‘You feel like a criminal’: How trans people are pushed further to the margins in anti-abortion Brazil

In the summer of 2023, Matheus terminated his pregnancy at a friend’s house. 26-year-old Matheus, who identifies as nonbinary and uses he/she pronouns, said he, ​​made the decision because he felt unsafe with the person he had sex with, and the pregnancy triggered his gender dysphoria.

“I thought about how my body would be with the pregnancy, and it shakes me,” he told CNN, sitting at a park in the Brazilian city of São José dos Campos. “My breasts ​​would have milk, and my breasts are a part of my body​​, that really bothers me”. Despite the toll the pregnancy would have taken on Matheus’ mental health – whose real name has been changed to protect his identity – what he did is illegal.

In Brazil abortions are criminalized, except in cases where the pregnancy is a result of rape, the life of the pregnant person is at risk, and in cases of fetal anencephaly – a fatal birth defect. Violating the penal code can carry a prison sentence of up to three years.

Despite the risk of imprisonment, multiple gender and abortion rights activists told CNN, some cis gender women (women whose gender identity match their biological sex) as well as trans men prefer to end their pregnancies illegally, even if some of them could qualify for the legal exceptions. This way, they avoid both the stigma they have historically faced while seeking an abortion and the requisite assessments by a multidisciplinary health team including a doctor and a psychologist which are arduous and can be traumatic.

In 2023, as many as 213 people were prosecuted in Brazil for self-inducing abortion or performing abortion with the person’s consent, according to the National Council of Justice, a public institution tasked with improving Brazilian judicial system.

“All these difficulties, for both trans men and cis women, makes them forget legal abortion and pursue an illegal abortion,” said Helio Oliveira, who was working as a bioethics professor at the União Latino-Americana de Tecnologia College (ULT), a higher education institute in the state of Paraná in Brazil, when CNN interviewed him earl​ier​ this year. He recently retired from the position.

In his 2023 study on trans people’s access to legal abortions, Oliveria said he didn’t find a single publicly recorded case of a trans person accessing abortion legally in Brazil. “I don’t know if there were actually no legal abortions, perhaps because their abortions were denied, or trans abortions were just recorded as women’s abortions,” Oliveira told CNN.

For Matheus getting an abortion meant buying a drug called misoprostol on Whatsapp. The pills arrived by post. Matheus said he took the pills over to a friend’s house where he read through the instructions, took the medication, laid down with his legs up, watched TV, and eventually bled out the embryo.

But unlike Matheus, 27-year-old Antonio, a Black trans man from southeastern Brazil, couldn’t afford the abortion pills. Instead, Antonio who uses he/him pronouns, told CNN that he relies on chás abortivos, cheap herbal teas to attempt to avoid pregnancy. It is common for women to take such teas including marijuana tea and cinnamon tea believing that these teas will avoid or terminate pregnancy, but it almost never works, said Rebeca Mendes, founder of Projeto Vivas, a non-profit that helps people access safe abortions.

For Antonio, whose name has also been changed to protect his identity, access to safe, legal abortions is an issue of freedom. “Abortion should be legal because women should have more freedom. It’s not right that only cisgender, heterosexual, white, rich men can have freedom,” he told CNN.

Brazil is, in some ways, a leader in the inclusion of transgender people. Since 2018, people in Brazil have had the right to change their legal name and gender without being required to undergo surgery or professional evaluation. Adults over 18 also have the right to gender affirmation surgery – surgical procedures intended to bring one’s anatomy in line with one’s gender identity. Still, the trans community faces very high rates of violence: Between October 2023 and September 2024, 350 transgender people were reported to be murdered across the world, and Brazil topped the list with 106 murders, according to the Trans Murder Monitoring Update, a project run by non-profit Trans Europe and Central Asia.

Meanwhile, political backlash against the progress made for trans and nonbinary people has been growing in the country. An analysis by Brazilian newspaper Folha found that 77 municipal and state anti-trans laws were in force across the country in January 2024 – more than a third of which came into effect in 2023. CNN couldn’t independently verify how many of them are still active. These laws include prohibiting gender-neutral language, discussions about gender issues in schools, and restrictions on bathroom usage.

Such ongoing discrimination can have consequences for transmasculine people accessing medical care beyond abortion healthcare. For example, Matheus developed a vaginal yeast infection following the abortion but he said he put off going to see a doctor, fearing ​the doctor ​might find out about his abortion. When he finally did go to a doctor, he said nothing of having taken misoprostol. “I was afraid of being reported [to police],” he told CNN. “It’s tough because while I want to tell the truth, I can’t.”

A 2021 study analyzing 43 court records from 2017 to 2019 in the state of Paraná where women were prosecuted for self-induced abortion, found that 44% of the women in those cases were reported to the police by health professionals and 65% had their medical records delivered to the police without their consent. “Many women and pregnant people in Brazil continue to be reported by doctors and nurses when they seek assistance after having undergone some type of unsafe or legal abortion. This is a practice driven by a moralistic culture that judges women for unsafe abortions,” Luciana Boiteux, a lawyer and council woman for the city of Rio de Janeiro told CNN.

Another 2018 study found that discrimination they had experienced at some point in the past made trans and gender diverse people almost seven times more likely to later avoid health services altogether. And this is still very much the case today, said Dan Kaio Lemos, a trans activist and PhD candidate at the University of Brasília. “Anti-trans movements attack us daily and parliamentary conservatism blocks our demands,” Lemos told CNN.

For Lemos, whose doctoral dissertation compares reproductive rights for transmasculine people in Brazil and Canada, the problem is systemic. “The system doesn’t understand a pregnant man,” Lemos said, adding that many trans people are reluctant to access healthcare for fear of being asked inappropriate questions or not having their pronouns respected during medical exams.

​​​​​In an email statement the Ministry of Health in Brazil told CNN that the country’s public health system “operates with the principles of universality, comprehensiveness and equity, ensuring care for all people, regardless of origin or identity, through policies that respect cultural and social particularities.” Legal abortion in Brazil is guaranteed to trans men and non-binary people in the same way as cisgender women, the statement added.

However, multiple abortion rights activists interviewed by CNN told stories of religiously conservative healthcare workers preventing people from accessing abortions, or reporting them to the police for seeking medical attention for complications following abortions they may have had illegally.

Brazil has the largest number of Catholics in the world and has a fast growing Evangelical population. Earlier this year, conservative lawmakers proposed a bill that would equate abortions after 22 weeks with homicide– and carry with it a prison sentence of up to 20 years.

This proposal “is under urgent consideration in the National Congress, awaiting a report after social mobilization against it,” the health ministry’s statement read.

While there is no data on trans or gender-diverse people accessing abortions in Brazil, nearly one in every seven Brazilian women are estimated to have had an abortion by the age of 40, with over 40% needing to be hospitalized to finalize their abortions, according to the most recent National Abortion Survey. 52% of respondents were 19 years old or younger when they had their first abortion. The same survey found that abortion rates were higher among women “with lower educational levels, Black and Indigenous women, and women residing in poorer regions.” Black Brazilian women are two times more likely than White Brazilian women to die during an unsafe abortion because they are “more likely to have one in the first place,” found a report by Amnesty International.

Despite these sobering statistics, religious conservatism in Brazil still seems to shape public perception and personal decisions – even among the LGBTQ+ community.

At the Brunna Valin Diversity Reference and Defense Centre, a space for vulnerable LGBTQ+ people to access health and social services in downtown São Paulo, 55-year-old Rodrigues told CNN: “I’m completely against abortion. It doesn’t matter if it was because of rape or anything. I think it’s a life and no one has the right to take away that life.” Rodrigues is part of The Transcidadania Social Integration Program, an initiative of the local government to support trans people who are in vulnerable situations. Rodrigues added that he recently convinced a friend, a trans man, to keep his pregnancy that resulted from a rape.

Bruna Benevides, a prominent transgender activist, told CNN that despite the perception it has cultivated “as a welcoming country with its carnival and football,” Brazil is in fact deeply conservative. She described Brazil’s colonial religious history as the greatest challenge to the rights of women and LGBTQ+ people​​.”

But there is a ray of hope. Some activists and NGOs are trying to build bridges between different groups. Tabata Tesser who works with Catholics for the Right to Decide, an NGO, said she is passionate about helping Brazilians with strong religious beliefs to reconcile them with the sexual and reproductive healthcare for people of all genders.

Public awareness of the reproductive health needs of trans men is ​​​​slowly growing. A march organised earlier in the year was attended by ten thousand people, according to the Brazilian Institute of Transmasculinities (IBRAT). Some people were carrying signs that read: “Legal and safe abortion for everyone with a uterus!” and “Transmasculine people also have abortions!” The body autonomy exercised by trans people contributes to the fight for abortion rights for all in Brazil, Lemos said.

Back in São José dos Campos, Matheus was tearful as he talked about his abortion. The decision wasn’t easy, he said, but he stands by it. It was the right choice, he said, ​​made at a time when he was trying to find new meanings for his body. “My choice was to be reborn for myself, to understand who I am.”

When CNN asked what he would wish for someone else in the same situation, Matheus said, “more information and medical care, without having to go through procedures where you feel like a criminal.”

This reporting was supported by a grant from the International Women’s Media Foundation’s Reproductive Health, Rights, and Justice in the Americas Initiative.

Mariana Della Barba, Carolina Oms, Júlia Das Carneiro, Maria Martha Bruno, Roberta Fortuna contributed reporting.