In 2012, Oliver, then a 19-year-old living in Missouri, found out he was pregnant. “It was really surreal for me. And I think that being trans kind of complicated that surrealness,” Oliver said. (Last names have been withheld throughout this story to protect people’s privacy.) “I didn’t really know that trans people existed, so I didn’t know why I had dysphoria. ... I just knew that anytime my body did something that was considered female, it was confusing and uncomfortable for me.”
It didn’t take Oliver long to make a decision. “It kind of felt like a life-ending situation because ... I couldn’t afford to feed myself a lot of the time. When you’re in a situation like that abortion was the definite answer,” he said. His boyfriend at the time agreed; he already had a kid and couldn’t keep up with the child support payments. Oliver was also estranged from his parents, who he says were abusive. He was struggling financially and began looking online for abortion providers, but feared he wouldn’t be able to afford the abortion. “I was too scared to ask people for help, and I was really young and just kind of stupid, honestly,” he said. He borrowed about $400 — most of it from his 15-year-old sister. “She had saved it up for Christmas [presents], which is really crazy and sad but very lifesaving and awesome at the same time.”
He found a single Planned Parenthood in Kansas that provided abortions, and it was about two and a half hours away. He scheduled an appointment for July 5. The day before, he went to a 4th of July celebration, and among the corn dog vendors was a stand set up by an anti-abortion group. He considered telling them about his plans the next day but decided against it.
By the time of the appointment, he was 11 weeks and four days along, three days away from being too late to get the abortion. He feared protesters would be lingering outside the clinic, but there were none. After the procedure was over, he sat in a recliner in the waiting room for 30 minutes eating saltine crackers, drinking water, and downing ibuprofen. Next to him was another abortion patient, who told him she already had two kids and didn’t want another.
“It was a nice little therapeutic moment where we’re just like, ‘Yeah, this was the right decision for me,’” he said.
Oliver kept his abortion a secret. He lived in a conservative area and had been raised by Catholic parents. He assumed the news of his abortion wouldn’t go well. Then, two years after his abortion, he got more interested in activism. “I decided that I wanted to be public about my abortion,” he said. “I decided I’m just gonna say it on Facebook ... and see what happens.”
Oliver is one of hundreds of trans men and nonbinary people who get abortions each year in the United States. A 2017 study found that about 500 transgender and nonbinary people got abortions in a clinical setting in the US that year. But the actual number is probably higher, according to Dr. Heidi Moseson, a senior research scientist at Ibis Reproductive Health, who specializes in epidemiology and reproductive health and has published articles about trans and nonbinary people’s experiences with abortion.
The exact data is hard to come by because clinics don’t collect data on gender, and many trans and nonbinary people self-administer abortions outside of clinics. Nineteen percent of trans and nonbinary people attempt abortion on their own, a much higher rate than the 7% of cis women. One trans man I talked to said he had bookmarked webpages detailing how to give himself an abortion with herbs in case he wasn’t able to get an appointment. “I hadn’t quite gotten to coat hanger desperation yet, but I wasn’t far,” he said.
Trans men have been largely left out of the conversation since the overturning of Roe v. Wade in June. Yet the experts I spoke to say trans people will be most direly affected by making abortion illegal. Trans people “already face the greatest barriers to accessing care,” Moseson said, including financial struggles, a lower rate of medical insurance, and anti-trans discrimination at the doctor’s office. Now that abortion is criminalized in some states, she thinks trans people might be disproportionately targeted for arrest.
Trans people also face high rates of sexual assault. The 2015 US Transgender Survey found that 47% of transgender people had experienced sexual assault in their lifetime. “When there is not space for us to talk about how we can get access to abortion care, there is certainly not space for us to talk about the ways in which we have been sexually assaulted,” said Rena Yehuda Newman, a transmasculine comix artist and the editor-in-chief of New Voices magazine, who created a trans-inclusive abortion illustration featuring a nude drawing of themself wearing a kippah. Newman said their illustration was a rebuttal to the people who are implying trans people need to keep quiet about abortion. “I really wanted to tell the people who are like me and have bodies like mine and are struggling in the way that I’m struggling that they actually deserve to take up that space when the world tells them that there isn’t room for them,” they said.
Trans-inclusive advocates who suggest people use terms like “pregnant people” or “birthing people” instead of “pregnant women” have been ridiculed.
Including trans people in the conversation about abortion has been politically fraught. Trans-inclusive advocates who suggest people use terms like “pregnant people” or “birthing people” instead of “pregnant women” have been ridiculed. Bette Midler’s viral tweet from last month sums up this argument: “WOMEN OF THE WORLD! We are being stripped our rights over our bodies, our lives and even of our name! They don’t call us ‘women’ anymore; they call us ‘birthing people’ or ‘menstruators’, and even ‘people with vaginas’! Don’t let them erase you! Every human on earth owes you!”
Midler is not the only prominent person to make the claim that changing the terminology or including trans men in the discussion on Roe erases women.
During a Senate Judiciary Committee meeting, Republican Sen. Josh Hawley scoffed at the term “people with the capacity for pregnancy,” saying, “You mean women?” when sparring with UC Berkeley law professor Khiara Bridges, and later adding, “No, I don’t think men can get pregnant.”
Moseson disagrees with sentiments like Hawley’s. “The majority of people who need abortions and seek abortion care are cis women,” she said, but we can acknowledge that transgender men and nonbinary people need abortion access too. “As a scientist, as an epidemiologist, it’s just inaccurate to talk about abortion as only an issue that affects cis women. ... It takes one extra breath.”
Aspen Ruhlin, the community engagement coordinator at Mabel Wadsworth Center, a reproductive healthcare center in Maine that specializes in gender treatment and trans-inclusive abortion care, said, “One thing that always blows my mind is how typically TERFs will say that by saying ‘pregnant people’ that women are being excluded or women are being dehumanized. That always confuses me a little because women are people,” they said. Anti-abortion laws “go hand in hand” with “laws attacking gender-affirming care,” Ruhlin said, because both laws are “firmly rooted in controlling the bodies of anyone who is not a cis white man.” The same people who oppose abortion access don’t oppose forced sterilization of disabled people, which is legal in most of this country, they said.
To find out how Roe may affect trans men, I talked with 14 trans men who’ve had abortions or are planning hysterectomies now that Roe has been overturned. Most of them were from the United States, but I also spoke to men in Canada, England, and France. They felt it was important to speak out because their voices have been largely erased from the conversation around Roe, and they want to spread awareness that transmasculine people need abortion access.
After Oliver posted about his abortion on Facebook, a former high school classmate shared the post. “She captioned it with something like, ‘Look how disgusting this person is, [they’re] proud of the terrible murder they’ve done,’” he recalled. Soon Oliver began getting harassing messages from his classmate’s friends. “That was a little bit scary, but it didn’t make me want to be quiet about it,” he said. “If I sat down with any of these people individually and told them what happened to me and how badly I needed this, I think most of them would probably, if they were halfway decent people, they would understand.”
Seven years after his abortion, in 2019, Oliver started testosterone at a Planned Parenthood clinic and changed his gender marker.
“I’m a trans guy. When I was 19, I had an abortion. Planned Parenthood saved my life two times”
Soon after he found out Roe was overturned, Oliver went to an abortion rights rally. After the demonstration was over, the organizers asked if anyone in the crowd wanted to speak. Although he was extremely nervous, Oliver stood up and walked to the mic. “I’m a trans guy. When I was 19, I had an abortion. Planned Parenthood saved my life two times,” he said. The audience clapped. A nonbinary person in the crowd came up and thanked him for speaking out.
Oliver has had a much more positive experience sharing his abortion story as a man than he did when he presented as a woman. “When you present as female, just because we live in a culture where misogyny is the norm ... your decisions and your morality are more infantilized. People think that you don’t understand what you’re doing,” he said. “As a guy, I’m more often and more consistently perceived as competent and [aware of] what’s going to be good for me. I feel like I’m believed more, and I feel more confident stating that this was the right thing for me.”
But he said that aside from this experience, he hasn’t felt very included in the abortion debate since he transitioned. Before transitioning, he said, “Liberal people were always wanting to boost my voice. And now that I’ve transitioned, I feel almost like I’m inconvenient for some people. ... People who consider themselves my ally are not only forgetting about me, but they’re also telling me that, ‘If men could get abortions or if men could get pregnant, then blah, blah, blah,’ and it's like, well, I’m a man and I can get pregnant, so are you telling me that you haven’t thought of me as a man this entire time?”
Earlier this year Oliver had been considering a hysterectomy as part of bottom surgery. “I realized I’ve never wanted to have biological kids, and I never want to be pregnant, and it’s just a body part that I definitely know that I don’t need and I don’t want,” he said. “But at the same time, I realized I was hesitating because I felt like removing this body part genuinely would make my voice less important in this conversation because I’ve seen that repeated so many times” (a reference to the “no uterus, no opinion” slogan).
“I’m like, this could get me killed. … So I need to hurry up and get this done,” he said.
Then in 2019, Missouri introduced a law that could affect abortion treatment for ectopic pregnancies and the Roe draft leaked. “I’m like, this could get me killed. ... So I need to hurry up and get this done,” he said. “If we lived in a vacuum and I didn’t have to deal with politics, I probably would have waited longer.” He scheduled an appointment for a hysterectomy. Initially his health insurance declined to cover the procedure because he’s a trans man. He filed an appeal and spent a long time talking with the billing department, and they eventually agreed to cover it.
Oliver’s experience is not uncommon among trans men seeking abortion care, according to Ruhlin, who was initially hired by the center to advocate for patients whose insurance companies denied them coverage because they were trans. “It is actually against federal law for insurance companies to do that,” they said. “The second you mention it’s illegal, they start following the law.” However, because many electronic medical records do not have a section for male patients needing pregnancy, abortion, and OB-GYN care, insurance companies continue to deny coverage.
On July 22, 2022, less than a month after Roe was overturned, Oliver got a hysterectomy. When I spoke to him before the surgery, he said, “I feel very secure in the fact that my voice is still going to matter. I’m not going to have a uterus anymore, but I’m still gonna keep being loud about this as often as I can.”
Like Oliver, many trans men I spoke to are scheduling bottom surgery and planning to have hysterectomies in response to the overturning of Roe. They fear being forced to carry a pregnancy to term and having their rights to transition-related care taken away.
Jaden*, a 19-year-old college student in Los Angeles who is studying biology and aspires to be a pediatrician, said, “When I heard about the decision I was freaked out. My first thought was that I would be OK the next 10 years because I do have the copper IUD. I got that a couple months ago just in case anything happened like this,” he said. But he is fast-tracking his bottom surgery. “I’ve always wanted to do top surgery first. But I can survive without top surgery first. ... If I got pregnant, I would not live through that experience. ... The amount of dysphoria that it would induce ... is very sickening to think about.” Jalen says he loves kids and may adopt, but he doesn’t want his own biological kids. A.J. Lowik, a trans reproductive health researcher who wrote a manual on trans-inclusive abortion care for the US in 2019, said that while many trans people experience dysphoria with pregnancy, not all do. Some trans men seek out pregnancies (in fact, an entire subreddit is devoted to them: r/seahorsedads).
John*, a 34-year-old trans man, is also scheduling a hysterectomy sooner than he expected because of Roe. He had top surgery last year and was going to wait until 2023 to give his body time to heal and to save up money to have more of a financial cushion, but his plans have changed.
“I live in a red state that had a trigger law, so getting an abortion if I was raped would be hard. I would have to travel to another state to do so. And with the fact that some conversion therapy uses rape and pregnancy to try to ‘fix’ trans men, it becomes even more worrying,” he said. It’s not just fear of having to carry a child to term that’s worrying; he said anti-trans discrimination has gotten worse recently as well. Roe being overturned “seems to have brought out the worst in some people,” he said. “I pass pretty well as a young guy, but even I have had to deal with people suddenly talking loudly about what they thought should be done to fix trans people, and getting a side questioning eye. It’s getting more dangerous to be seen as other, or different. I don’t want to take any chances.”
“Blue state people don’t know how scary this is.”
Dan*, a 30-year-old trans man who lives in Tennessee, is not only scheduling his hysterectomy for Aug. 1, much sooner than he expected; he is also preparing to move from the state, where he has lived his whole life and where five generations of his family have grown up. He has been taking care of his mom, who has a serious illness, and fears she won’t get good care if he leaves. “I went into a real downward spiral of panic over just the Dobbs draft. I knew that very little stood between the state of Tennessee and direct persecution of transgender adults if Roe, Griswold, Lawrence, and Obergefell were repealed,” he said. “Blue state people don’t know how scary this is. There’s still this perception that it’s all about pronouns and elite sports. The real questions are: If my top surgery or tubal ligation gets denied and the appeal process stretches out months, will it still be legal next year? ... If I get the HIV prevention pill now, could it be used as evidence in my sodomy trial in 2025?”
Dan has extreme tokophobia, a fear of pregnancy, mostly because of the gender dysphoria that could accompany it, but also because he’s afraid of the inherent dangers of giving birth, ever since his mom worked at “a crunchy natural birthing center that got nearly sued out of existence.”
Roe has caused Dan to make other changes as well. “I’m not only rushing surgery,” he said. “I’m rearranging my life. I'm going to trade school for medical billing so that I will be able to afford to live somewhere else in the future. I'm shedding excess possessions that would make it harder to move.”
Dan believes that the right wing has regressed to viewing the LGBTQ community the way it did in the 1980s. “You can smell the Aqua Net and cigarette smoke,” he said. “A pastor connected to law enforcement in my area went viral for claiming AIDS was God's punishment.”
Tim, a 17-year-old trans man, was in his British public high school classroom when his teacher brought up the news that Roe v. Wade had been overturned in the US. All his classmates agreed that people should have the right to abortion, he said. Then his teacher added that she was leading a change in curriculum about sexual health and was looking to do some research. Tim lingered after class was over. “This is going to sound weird, but a month ago, I went through an abortion, and I’m happy to talk about it,” he said to her. His teacher wanted to hear his story. In fact, she asked him to speak to other teachers at the school about abortion education and “routes that students can take if they are going through that problem and can’t talk to their parents about it. Because it’s all well and good saying ‘Talk to a trusted adult,’ but not everyone has a trusted adult,” he said.
Early this year, Tim had been feeling nauseated, so he took a pregnancy test while on vacation just to ease his mind. When the test came back positive, he texted a picture to his boyfriend of 10 months, who immediately called him. “He was making sure I was OK because the hormones and the dysphoria were raging,” Tim said. “On a day-to-day basis, I can usually just ignore the fact that I'm born female ... but being pregnant was just like the worst ’cause it was just that constant feeling of, ‘This isn’t right.’” His boyfriend agreed that they should get an abortion. “He knows that I’m not much of a child person, especially at the age of 17, and I knew he isn’t either,” Tim said.
He called his mom to tell her the news. “I knew she had gone through two abortions in the past, and she’s always been like, ‘If you need any help with this, come to me,’” he said. “So I was very lucky in that respect that I didn’t have to tiptoe around her.” Tim’s mom helped him schedule the abortion, which was free with his health insurance. In the UK, if you’re under 18 and want an abortion, you can get one without parental permission.
“The people at the clinic were super welcoming, super kind,” he said. When he told them about his dysphoria, they were understanding. They used his pronouns and chosen name. Because he was seven weeks pregnant, he had a choice between a pill or a surgical abortion. He chose the surgical procedure because he could be anesthetized throughout it. The only weirdness happened during the ultrasound. He was lying on the table as the technician placed the ultrasound transducer on his stomach below his lifted-up T-shirt. “Would you change your mind if it was twins?” she asked. Tim said, “No.” The technician paused, looked at the screen, and said: “It’s not twins.”
“Great. Thanks,” Tim replied. He made a TikTok about the experience that has received 2.4 million views. Most of the comments have been positive, but some are anti-trans, as are some of the responses to his post on Reddit. “Why are you having sex if you’re trans and you don’t like yourself ... if you don’t want a child?” one of the comments said. “Trans people should have a right to like the intimacy that comes with it, like sex with their partner, just as much as anyone else,” Tim said.
Archie, a 23-year-old trans man who lives in the Southwest of the US (he declined to be more specific because of privacy concerns), discovered he was pregnant in January of this year. He was working at Walmart at the time and was out to some of his coworkers but not all. “In the South, if you’re loud about [being trans] and assertive about it, people will be loud and assertive about pushing you back,” he said.
“The reason I got pregnant is because I had been going through a bout of depression for a while and not really having all the money to get my testosterone, so I kind of stopped taking it for a while,” he said. (Testosterone can affect fertility, but it is not birth control.) He had also stopped taking the birth control his provider recommended.
Planned Parenthood told Archie that he had probably conceived in November. “So I was kind of freaking out,” he said. He decided on an abortion soon after finding out, and his partner, who is nonbinary, was supportive of his decision.
He initially got an appointment for abortion pills through a local provider, but the appointment was too late; by that time, he’d no longer be eligible for a pill abortion. So he drove for two hours to the closest big city with a friend, to get abortion pills. She loaned him the money. “When I finally got the pills, I think I was 10 weeks, five days — so two more days and I wouldn't have been able to take the pill,” he said.
At the clinic, he wasn’t open about his gender identity to the nurses. “I didn't even want to try to explain that. I just wanted to get in and get it out,” he said. Nor did he tell the patients he talked to in the waiting room about his gender identity. “I just try to be safe in the South,” he said. He hopes abortion providers will include trans and nonbinary people in their messaging in the future.
“After the conversations about abortion in the US started getting more heated, I’ve been seeing graffiti around the city where I live [in Ontario, Canada], which says, ‘Abortion is murder,’” Elliott, a 26-year-old Canadian trans man, told me. “It’s a really, really concerning thing to see, especially in a province and in a city that I consider to be very progressive and in a place where I get gender-affirming care, and I got my abortion. It’s just really scary because I’ve never seen anything like that before.”
His abortion and top surgery were covered by Canadian national health insurance. Although Prime Minister Justin Trudeau has spoken about enacting a law protecting abortion in Canada, Elliott said he is afraid because what happens in the US affects Canada.
Elliott had been on testosterone for a week when he found out he was pregnant. His period was a month late. “I just kind of noticed something wrong with my body. I had been getting really sick,” he said. So he took a test. “I remember to this day that immediate panic that I felt when I saw the test becoming positive,” he said. “Pregnancy itself is something that I’ve always been absolutely terrified of and I already knew I didn’t want to go through with it. But the moment that I knew that there was something inside me that I did not want, my brain began to fire on all cylinders.”
He already had an appointment scheduled the next day with his primary care doctor to monitor his testosterone therapy. His spouse called the doctor and asked if an abortion procedure could be done as well. The doctor told his partner they would “get that sorted out,” Elliott said.
Although he was anxious prior to the appointment, he soon felt at ease in the doctor’s office. He told his doctor matter-of-factly: “I wasn’t as careful. And I ended up getting pregnant. This is not something that I want to follow through with, and I would like to get an abortion.”
Elliott wasn’t sure how his doctor would react. “He didn’t fight me or argue with me or even ask me if I was sure, because we had already discussed prior that pregnancy is not something that I was OK with,” he said.
Then the doctor asked if his dysphoria was bad. Elliott told him it was. “The process of telling him that and getting the pills took maybe about 20 minutes,” he said. After his abortion, he got an IUD implanted.
“It is killing trans people to push them away from the conversation.”
When he heard the news that Roe was overturned, he had a pit in his stomach. “The first thing that I thought was … if I was in a situation where the government were going to do everything to force me to keep a baby that I knew I wasn’t going to love, I probably would have either gotten close to or just straight-up taken my life. ... And I know that many people are probably considering these options as well in the US,” he said. “It is killing trans people to push them away from the conversation.”
Experts believe there are changes that could make getting an abortion safer and more accessible for trans people and the OB-GYNs who provide them treatment. (A 2015 survey of OB-GYNs found that nearly two-thirds did not feel comfortable treating transgender patients.)
Lowik, the trans reproductive health researcher, said, “It’s about meeting patients where they are, not making assumptions about their body parts, their reproductive health, [and] making an effort to mirror the language that your clients or patients use. Some of the changes are easy to implement, such as altering gendered language on intake forms and having gender-inclusive signs to ensure that someone who did not identify as a woman would experience a space and its service positively.”
Because some abortion service providers are geared toward cis women only, trans people often don’t feel welcome. As Ruhlin said, “If a trans man who has been on T for a while — he’s got facial hair, he’s got a deeper voice, his name is Dylan — goes to an abortion clinic, [the employees] make the assumption that he's not the patient, or they make the assumption that this is a cis man who’s trying to pull something sketchy.”
Lowik said we should use terms like “pregnant people,” although they recognize that many people fear more people using inclusive language will spur more effective attacks on abortion access, as Carrie N. Baker and Carly Thomsen recently argued in Ms. magazine. Lowik believes this worry is unfounded, however. “This is a recycling of an old argument. Feminists in the ’70s were concerned that if they included lesbians that it would dilute the message. Lesbians were being told to wait their turn, that we would fight for the rights of heterosexual women first, and once established, lesbians would have a seat at the table and would be able to fight for their unique needs,” they said. This is not exactly what happened. Betty Friedan, cofounder of the National Organization for Women, famously called lesbians the “Lavender Menace” and fired some prominent lesbian members of the organization because she was afraid lesbians would hurt the cause of women’s rights. Lesbians were forced to form their own organizations and struggled to be accepted within the wider women’s movement.
Lowik believes that some anti-abortion groups are intentionally stoking infighting among abortion advocates because if groups “fight each other, then we’ll be less effective at working together in order to collaboratively fight the patriarchy and to fight the systems of power that are invested in keeping all of us in subordinate positions in society.”
Ignoring trans and nonbinary people will backfire, Lowik said. “I don’t think it makes sense as a political strategy to leave people behind and to tell them to wait; meanwhile, those are the people who are actually most negatively impacted, the people who are experiencing the brunt of the oppressive violence at the hands of governments and of individuals.”
Abortion rights advocates are understandably angry, Oliver said, “but they’re pointing their finger in the wrong direction where they’re pointing at men, instead of pointing at who I think is to blame ... religious people who go to church ... and conservatives.”
Oliver said speaking out is a matter of life and death. “In 1999 there was a trans man named Robert Eads who died from ovarian cancer because every doctor he called refused to treat him on the basis of him being a trans guy,” he said. Like Oliver, Eads was from a Southern state. OB-GYNs feared that if they gave cancer care to Eads they would be shunned by other patients. “One of the main reasons I advocate for inclusion of transmasculine people in conversations about abortion and gynecology overall is for the safety and well-being of transmasc people,” Oliver said.
Oliver is not just worried about his right to abortion being taken away — he also worries about access to testosterone being denied. He and his girlfriend, who is also trans, plan to leave Missouri, where both were born and raised, within the next four years. “Reproductive rights are for everyone, period. It doesn’t matter what kind of genitals you have, what identity you have,” he said. ●
*Pseudonyms were used for people who wished to protect their privacy.
Correction: Oliver's age when he found out he was pregnant was misstated in a previous version of this post.