Unlearning Cisnormativity in the Clinic: Enacting Transgender Reproductive Rights in Everyday Patient Encounters

In recent years, transgender reproduction has become increasingly visible in public debates in Sweden. Heated debates and years of activism and advocacy ultimately led to a change in law in 2013. In the new law, the previously controversial demands for patients to be unmarried and sterile had been removed from the legal framework. As a consequence, transgender patients also became entitled to fertility preservation through assisted reproductive technologies (ARTs). This gave rise to a new patient group of fertility patients with specific medical and psychosocial needs. Drawing on qualitative in-depth interviews with healthcare professionals in a Stockholm clinic for reproductive medicine, we discuss the professionals’ strategies for unlearning cisnormativity and what Riggs has called ‘mundane transphobia’ in the clinic. We also analyze the processes of relearning that the healthcare professionals (more or less successfully) went through. Our findings demonstrate that there is still room for improvement when it comes to meeting the specific needs of transgender fertility patients, but the clinic staff had taken a number of actions. They had gone through training with an LGBTQ organization, they had changed some of their materials such as medical posters and forms to less binary counterparts, and they had developed a number of mental strategies for being better prepared in patient meetings. One major conclusion of our study is that the reason for the remaining problems was largely associated with the fact that re-learning clinical everyday practices takes both time and continuous efforts, rather than there being any reluctance by staff to learn new habits. A major problem pointed out by the staff was that the legal reform increased the number of patients without increasing the clinic’s budget, and that this had required a ‘creative reallocation’ of funds from other patient groups