NCRP: Health Equity — and Abortion Access — Must Be Gender Affirming

Second track of Abortion Access Roadmap Calls on Funders to 
Support the Abortion Access Needs of Transgender and Gender Expansive Patients 

For every million dollars that the philanthropic sector spends, 
only $11.44 goes toward transgender and nonbinary reproductive health. 

WASHINGTON, DC — The National Committee for Responsive Philanthropy (NCRP) is marking this month’s 49th anniversary of the Supreme Court’s Roe v. Wade decision by calling on philanthropy to invest more in the addressing the unique obstacles that trans and gender expansive (TGE) people face when seeking abortion services. 

“There is no reproductive justice without centering transgender and gender expansive people,” write NCRP Movement Engagement Manager Brandi Collins-Calhoun and Movement Research Manager Stephanie Peng. “They too have the right to maintain personal bodily autonomy and decide if, when and how they experience reproductive parenthood.” 

Funding Abortion Beyond the Binary” is the second of four planned releases organized in a roadmap for grantmakers who are looking to support health equity through abortion access. 


Nick, a trans storyteller and activist, centers the report by telling their abortion story and their expectations when receiving healthcare, connecting it to the larger systemic obstacles that TGE people face.  

“When I called the abortion clinic, I ended up crying on the phone, because I was afraid of being misgendered,” Nick tells NCRP’s Collins-Calhoun. “I was afraid of going through an experience where I was going to be misgendered in addition to it just being a medical procedure. Then all of the cultural baggage that goes along with abortion in the United States, and my fear of having an experience that would be very – that would cause me a lot of gender dysphoria.” 

For trans and gender expansive communities, the dollars philanthropy dedicates to their reproductive needs comes woefully short. According to Funders for LGBTQ Issues, for every $1 million awarded by the sector, just $400 are allocated for transgender/nonbinary people, with $88 set aside for transgender/nonbinary health and well-being, and just under $11.44 was for sexual and reproductive health. 

Meanwhile, each year about $448 of every $1 million given by US foundations goes to Harvard alone. 

“While it is obvious that a handful of foundations are committed to advancing health equity and improving women’s health, much of their time, interest, and dollars invested too narrowly define what barriers exist in accessing reproductive and sexual health care,” writes Dr. Jamila Perritt of Physicians for Reproductive Health. “The philanthropic sector’s continued silence about abortion has impacted many people, including transgender and gender expansive abortion seekers, who often bear the brunt of philanthropies inequitable practices. The struggle to contextualize abortion services as part of essential health care services or to center transgender and gender expansive abortion seekers, means many communities are overlooked in their giving. 

The roadmap’s previous track highlighted the active role that independent abortion clinics play as frontline providers and advocates and the geographic, economic and social barriers patients face in getting to them. Future sections of the roadmap will look to explore how abortion funds in supporting patients and how “crisis pregnancy centers” are undermining community access and health. 



Additional materials further detail how trans and gender expansive people seeking abortions must overcome major hurdles before they even make it to the clinic to receive medical attention.  Biased websites and crisis pregnancy centers intentionally give out misleading information, and other medical facilities exclude TGE people altogether by using gendered, woman-focused language.  

Health care providers are not much better: nearly half of trans adults report being misgendered. A quarter are denied healthcare outright. One in three transgender patients have to teach their doctor how to appropriately care for them.  

“The quantitative and qualitative data describes an often deeply traumatizing experience for a group of people who are already facing systemic poverty and stigma,” says Peng. “Unfortunately, these obstacles can lead to dangerous medical outcomes and other heartbreaking consequences.” 

Collins-Calhoun, Peng and a host of advocates and organizers interviewed urge health providers and funders to see gender affirming care as essential in all health spaces, especially abortion care.  

“When philanthropy fails to prioritize people of all and no genders, it creates gaps where transgender and gender expansive people often get lost,” says Collins-Calhoun. “That’s why it’s critical that funders recognize that cisgender women are not the only people seeking access to reproductive and sexual health care, particularly abortion services.” 

The report offers five recommendations grantmakers can do to invest in transgender and gender expansive patients’ visibility in health care and divest from their erasure:  

Nick's Quote: Just make sure that when you're listening to people, when you're creating policy, and when you're creating internal policies, trainings, and programming, that you have people from a lot of different experiences who are represented.....

  • Prioritizing Care at the Margins   
  • Funding Trans-Focused Research 
  • Applying Gender Neutral Language in Their Grantmaking   
  • Holding Existing Grantees Accountable to the Transgender Folks in the Communities they Serve 
  • Elevating & Following the Knowledge of Transgender Leaders 


NCRP President and CEO Aaron Dorman hopes that the NCRP’s Funding the Frontlines’ collection of stories, resource links and recommendations provide organizers on the ground another tool to push donors to broadly support all parts of the reproductive justice and abortion access movement. 

“Philanthropy has both an opportunity and obligation to help make health justice real for thousands of Americans. Accomplishing that goal depends on everyone getting the care that they need, especially when they need it the most, including abortions.” Dorfman says. “We hope this roadmap continues to provide not just food for thought, but ideas for urgent action that immediately supports providers and patients.”


The National Committee for Responsive Philanthropy (NCRP) has served as philanthropy’s critical friend and independent watchdog since 1976. We work with foundations, nonprofits, social justice movements and other leaders to ensure that the sector is transparent with, and accountable to, those with the least wealth, power, and opportunity in American society.  

 Our storytelling, advocacy and research efforts, in partnership with grantees, help funders fulfill their moral and practical duty to build, share and wield economic resources and power to serve public purposes in pursuit of justice.

To learn more about to learn more about to support this and other movement work, check out our Movement Investment Project.