When we talk about birth control, we need to remember that cis straight women aren’t the only stakeholders.
By Neesha Powell
Originally published on Everyday Feminism.
I ’ve been on and off different types of birth control for the past 15 years. Last year, I got Mirena, an IUD that’s 99 percent effective in preventing pregnancy and lasts up to 6 years.
While dating cisgender straight men in the past, I used birth control to prevent pregnancy. And although I can’t get pregnant by my current sexual partner, my IUD is still a lifesaver because my periods have become lighter, shorter and less painful.
Queer and trans people of color, like myself, however, are almost never reflected in the visible fight for birth control rights. The poster child of the mainstream reproductive rights movement is usually a middle-class, cis, heterosexual white woman — everything that I’m not.
In the resistance against Pres. Donald Trump’s war on reproductive rights, stories like mine aren’t centered due to myths that LGBTQ+ folks don’t use birth control, get abortions, or have kids. In reality, we do all of these things, and we desperately need better access to them.
Queer and trans people of color, like myself, however, are almost never reflected in the visible fight for birth control rights.
Trans, gender nonbinary,and queer folks experience barriers to culturally-competent reproductive healthcare because most doctors don’t understand our bodies or our sex lives. Legislative attacks on birth control make it even harder for us to get the good care we deserve.
One of Trump’s most recent attacks on reproductive healthcare happened on Oct. 6, when the Department of Health and Human Services issued new rules that allow employers to opt out of covering birth control on their health insurance plans based on moral or religious reasons.
This is a part of Trump’s plan to dismantle Obamacare, which made contraception a preventative service and required employers to pay for it. These new rules open the door for future laws that allow discrimination against LGBTQ+ people based on sexual orientation and gender identity.
When we talk about birth control, we need to remember that cis straight women aren’t the only stakeholders. As a pansexual nonbinary woman, birth control changed my life for the better, yet narratives like mine are missing from the media.
The erasure of LGBTQ+ folks from conversations about birth control is harmful, for a number of reasons. Here’s why trans and queer voices must be centered in the fight for just access to birth control:
1. We need birth control for the same reasons as straight folks: to prevent pregnancy and to treat medical conditions.
This may be a surprise to some, but trans and queer people have the ability to procreate and to engage in sex that results in pregnancy. It’s frustrating that birth control is only marketed to cis straight women when LGBTQ+ folks need it just as much.
Evana Enabulele, a Black queer parks and recreation worker living in Seattle, uses a birth control implant called Nexplanon for both pregnancy prevention and Polycystic Ovary Syndrome (PCOS), which causes irregular periods that are abnormally heavy and long.
She enjoys telling others about her birth control implant because many people think their only option is taking pills. It takes as little as 10 minutes to insert the tiny rod into the upper arm and is more than 99 percent effective in preventing pregnancy.
Being on birth control makes Enabulele’s life more stress-free, not only because she can’t get pregnant, but also because she now gets a regular period. When her PCOS was untreated, she worried about not ever being able to conceive because her periods were so irregular.
Enabulele feels personally attacked by the Trump administration’s new rules allowing employers to deny covering birth control.
ChiChi Madu is a Black queer LA resident working in the startup industry who got an IUD for free at Planned Parenthood 6 years ago when she was low-income. She’s also appalled by Trump’s actions.
“I think it’s downright evil to take away someone’s ability to access healthcare,” says Madu, who got on birth control to prevent pregnancy when she had cis male sexual partners, as well as to regulate her mood and decrease the flow and frequency of her period.
Although she now gets health insurance through an employer that holds progressive beliefs, she knows that other LGBTQ+ people aren’t so lucky.
“I have to think about all these people who don’t have my same circumstance and so it’s aggravating and disheartening. It’s tough to think about, to be honest,” Madu says.
2. There are challenges keeping us from getting birth control when we need it — including fear of discrimination from medical providers and lack of access to health insurance — but not being able to get birth control can have harmful consequences for us.
Going to the doctor is not fun for a lot of trans and queer people, especially when we have to talk to them about the most intimate parts of our lives.
Lucia Leandro Gimeno, the director of Q/tpoc Birthwerq Project in Seattle, says that accessing reproductive healthcare can be an anxious experience for trans and queer people, especially trans and queer people of color.
The fear of being discriminated against by their medical provider is a major barrier. The fact is that most medical providers do not get adequate training in working with LGBTQIA+ folks.
“I think that if you’re white and trans, it’s not easy, but whiteness generally helps you better navigate a lot of systems, whereas if you’re a trans person of color, doctors just kind of look at you sideways,” says Gimeno, who’s an Afro-Latinx queer transmasculine femme.
Most medical providers do not get adequate training in working with LGBTQIA+ folks.
While seeking out reproductive healthcare, LGBTQ+ people are often shamed for our sex lives or treated differently because of our marginalized identities. Even well-intentioned doctors don’t know much about how we have sex and how birth control impacts our bodies.
Additionally, LGBTQ+ Americans have barriers to getting birth control because we’re almost 10 percent less likely than straight Americans to have health insurance, and 20 percent of us are living in poverty.
23-year-old Enabulele’s scared of what will happen if Obamacare’s repealed because she could be kicked off her dad’s insurance plan. Her birth control implant was only $10 under her father’s insurance and would have cost $800 without it.
When trans and queer people can’t access the reproductive healthcare we need, we’re forced to go underground to get it. Some trans women buy hormones on the black market because they can’t get them from a doctor, and they sometimes end up being toxic.
Trans and queer folks deserve access to birth control that is safe and low-cost or free. That can’t happen when we’re left out of conversations about contraception.
3. We’re excluded from the reproductive rights movement, even though we actually have the hardest time getting adequate healthcare.
Our society loves to gender things, which led to “reproductive health” becoming synonymous with “women’s health” — cis women’s health, in particular.
Cis women refuse to prioritize trans women’s reproductive rights because they’re afraid of being forgotten about. But in reality, the reproductive rights movement isn’t winning because they’re ONLY representing cis women.
When we fight for barriers to accessing reproductive healthcare to be removed for trans and queer people of color (POC), everyone benefits, even cis straight women, because they face some of the same challenges.
Furthermore, trans and queer POC are currently leading countless grassroots movements to achieve social justice for us all. It’s only right to center their health and well-being when they’re literally putting their bodies on the line.
Gimeno says that reproductive rights organizations should include trans people of color (TPOC) in leadership and decision-making bodies, build projects that center TPOC and work in coalition with TPOC without tokenizing them.
Reproductive rights organizations should also embrace the values of reproductive justice, which centers women of color, LGBTQ+ folks and other historically oppressed groups and their right to make their own decisions about their bodies and their families.
When we approach birth control access with a reproductive justice lens, we acknowledge that certain groups, including trans and queer people, have a more difficult time getting contraception than others.
Fighting for the most oppressed to have access to birth control is the only way to ensure that birth control is one day accessible to everyone who needs it.
The state of Oregon recently achieved a huge reproductive healthcare victory, passing the Reproductive Health Equity Act of 2017 that covers all reproductive health services (including birth control) at no cost to all residents, regardless of gender identity, income or citizenship status.
It’s going to take a lot of work for similar legislation to succeed in other states, but I believe it can happen if the reproductive rights movement fully embraces trans, gender nonconforming and queer people.
Birth control rights will continue being eroded if our leadership isn’t centered.