"Let All Identities Bloom, Just Let Them Bloom": Advancing Trans-Inclusive Perinatal Care Through Intersectional Analysis.

Abstract

Intersectionality, as a praxis and methodology, enables researchers to attend to their social justice goals. Yet, intersectionality has been under-employed in research centering trans people's healthcare experiences. Not attending to intersectionality has been argued to reinforce the very structural inequities researchers are trying to challenge. This article presents a re-analysis of interview data of 20 Trans Pregnancy Care Project participants in Aotearoa New Zealand. Reflecting on our initial analysis, we returned to the data to understand how intersecting marginalizations experienced by our participants, based on their social identities, amplified their exclusion from perinatal services. The present analysis identified three themes describing how participants perceived and were affected by norms that privilege dominant social positionings within perinatal care settings. These norms often determined who felt anticipated and welcomed into care and undermined the quality of care received by multiply marginalized participants. Cisnormativity interacts with other power relations to layer and compound the exclusion experienced by multiply marginalized trans people in perinatal care. Participants also described strategies to challenge intersectional failures in their care, including efforts to comply with norms and to imagine the healing possibilities of being seen in their full selves when accessing services. Drawing on the Intersectionality Research for Transgender Health Justice framework, we discuss the implications of both our findings and our analytical process, asserting the necessity of intersectionality to advance trans-inclusive practices and trans health equity.