Facing Abortion Barriers: Benin Transgender Activist Calls for Inclusion

By: Nissia Benghazi

In the aftermath of the U.S. Supreme Court ruling to overturn Roe vs. Wade, the language around who’s affected by abortion rights has largely focused on one specific group: cisgender women. But trans activist Nazareth Osseni, from Benin, says the conversation about reproductive rights needs to be more inclusive of those with reproductive organs but who might identify differently. “Validate our feelings, we exist,” he says. It’s no doubt institutional misogyny and policing people’s bodies constitutes a major threat to reproductive justice everywhere. It’s time for lawmakers to stop attacking this right and start working to ensure that women and transgender men have access to the care they need, regardless of their gender identity.

Abortion is a highly controversial and polarizing issue, with people holding widely differing views on the morality and legality of the procedure. In spite of the Maputo Protocol turning 20 this year, abortion laws in Africa still vary considerably. In some countries, it is illegal in all circumstances, while in others, it is permitted only to save a woman’s life or in specific cases of rape or incest (1). Up until October 2021, Benin firmly criminalized abortion seekers or anyone who intentionally caused an abortion or provided the means for an abortion. Clearly established in the Criminal Code, Article 352 stated that breaching the law could be punished with imprisonment for up to three years (1).

Abortion Context in Benin

In light of this major human rights deprivation, efforts to expand access to safe and legal abortion in Benin have been met with resistance from conservative groups, including religious organizations. In 2018, the government proposed a new law that would expand access to abortion in cases of rape, incest, fetal malformation, and when the pregnancy poses a risk to the health or life of the pregnant person. However, the law has not been implemented yet; therefore, information relating to who is authorized to operate these services remains vague. So while the Ministry of Health has issued guidelines allowing for certain circumstances of abortion, the legal context of safe abortion in Benin remains restrictive, and women face significant barriers in accessing the care they are entitled to. As a reminder, where abortion is illegal or difficult to access, people are more likely to seek out unsafe methods, potentially exposing them to irreversible, lethal danger.

To expand this discussion, I had the honor of interviewing Nazareth Osseni, an inspiring transgender rights activist from Cotonou, Benin, to discuss the unique hurdles restrictive abortion laws create for people like him. Osseni warns the risks of excluding this already marginalized group from the conversation increases barriers transgender people encounter when accessing abortion care in Benin. For context, Benin is one of the few countries in Africa to authorize abortions. The new law was voted in during October 2021; however, its implementation is not yet completely on the ground. The Ministry of Health has updated its guidelines to allow for abortion in certain circumstances, stating that: upon request of the pregnant woman, voluntary termination of pregnancy can be allowed when the pregnancy is likely to aggravate or cause a situation of material, educational, professional, or moral distress incompatible with the interest of the women and/or the unborn child.

Despite these progressive measures, it is important to note that access to safe abortion care in Benin remains limited, and unsafe abortions continue to be a significant public health issue. Many women and trans people seek unsafe abortions, which can lead to serious health complications and even death in some cases.

Trans Activist Testimonial

“Transgender people attend the same medical facilities as regular people, exposing them to major discrimination and stigmatization from patients. These threats are discouraging, depressing, and why many trans people would rather self-medicate than go to the doctor and face all these menaces. Although dissemination from health workers is becoming increasingly rare.” – Nazareth Osseni

Osseni claims that transgender individuals are still heavily ostracized due to their trans status and describes the lives of transgenders, especially in Benin, as characterized by pain, social rejection, and hate-motivated harassment. Due to being excluded, the ones with reproductive organs are at a higher risk of unintended pregnancies, given the lack of access to comprehensive sexual education and contraception. This directly puts them in a vulnerable position, with a higher probability of facing unwanted pregnancies and the challenges associated with them. They face additional barriers when accessing medical care due to the lack of understanding from health-care providers, although these numbers are decreasing (2). This can be attributed to the fact that the organization Synergie Trans Bénin is now partnering with identified health centers where working professionals close to their communities facilitate referrals and operate as focal points for trans people.

“In society, trans people like me are regularly raped, sometimes even organized rape by the family, to get what they call the “taste” of the penis … To get them back on the right track. Oftentimes, these situations lead to cases of unintended pregnancies and cause them to resort to unsafe abortion methods. Although Benin voted for an expansive law on abortion, it is still a deeply religious society where christianity bans it,” said Osseni.

This touching testimonial highlights another side of reality that many trans people are confronted with to this day: forced sexual intercourse – rape. It’s a traumatizing experience and fear-provoking process that can trigger anxiety about childbirth among transgender men. Feelings of gender dysphoria are often exacerbated by unwanted pregnancies, which can impact their mental health and well-being (2). Gender dysphoria is typically characterized by feelings of unease that a person may experience due to a mismatch between biological and gender identity.

Osseni claims, “The person sees himself as a man – it is violent to get pregnant against your will and to assume it in front of others – a very emotionally painful circumstance. Your own feelings of malaise and discomfort, other people’s perception of you, it all reverberates in the background of your consciousness. People have a hard time accepting trans people already, so imagine trans pregnant people? Very few have the capacity to understand us and our reproductive challenges … Some trans individuals get voluntarily pregnant and embrace it, but that isn’t the case for everyone. The health system in Benin needs deep structural reform.”

This is why Osseni advocates a special approach for trans men – a push for inclusion in the abortion rights movement that extends to the trans community, who generally tend to be excluded from the public sphere. According to the activist, health measures should be shifted to focus on educating and training medical staff on capacity building and trans identity gender issues, sensitizing families and the youth through focus groups. Trans people should benefit from more state-led development programs working to promote positive mental health, personal intercommunication sessions, and sexual and reproductive health counseling.

It is crucial to acknowledge that the right to control one’s own body and make decisions about one’s own reproductive health is a fundamental right for all people, including transgender men. This right should not be denied or restricted based on a person’s gender identity. Access to safe and legal abortion is a central aspect of reproductive health care, especially for transgender men who face additional discriminatory barriers. It’s important for lawmakers and health-care providers to work together to remove roadblocks and ensure that everyone has access to the care they need, regardless of their gender identity or orientation.