: blatant, unchecked transphobia run amok. We're seeing a larger number of overtly vocal Trans Exclusionary Radical Feminists (TERFs) in online spaces, refusing to acknowledge that pregnancy, miscarriage, and yes, abortion, are experiences trans and gender expansive folks face. Leaders past and present are doubling down on transphobic practices while organizations are issuing transphobic statements about their values and the patients they claim to serve. And this is what we see publicly online. We know much more damage takes place in your private meetings and patient interactions.
Change is possible, but it is going to take a lot of concerted effort by cis people to push their organizational leadership to make meaningful changes with direct community input. In the meantime, here are some tips to make the movement more trans-inclusive that go beyond pronouns in everyone’s bio and gender inclusive language on your website:
Do your own homework. Read about the history of transphobia in progressive movements, and reproductive rights in particular. Read statements and research from experts about why it's essential to go beyond framing these issues as "cisgender women's health." Read the stories of trans folks who've had abortions.
Keep transphobic people off your team. This one may seem obvious, but don’t hire TERFs in the first place. When hiring new staff, ask open ended questions about their understanding of and beliefs about trans people. A question such as, “how do you feel about working with transgender patients and co-workers?” won’t be as telling as asking the applicant to tell you about a specific experience where they stood up for a transgender patient or co-worker. Pay close attention to transphobic behavior/remarks, and make sure to say something when you hear them. Work with management to develop and implement a swift and effective disciplinary process that can be used as soon as you hear these ideas verbalized or see them acted upon. Don’t be afraid to fire transphobic employees. They are doing more harm to your patients and to the movement than good. If it turns out that someone in management or HR are transphobic, there are EEOC protections through Title VII that could help. Some major cities even have a transgender-specific legal team that can help you navigate your options.
Have ongoing training for staff members and pay attention to their progress. Many reproductive organizations host in-service training on gender identity and inclusion. Some larger orgs even have virtual training courses available for staff to take at any time. A lot of organizations assume that the people they hire are automatically trans competent and/or do not hold any contempt for transgender people. If they want to do the work within this movement, they obviously care about the reproductive rights of all people, right? So then why bother training staff what they already know? This is how so many problematic staff members fall through the cracks. Not all trainings are created equal, and unless they're repeated regularly, they may be useless. Most of these trainings place the onus on individuals to retain and implement the suggestions on their own with no support, funding, or oversight. There are plenty of folks who want to do this work, but there are too many who will make excuses for their poor behavior while claiming solidarity. Someone who is trying forever and still not getting it most likely doesn’t care to learn. Have a time limit on their progress. This goes double for people in management and leadership positions.
Hire trans people. We need more trans people in the movement, and not just the token hire or two. We need trans people in leadership positions, not just forward facing low-paid positions. However, before you hire trans people, make sure your environment is safe for them using the other suggestions in this article and through policy change! In addition to building a team of trans-affirming staff, a safe environment for transgender staff includes employee benefits that cover trans healthcare, gender neutral bathrooms in accessible locations, strict and enforceable anti-discrimination policies, and policies regarding the way staff handles patients mistreating transgender staff. Do not hire trans people and assume the issue will work itself out. This course of action has been tried time and time again, and yet the problem still persists through the entire field.
Use systems that allow for open-ended responses to name and gender. This includes intake forms and EMR systems. Transgender healthcare groups and universities like The Fenway Institute, WPATH, and The University of British Columbia provide information and guides for developing trans inclusive forms and intake systems. They are online and FREE! Use them.
Take patient or community complaints about transphobia seriously and make amends in a timely manner. I cannot tell you how many times I have been referred to a “trans-inclusive” repro healthcare provider or organization just to find they have tons of negative reviews online outlining horrific stories of transphobia. Negative reviews can be tough to read, but it is necessary to take in the bad with the good in order to start the work of repair. A sense of urgency to resolve these issues without thinking through the entire problem is not helpful, but don’t let issues like this fall on the backburner forever. Decide on a reasonable timeframe in which to respond with an apology and a public action plan, and stick to the plan. If you notice organizational leadership dragging their feet to do this work, ask them about it. Put the pressure on them and let them know you care, especially if you are a person in a privileged position to do so.
Keep pushing your organizations and movement leaders to make these changes and to never stop working for a movement that truly centers the people who are most marginalized.
Content Note: The author is a non-binary, agender, trans person. I was assigned female at birth (AFAB), meaning I am transmisogyny exempt (TME). This puts me in a position of privilege within the transgender community. My gender identity often goes unseen or unacknowledged based on my appearance, which I believe helped me enter and stay in the reproductive healthcare world because I was seen as a woman or “woman light.” I did my due diligence to speak with other trans folks about their thoughts and experiences however,I had difficulty finding trans women or transfeminine folks who were willing to contribute their thoughts and experiences. My guess is that there is an extremely limited number of trans women working in reproductive health. It seems as though most of the trans folks in reproductive healthcare are like me- AFAB and nonbinary. When considering the information above, keep in mind that there are many other trans people's voices who need to be added to this discussion. Seek them out and listen to them.