S3, Ep 3: Transgender Healthcare and Contraceptive Care

Episode Description: In this episode of WHAT IFF?: Exploring Intersectional Feminist Futures, we are joined by Kit Fischer, a dedicated advocate for transgender health, to shed light on the critical gaps in reproductive healthcare for trans individuals. Together, we delve into common misconceptions, such as the mistaken belief that trans men cannot get pregnant while on testosterone, and how these myths impact access to essential contraceptive care. 

Kit shares his personal experiences and expertise, offering valuable insights into navigating healthcare as a trans person, including how to advocate for yourself in medical settings. We discuss practical resources like inclusive healthcare resources, support networks, and educational tools for both patients and providers to bridge gaps in understanding and improve outcomes.

This episode also explores actionable strategies for healthcare providers to create affirming environments, from using inclusive language to recognizing the diverse needs of trans patients. With a focus on dismantling stigma and empowering individuals, we envision a future where reproductive healthcare is accessible, compassionate, and affirming for all.

Join us for an essential conversation that challenges misconceptions, amplifies trans voices, and offers a roadmap for building more inclusive systems of care.

Resources Mentioned in Episode

• “Standards of Care 8 | WPATH,” n.d. https://wpath.org/publications/soc8/.

Transcript

00;00;00;00 - 00;00;45;25
Molly and Emily
Welcome to What IFF? Exploring Intersectional Feminist Futures podcast that brings varied activism and community stories together to imagine a more inclusive world. I'm your host, Molly Dickerson, and I'm your host, Emily Currey. In today's episode, we are addressing transgender health care and contraceptive care, which is an essential intersection of reproductive justice, gender identity, and bodily autonomy. Concepts often explored in gender studies yet rarely apply to the lived experiences of trans men.

00;00;45;28 - 00;01;11;00
Molly
Today, we'll dive deep into how reproductive care for trans men is part of a broader demand for health care systems that uphold everyone's dignity, respect and choice. Let's begin by anchoring this discussion in the framework of reproductive justice, a concept pioneered by black feminist scholars and activists. Reproductive justice is about more than just the right to avoid pregnancy.

00;01;11;02 - 00;01;39;02
Molly
It's about the right to have children, to avoid having children, and to parent in safe environments. When applied to trans men. This framework highlights that their access to contraceptive care is about much more than preventing pregnancy. It's about supporting their right to make choices for their bodies and their health on their own terms. But why is it that the reproductive justice movement, so often inclusive in theory, struggles to serve trans men effectively?

00;01;39;04 - 00;02;05;12
Molly
There's a critical gap here where trans men's unique reproductive needs often remain invisible within both mainstream health care and feminist spaces. This lack of inclusion stems from systemic biases and unwillingness to see reproductive care as a concern beyond cisgender women. In this episode, we'll talk about the impact of cis normativity in health care and why contraceptive care remains neglected need for many trans men.

00;02;05;14 - 00;02;33;19
Molly
We'll explore common misconceptions about contraceptive care even within the trans community, and we'll explore how a feminist approach to reproductive justice can challenge these gaps. We will also provide resources throughout this podcast. Today, we are joined by Kit Fischer, a transgender man and junior here at the College of Charleston who is going to help us navigate this conversation about transgender health care and contraceptive care.

00;02;33;21 - 00;02;55;29
Molly
We're so excited to have Kit on today and we can't wait to begin. Through this conversation, we hope to expand our understanding of reproductive justice and ask, what would a future look like for all people, regardless of gender, can access the healthcare that they need and deserve? Without further ado, let's jump right in. Hello? Yeah. Would you like to introduce yourself?

00;02;55;29 - 00;03;27;08
Kit
Yes. Hello. My name is Kit Fisher, as previously stated. I am a junior here at the college. I use him pronouns, and I am a transgender man. I've been openly transgender for about four years now, five years, and I have done a lot of gender affirming medical care, in the past two ish years. And I'm really excited to be here.

00;03;27;08 - 00;03;56;14
Kit and Emily
I'm really excited to share my experience. I'm excited to talk to you today. Yes, there are many misconceptions about birth control out in the world, but today we're going to be focusing on the misconceptions about birth control and trans communities. Some common myths are that trans men can't become pregnant when they're on T. People on T can't menstruate, and that estrogen based hormonal birth control is a feminizing treatment that can form a type of hormone therapy for people assigned male at birth.

00;03;56;17 - 00;04;19;26
Emily and Kit
Have you heard any of these before, Kit? Yeah. So I've been on testosterone for about, going on two years now. And, when I. Because I get my hormones through Planned Parenthood. So when I went to the office, for my consultation, for that kind of thing, they sat me down. The healthcare professional sat me down and told me, you look me in the eyes.

00;04;19;26 - 00;04;46;09
Kit
You need to be careful because you can still 100% get pregnant on testosterone. A lot of people tend to think that just because testosterone changes your secondary sex characteristics, and can also have some effects on one's uterus that you're essentially barren. But that is not the case. You know, there are so many trans men who have been on testosterone for years that, get pregnant.

00;04;46;16 - 00;05;14;26
Emily and Kit
Have you felt affected by the misconceptions about birth control within trans communities? Yeah, I certainly have. You know, a lot of people have a lot of misconceptions about the intersection between trans identity and birth control and that kind of contraceptive health care, because they really just they don't teach you this in school and in class. If you do get sex ed, it's from a cisgender, heterosexual perspective.

00;05;14;26 - 00;05;48;22
Kit
It's not from any kind of queer or trans lens. And also like even, you know, if you're seeking gender affirming health care, a lot of doctors don't even they're not even trained on this kind of thing. There's like a path guidelines. It's the the World Professional Association for Transgender Health Care. It's a set of guidelines that they publish to help doctors, like, maximize their effectiveness of gender affirming care and kind of updates with with standards and things that have come out based on research and evidence based investigations and things like that.

00;05;48;22 - 00;06;18;00
Kit and Molly
So some doctors follow path guidelines and some don't. And so, you know, it's it's a very inconsistent even if you're in a professional setting getting gender affirming care or contraceptive care. We looked into W path guidelines for health care providers and the most recent standards standards. Eight encourage doctors to conduct thorough evaluations to understand patients gender identities, mental health status, and any coexisting conditions.

00;06;18;02 - 00;06;47;21
Molly
W path encourages the assurance that assessments are culturally sensitive and respect the individual self-identified gender. They urge health care providers to prioritize informed consent as the cornerstone of transgender health care, ensuring patients understand the risks and benefits of the treatment. Now, this is a growing topic of discussion in public health and medical humanities, but they also facilitate shared decision making models between patients and providers.

00;06;47;24 - 00;07;14;25
Molly
They offer a lot of resources about hormone therapy, how to ensure it's properly and safely monitored, and advocate for educating patients about the potential side effects. And they do so much more. So check them out in the episode description, especially considering the potential for increasing legislative barriers and misinformation campaigns following the future change of administration. Understanding what resources are available is critical.

00;07;14;28 - 00;07;56;29
Molly and Kit
Let's talk to Kit about where he finds tools and resources. So I, I think community based information is really important. I am a serial lurker in Oregon FTM. Any time I have any like questions about my body or what's going on with myself or any kind of health care related question, or any just question related to transition at all, I am in the Reddit threads, I am looking, I am looking at the questions and the answers because there are so many people who have been in my exact same situation, and there are people who have answers for me that actually know their stuff.

00;07;56;29 - 00;08;17;10
Kit
And they're not just some cisgender doctor who has received like one training and that's it. You know, it's people who have lived experience. There are people who are transgender that work in this field that have the professional experience of, the research, but also, you know, have the lived experience of, of just day to day life as a trans person.

00;08;17;10 - 00;08;35;02
Kit
So seeking those perspectives out on like social media is really important. Also, just I just talk to my trans friends about like, hey, how are you staying safe? How are you like practicing safe sex? How do you make sure that you know you're not getting pregnant or you're not getting other people pregnant, you know, how do you maintain wellness?

00;08;35;02 - 00;09;01;02
Kit
And there's also like a psychological aspect to it, too, because, you know, like for a lot of trans people getting healthcare for a lot of like trans masculine people or trans men getting gynecological care or getting contraceptive care can be really dysphoria inducing, because it's like admitting to your health care provider that like, you have a certain set of anatomy that can be incongruent to your your identity and your perception of yourself.

00;09;01;02 - 00;09;22;14
Kit
So that can be really like tender and vulnerable. And a lot of people don't want to necessarily get into it and don't want to do that. Understandably so. Right. And honestly, I was really apprehensive about going to the doctor as a trans person, even just just like, you know, get a checkup, just the, the, the psychological aspect of like, my doctor knows this very vulnerable thing about me.

00;09;22;14 - 00;09;54;22
Kit
Yeah, it's very scary. It can be very it can be a barrier to care for a lot of people. So, you know, even if you either don't have the funds or you don't have the mental state, I guess, to be seeking health care in a professional environment, like talking to people who have been there and people who do have that lived experiences, lived experience and community building and connection is really important and it helps to kind of helps to kind of reduce some of that misinformation that goes around and, and helps you stay informed and keeps you safe.

00;09;54;24 - 00;10;20;29
Emily and Kit
So Kit, yes, looking towards the future, what do you think that doctors and health care providers can do to improve the experience of accessing birth control, or being informed about birth control to patients? I think that doctors just need to stay aware of what's happening in the world, as we've seen by the overturning of Roe v Wade. The criminalization of abortion in some states, including our own.

00;10;21;01 - 00;10;39;29
Kit
So I think doctors just need to be aware of what even is available or what is legal in in the state that they're practicing in and in the country at large. I think that's really important. And also just keeping up to date with research about things that are coming out, you know, the the field of trans health care is ever expanding.

00;10;39;29 - 00;11;05;10
Kit
There's new research being published, like every week that has something new to say. And I think doctors and people who are in the health care field need to stay aware of of of what's going on and how they can better serve their trans patients. Keeping up to date with policy, you know, knowing who your representative is, are following things like path and keeping up to date with transgender health care, especially when it comes to contraceptive care, is really important.

00;11;05;10 - 00;11;32;19
Kit
Also, I would just say that like knowing your community and like knowing the issues that are going on locally is really important. Knowing the needs of the trans people in your community is really important, is it's hard to think about access to care when you don't even have a home, right? And we know that transgender people are at disproportionate risks of homelessness, of losing their jobs, of being, you know, at or below the poverty line.

00;11;32;23 - 00;12;01;12
Kit
We know these things that these things have been proven through through research. So just kind of staying aware of the needs of your community, you know, outside of just the medical, outside of just the clinical, outside of just what you're seeing in the office is really important because doctors are members of the community. They're helpers, just like teachers, just like essential workers, things like that, like you as a member of the community, have an obligation to stay aware of what's happening in your community and, push for equity within your community.

00;12;01;12 - 00;12;19;05
Kit and Emily
So, yeah, there's a there's a medical kind of academic aspect to that. And there's also like a social justice side of that too. Yeah. Thank you so much. This has been incredibly informative. Yeah. Thank you so much. I appreciate you so much. I appreciate you also, I love getting to interview you because I love you so much. Oh, I love you too.

00;12;19;05 - 00;12;46;07
Emily and Molly
But it's just been so fun. Thank you for, you know, putting up with, the technical difficulties you had. Thank you for listening to this episode of What If. In the face of political challenges, hope for transgender patients can be fostered through resilience, solidarity, and a focus on the progress and support systems that continue to grow while setbacks may arise, there are reasons for hope and actionable ways to remain empowered.

00;12;46;09 - 00;13;20;03
Molly
Transgender individuals and their allies have consistently organized, advocated, and supported one another through hostile political climates. Despite political opposition, transgender voices are more visible than ever in media, politics and advocacy. And for good news, Sarah McBride just became the first out transgender person elected in Congress. Organizations like the ACLU, Lambda Legal, and the Transgender Law Center remain committed to fighting discriminatory policies and defending the rights of transgender individuals in courts.

00;13;20;05 - 00;13;54;28
Molly
Many healthcare providers and organizations are dedicated to offering affirming care, even in areas with restrictive policies. Online directories help patients find supportive providers such as transgender care listings, trans gender map, gloomy CU spaces, Rad remedy, and alcohol support. Networks and resources include transgender legal Defense and Education Fund and the Human Rights Campaign Health Care Quality Index. While the political climate may feel uncertain, transgender individuals are not alone.

00;13;55;01 - 00;14;17;22
Molly
There is a vast network of support from communities, advocates and allies committed to protecting their rights and well-being. Progress may be met with challenges, but history has shown again and again that resilience and collective action can lead to meaningful change. Thank you again, Kit, for being that voice for education, awareness and justice in today's episode of What Iff?

00;14;17;24 - 00;14;43;22
Molly and Emilly
Exploring intersectional feminist futures, we'd like to thank our site supervisors Cristina Dominguez and Priscilla Thomas, as well as the director of the Women's and Gender Studies Department for Not Go. Thank you for listening to this episode of What Iff? And thank you for learning with us. I'm your host, Molly Dickerson, and I'm your host, Emily Currey. We'll see you next time.