A.J. Lowik says that trans-inclusion in clinics involves more than an ‘everyone is welcome’ motto. (Devon Bidal/News Staff)

A.J. Lowik says that trans-inclusion in clinics involves more than an ‘everyone is welcome’ motto. (Devon Bidal/News Staff)

Women-only clinics create barriers for trans folks seeking sexual health care

Part two of a series looking at trans-inclusive sexual health care in B.C.

  • Aug. 6, 2019 12:00 a.m.

This article is the second in a series looking at trans-inclusive reproductive health care in B.C. The next article in the series will focus on the barriers created by the gendered billing codes used by the B.C. Medical Services Plan, find it in Friday’s edition of the Saanich News or online at saanichnews.com/tag/transgender-inclusive.

Women’s clinics serve the sexual health care needs of people with internal reproductive organs. But what happens when a trans man needs to access that reproductive health care?

Many women’s clinics use gendered language on their websites, but when asked, indicate that all are welcome to come in for care.

A.J. Lowik, a PhD candidate with the Institute for Gender, Race, Sexuality and Social Justice at the University of British Columbia, hypothesizes that this disparity between website and motto is due in part to the fact that the clinics’ trans-inclusive policies haven’t been fully implemented. Another factor could be that folks don’t know how to integrate trans-inclusion into all aspects of their practice or that they haven’t had the time to update their websites, Lowik explained.

Lowik, who uses the gender-neutral pronoun they, teaches trans-inclusion workshops in clinics and wrote the Trans-Inclusive Abortion services manual for Canada and the U.S.

“Trans-inclusion extends beyond ‘everyone is welcome’ platitudes,” Lowik noted. “People worry that trans-inclusion means welcoming men, which it does — and this, in turn, seems to spark mistrust, suspicion [and] fears over destabilizing the gendered foundations.”

If the inclusion doesn’t go beyond language, Lowik felt the message trans folks get is that space is still for ciswomen (women assigned female at birth).

“It’s as though providers are saying … ‘If you need us and you don’t identify as a woman, we’ll make it work, but we aren’t willing to have your presence as a non-woman-identified person alter our main mission and message,'” Lowik said.

Folks on Vancouver Island looking for abortion care must go to the Vancouver Island Women’s Clinic in View Royal, the only abortion clinic on the Island, or to a local hospital that offers abortion care.

The Vancouver Island Women’s Clinic’s name indicates that their space is for women, and their website uses gendered language. They define themselves on the homepage as “a specialty clinic that offers a range of services for women during [their] reproductive years.”

Dawn Fowler, executive director of the clinic, said that while they do mainly cater to women, the clinic staff will “try to treat everyone who comes through the door respectfully.”

She’s only aware of two trans patients who have come into the clinic for abortion care in the last five to eight years. Fowler said the clinic uses the Trans-Inclusive Abortion services manual, but that there isn’t a lot of demand. She noted the clinic sees more trans men coming in for IUD insertions.

“[For the] majority of the population, abortion is a women’s issue,” said Fowler.

The clinic was started in 2003 and has always been called the Vancouver Island Women’s Clinic. The name wasn’t considered “an issue at the time,” said Fowler.

Now, the clinic staff make an effort to use gender-neutral language, but Fowler said there are no plans to change the name of the clinic.

Despite their name, the Vancouver Island Women’s Clinic does provide care to trans men, but has no services for trans women. Trans women may need prostate exams and testicular cancer screenings, among other things, and these services cannot be accessed at this location. “We don’t get calls about that,” Fowler added.

While the clinic strives to create a supportive and respectful environment, Fowler said she doesn’t see care for trans women becoming available anytime soon.

“That’s not something our doctors specialize in,” she said. “The clinic was set up with a very narrow mission and we’re not looking to expand that.”


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