REGION — In light of International Transgender Day of Visibility, Community and Client Advocate Aspen Ruhlin of Mabel Wadsworth Center in Bangor addressed current stigmas around health care that contribute to the exclusion of transgender and nonbinary people.

Ruhlin specifically highlighted reproductive care services that often fall under the umbrella of what is classified as “women’s care,” a term that does not encompass the scope of people accessing these services.

“Instead of saying, abortion care, prenatal care, postpartum care, birth care, when we instead say things like women’s health, it’s very vague and a vague use of language increases stigma around accessing these services,” Ruhlin said in a Zoom interview.

Using specific language has multiple benefits, Ruhlin noted explaining that abortion care already has negative associations which get reaffirmed through vague terminology.

“When people say women’s health instead of abortion, what’s not being said but what’s being communicated is that abortion is a shameful thing that shouldn’t be openly stated and so by really looking to use inclusive language around abortion care access, not only are we including trans people in the conversation who need to be included, we’re also just having a more honest and a more bold conversation,” they said. 

Alongside practicing inclusive and more specific language, recognizing that trans people access these services is also a vital component to breaking down health care barriers.

“Obviously for some trans people, pregnancy could be a trigger for gender dysphoria for them, but that’s not the case for everyone,” Ruhlin said. “And so we need to remember that all of this care in the spectrum from abortion care to prenatal to birth to postpartum, this does not need to be a gendered thing, this needs to be an accessible thing. I personally know trans men who have continued pregnancies and given birth because that’s what they wanted to do.” 

Ideologies that remove an individual from the freedom to choose health services specific to their own body also inhibit accessibility. For example, anti-choice attitudes towards abortion care presents the idea that people should not have full rights over their own bodies. This same attitude is often encountered by people when pursuing gender-affirming care.

“There’s a lot of stigma around that as well and I think one of the things other than stigma that connects trans healthcare and abortion care, aside from the fact that the same people access both sometimes, is that they’re both rooted in autonomy, really rooted in having control of your own life and self-determination,” Ruhlin said. 

At the Mabel Wadsworth Center, Ruhlin explained that they take a trust approach in which the center trusts that their patients know what they need when it comes to healthcare.

Shifting attitudes and practicing inclusive language are only a fraction of what needs progressing to make healthcare more accessible for transgender and nonbinary patients. Funding can play a dictatorial role in the type of services a health clinic can offer and limit services for all patients. Ruhlin said that the Mabel Wadsworth Center intentionally does not accept Title X funding to avoid federal prohibitions.

Title X was established in 1970 as a federal grant program to help fund health clinics such as Family Planning and Planned Parenthood that provide reproductive services to low-income individuals. In 2019, the Trump administration enacted what is commonly referred to as the gag rule which restricted recipients of the grant from referring patients for abortion care among other stipulations.

This has left the non-profit Mabel Wadsworth Center as the northernmost health clinic in the state to offer full-abortion services and Ruhlin said they often see patients traveling hours away from Aroostook County.

“So while it is a lot of work to get the fundraising to run a clinic without getting those Title X funds, it’s pretty clear why we make that decision because then we don’t have to worry about having the rug pulled out from under us,” they said. 

The center also works with patients to ensure their healthcare is as affordable as possible while also connecting patients with other resources such as SafeMaine which provides abortion funds.

For more information about the Mabel Wadsworth Center, visit or call (207) 947-5337. The center also accepts individual donations by going to



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