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. 2024 Sep 27;21(1):137.
doi: 10.1186/s12978-024-01863-5.

Opportunities for improving abortion care: a key stakeholder analysis of best practices for addressing the needs of transgender, nonbinary, and gender expansive people seeking abortions

Aliza J Barnett  1   2 , Subasri Narasimhan  3   4 , Sophie A Hartwig  4   5 , Anna Newton-Levinson  4   6
Affiliations

Opportunities for improving abortion care: a key stakeholder analysis of best practices for addressing the needs of transgender, nonbinary, and gender expansive people seeking abortions

Aliza J Barnett et al. Reprod Health. .

Erratum in

Abstract

Objectives: Transgender, nonbinary, and gender expansive (TGE) persons experience pregnancies and have abortions, yet abortion care remains rooted in a gender binary, often centering the needs, experiences, and challenges of cisgender women. Despite guidance supporting gender-affirming sexual and reproductive healthcare (SRH), barriers for TGE people seeking abortions persist. We conducted an exploratory case study with key informants to understand their perception of TGE abortion seekers' needs with specific considerations for those in restrictive abortion settings.

Methods: Qualitative interviews focused on gender-affirming care and abortion provision were conducted with U.S.-based key informant clinicians (n = 4) who could provide powerful insights into gaps and experiences faced by TGE individuals. Participants were eligible if they currently or previously provided abortions and had experience practicing gender-affirming care. Interviews focused on informants' perceptions of TGE patients' needs when seeking abortions.

Results: Findings highlight the unique barriers TGE patients face when seeking abortions, including lack of provider knowledge, in-clinic stigmatization, and gender marginalization. It is notable that key informants who practiced in abortion-protective political environments have greater access to resources to implement gender-affirming care than those in restrictive contexts. Results are summarized in a clinical recommendations document which provides an accessible starting point for clinicians to begin building gender-inclusive abortion spaces.

Conclusions: It is necessary to further understand barriers facing TGE abortion seekers and integrate recommendations and emerging evidence into abortion practice. This study contributes to a growing knowledge base which emphasizes the need for inclusive abortion spaces and highlights key considerations for improving access and quality for TGE abortions seekers.

Keywords: Abortion care; Case study; Gender-affirming care; Health care delivery; Sexual and reproductive health; Transgender, nonbinary, and gender expansive health.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Clinical recommendations document synthesizing major themes from key-informant interviews, to provide steps for clinicians to begin creating more gender inclusive abortion care spaces [–18]
See this image and copyright information in PMC

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References

    1. Moseson H, Zazanis N, Goldberg E, Fix L, Durden M, Stoeffler A, Hastings J, Cudlitz L, Lesser-Lee B, Letcher L, Reyes A, Obedin-Maliver J. The imperative for transgender and gender nonbinary inclusion: beyond women’s health. Obstet Gynecol. 2020;135(5):1059–68. 10.1097/AOG.0000000000003816. - PMC - PubMed
    1. Moseson H, Fix L, Ragosta S, Forsberg H, Hastings J, Stoeffler A, Lunn MR, Flentje A, Capriotti MR, Lubensky ME, Obedin-Maliver J. Abortion experiences and preferences of transgender, nonbinary, and gender-expansive people in the United States. Am J Obstet Gynecol. 2021;224(4):376.e1-376.e11. 10.1016/j.ajog.2020.09.035. - PMC - PubMed
    1. Fix L, Durden M, Obedin-Maliver J, Moseson H, Hastings J, Stoeffler A, Baum SE. Stakeholder perceptions and experiences regarding access to contraception and abortion for transgender, non-binary, and gender-expansive individuals assigned female at birth in the U.S. Arch Sex Behav. 2020;49(7):2683–702. 10.1007/s10508-020-01707-w. - PubMed
    1. Hastings J, Geilhufe B, Jaffe JM, Rapues J, St. Amand C. Creating inclusive, gender affirming clinical environments. In: Moravek MB, de Haan G, editors. Reproduction in transgender and nonbinary individuals: a clinical guide. Springer International Publishing; 2023. pp. 177–207.
    1. Coleman E, Radix AE, Bouman WP, et al. Standards of care for the health of transgender and gender diverse people, version 8. Int J Transgend Health. 2022;23(Suppl 1):S1–259. 10.1080/26895269.2022.2100644. - PMC - PubMed

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