RT Journal Article
SR Electronic
T1 Abortion attempts without clinical supervision among transgender, nonbinary and gender-expansive people in the United States
JF BMJ Sexual & Reproductive Health
JO BMJ Sex Reprod Health
FD British Medical Journal Publishing Group
SP e22
OP e30
DO 10.1136/bmjsrh-2020-200966
VO 48
IS e1
A1 Heidi Moseson
A1 Laura Fix
A1 Caitlin Gerdts
A1 Sachiko Ragosta
A1 Jen Hastings
A1 Ari Stoeffler
A1 Eli A Goldberg
A1 Mitchell R Lunn
A1 Annesa Flentje
A1 Matthew R Capriotti
A1 Micah E Lubensky
A1 Juno Obedin-Maliver
YR 2022
UL http://jfprhc.bmj.com/content/48/e1/e22.abstract
AB Background Transgender, nonbinary and gender-expansive (TGE) people face barriers to abortion care and may consider abortion without clinical supervision.Methods In 2019, we recruited participants for an online survey about sexual and reproductive health. Eligible participants were TGE people assigned female or intersex at birth, 18 years and older, from across the United States, and recruited through The PRIDE Study or via online and in-person postings.Results Of 1694 TGE participants, 76 people (36% of those ever pregnant) reported considering trying to end a pregnancy on their own without clinical supervision, and a subset of these (n=40; 19% of those ever pregnant) reported attempting to do so. Methods fell into four broad categories: herbs (n=15, 38%), physical trauma (n=10, 25%), vitamin C (n=8, 20%) and substance use (n=7, 18%). Reasons given for abortion without clinical supervision ranged from perceived efficiency and desire for privacy, to structural issues including a lack of health insurance coverage, legal restrictions, denials of or mistreatment within clinical care, and cost.Conclusions These data highlight a high proportion of sampled TGE people who have attempted abortion without clinical supervision. This could reflect formidable barriers to facility-based abortion care as well as a strong desire for privacy and autonomy in the abortion process. Efforts are needed to connect TGE people with information on safe and effective methods of self-managed abortion and to dismantle barriers to clinical abortion care so that TGE people may freely choose a safe, effective abortion in either setting.Per agreements in the informed consent materials with participants, the authors cannot make the data publicly available. However, in support of transparency in research, we can discuss secure ways to make de-identified quantitative (not qualitative) data available on a per-request basis. Interested researchers should contact the corresponding author (hmoseson@ibisreproductivehealth.org).