Clearing the Misconceptions About Transgender Pregnancy

For the longest of time, pregnancy and the concept of giving birth have been associated with something that women do. However, the reality is that people of all genders can get pregnant and give birth to babies all over the world. With advancements in medicine today, there is also a real possibility of a transgender woman bearing a child with a transplanted uterus. There have already been cases of cisgender women, women who are assigned the female gender at birth and are not transgender, giving birth with the help of a transplanted uterus from both living and deceased donors. But, as of now, most transgender people who are giving birth are those who are born with a uterus. There are so many misconceptions about transgender people giving birth and raising a family that it is important to clear the misconceptions about transgender pregnancy. Read on to find out more.

The biggest misconception to clear up is that cis-gendered women are not the only ones who can get pregnant or menstruate. There are many bodies that menstruate. Many trans men and non-binary people menstruate and, as a result, can get pregnant. At the same time, there are many cis-gendered women who do not menstruate. Menopause and other conditions like uterine disorders or polycystic ovarian syndrome can prevent cisgender women from having regular menstrual cycles. Therefore, to just associate menstruation with womanhood is not only wrong but also offensive. It is also medically dangerous.^{(1, 2, 3, 4)}

Awareness of gynecological and obstetric care for non-binary and trans men is important because their experiences with menstruation and pregnancy are still poorly documented and very rarely studied. In fact, a study found that many trans men experience extreme isolation and body dysphoria during pregnancy.⁽⁵⁾

Health professionals frequently tell many transgender men that taking testosterone will lead to infertility, and they will be unable to conceive. However, this is a common misconception. This can often result in unplanned pregnancies or, of course, a lack of awareness that, if desired, a pregnancy is very much possible. In October 2019, the first study that studied the female-to-male transgender people receiving in vitro fertilization found that the quantity and quality of eggs remained the same between cisgender women and transgender men.^{(6, 7, 8)}

When transgender men start taking testosterone, the process of ovulation might stop within 6 to 12 months, but the egg reserves don’t disappear.⁽⁹⁾

So if a transgender man stops taking the testosterone, the menstrual cycle will usually return, but it takes around six months for the cycle to become regular again.⁽¹⁰⁾ However, there is a lack of long-term studies, but there does not seem to be any cause of concern regarding the menstrual cycle restarting once the testosterone therapy is stopped. It also seems that taking testosterone before pregnancy does not have any impact on the health of the baby.

Today, hundreds of transgender men from all over the world have given birth successfully or even contributed their eggs to a pregnancy. While the exact number of transgender people who have carried successful pregnancies is unknown, but in a 2019 news report from Rutger’s University, it was reported that new research suggested that up to 30 percent of transgender men have had unplanned pregnancies.⁽¹¹⁾

However, amidst these misconceptions, physical health is usually not the biggest challenge facing pregnant transgender men and non-binary people. The biggest challenge is that of social stigma.

Perhaps the biggest barrier to transgender pregnancy is the expectations regarding pregnancy. After all, for years, the language and culture surrounding pregnancy and the process of birth have been extremely gendered. The terms women’s health and maternity ward are just the top two examples of the assumptions that any general person makes about a pregnant person.

These are the factors that most people do not think twice about that can cause significant hurt to pregnant people who are not women. This has made the entire process so much more challenging for transgender people – the fact that the process is tailored for women, from the language to the entire procedure.

From having to correct healthcare professionals caring for them about the correct gender to use, to getting laughed at by nurses and providers who refuse to see transgender men who are pregnant, to being denied lactation coaching in the hospital, there are many such challenges being faced by transgender people who are pregnant.⁽¹²⁾

According to a 2016 study, it was because of such type of treatment at healthcare facilities that 30.8 percent of transgender patients often delayed or did not seek medical attention.⁽¹³⁾ Another 2017 study found that transgender men did not leave the house itself in order to avoid being labeled as pregnant females, especially after working so hard to get people to accept them as a male.⁽¹⁴⁾ Another transgender man part of the same study felt that the healthcare providers were uncomfortable dealing with a transgender male patient seeking pregnancy.

The only way in which a lot of a transgender pregnant person’s overall experience with pregnancy can be improved is by the people around to start respecting their gender and avoid making general assumptions. Some of the common tips that healthcare professionals or anyone coming in contact with pregnant people should keep in mind include:

• Begin by using gender-neutral language. Get in the habit of saying pregnant people instead of pregnant women.
• It is better to use language about parts, such as using the terms uterus and ovaries, instead of saying female reproductive organs.
• Ask a pregnant person their preferred pronouns beforehand itself. This includes the/him/his, she/her/hers, they/them/theirs, and so on. Consistently make an effort to use the ones they tell you.
• Ask for and use the pregnant person’s preferred name, which might not always be their legal name.
• Ask for their gender identity, which could be different than their gender at birth or sexual orientation. This should be asked on the intake forms, and you should also have your staff check what has been written in the form before addressing the patient.
• Have single-stall gender-neutral washrooms.
• Train all staff on these practices and enhance cultural competency within the practice.

As more and more transgender people go through pregnancy and get the deserving support, it will make more people comfortable seeking support. The more competent the healthcare will be, the healthier the pregnant person and their baby will be. After all, that is the single biggest outcome everyone should strive for.

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