Trans and Nonbinary individuals may also get pregnant, and just like cisgender people, they deserve affirming and welcoming treatment when it comes to reproductive rights and gynecological health. Changing the discussion around transgender pregnancy is a vital first step.
I do not identify with a specific gender. I was born a female, yet I don’t identify as either sex. I had not yet transitioned and identified as a woman when my ex-partner and I were trying to have our first child.
We were a lesbian couple looking for a suitable sperm donor, and we were of the same gender. Although I was eager to start a family, the very thought of becoming pregnant filled me with dread and disgust. Fortunately, my then-partner was eager to become a mother, so we began shopping for sperm. Like Superman requiring kryptonite to function, I quipped that the idea that lesbians need sperm to start a family was ridiculous. Biological necessity dictated the procedure; therefore, considerations of gender and sexual orientation were irrelevant and unnecessary. There is only one way to have a baby: for sperm to fertilize an egg.
Every human being has an innate need to raise a family, and while some people find “modern” families charming, others have a hard time accepting gay parents in a society that is largely heteronormative. The most challenging aspect of pregnancy for trans and nonbinary individuals is not giving birth to a healthy child but rather convincing others that they can.
Pregnancy is possible for transmen (males designated female at birth) and nonbinary people (like myself) who do not identify with either biological sex. When talking about reproduction, reproductive rights, and gynecological health, transgender people should get the same respect and acceptance as cisgender people. Language is the first point.
Updating Terminology for Pregnancy
During the entire process of trying to conceive (TTC), pregnancy, and giving birth, all I and any other nonbinary person notice are labels. Most of the resources I utilized to learn about optimal conceiving, laboring, and delivering methods were written for and about cisgender, straight couples, more specifically, women and moms and their fathers-to-be husbands. When I learned more about pregnancy and how to be a helpful birth partner, I had to reframe the terminology in my thinking. Changing pronouns, gender, relationship status, or role was and is a fun linguistic challenge.
Childbirth instructor and lactation counselor Stefanie LeJeunesse concurs. “One of the simplest ways to improve [affirming baselines] is to change the language surrounding pregnancy and birth. Using correct phrases like “pregnant parent” and “breast/chestfeeding” doesn’t take away from the pleasure and respect of helping a new parent through pregnancy, labor, and birth.”
David Minerva was in a lesbian relationship while passing as a woman before he came out as a transgender male. Minerva tried to disregard the body dysphoria that pregnancy brought on, in contrast to my own very outspoken awareness of it. He hoped that becoming pregnant and giving birth would enable him fully embrace the concept of womanhood. Like a last-ditch effort to test out what he imagined it would be like to be a lady. Unfortunately, he only found more distress. Minerva struggled to put his “bristling” pregnant experience into words.
“The overwhelmingly cis-normative nature of the pregnant culture made me feel quite uneasy. The terms “pregnant women” and “expecting mothers” have always made my skin crawl and made me feel uncomfortable,” Minerva remarked.
He felt oppressed, thinking about his transgender male friends who were also expecting because he was in a “women’s” building. David was also considering himself at the time. Even though the nurses and doctors were friendly and concerned, the gendered terminology, assumption of gender, and default phrases used that referred to all birthers as women and moms made him feel excluded and uncomfortable, like he didn’t belong.
Building an All-Inclusive Healthcare System
They/them/theirs pronouns refer to Jenna Brown, the creator of Love Over Fear Health and Birth, a radical educator, and a queer full-spectrum doula. As a nonbinary person, I appreciated the site’s affirming and inviting atmosphere as I read about the services they offer and the ways in which they practice inclusive care. While becoming pregnant isn’t something I’m interested in, I do wish that all trans and nonbinary people could have access to the kind of care that Brown offers.
While Brown acknowledges the potential for LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual) inclusive services to be ubiquitous, she argues that more is required than one-time trainings and a rainbow sticker on the window. Education updates are essential for providing excellent care to the LGBTQIA+ community, especially in areas like transgender pregnancy and parenting.
“Trans, nonbinary, and gender nonconforming pregnant and nonpregnant parents have unique and changing requirements. The providers should also be ready to make a change to a more patient-centered approach,” they elaborated. To further ensure patient safety, “providers should be mindful that any person that their patients encounter with (receptionists, nurse practitioners, lab techs, etc.) should likewise be trained and involved in ongoing education.”
Allies that use not only gender-neutral vocabulary but also include all genders in conversations about reproductive health and rights are essential to creating a safe space for transgender and nonbinary people.
The circumstance described by Minerva is one in which I frequently find myself. As he puts it: “The constant presence of cisgender women who claim to be my ally only to scream “women women women” anytime the topic of reproductive rights and healthcare comes up is tiresome. Alternatively, you could remark, “If males needed abortions, they’d be easy to acquire.” Furthermore, it drives me to want to yell. There are men I know who have had abortions. Also, persons who don’t identify as male or female.”
The same way I feel. Abortion rights, like the right to contraception and fertility treatments, are a human right, yet pointing this out sometimes makes me feel like I’m invading someone’s privacy or trying to remove their repression.
Recently, I had to get a mammogram to screen for what is typically thought of as a female health issue, and I felt quite out of place in the women-only waiting area. I felt like a prisoner in the female bin because of my nonbinary identity. Although I was born a female, that has no bearing on who I am.
I’m an actual human being who has had to undergo a security check of my chest. Having a uterus and a vagina means I require regular gynecological checkups. For insurance purposes, though, I must present myself as a female provider. Pregnancy and postpartum care are typically considered “women’s health care needs” by insurance companies and hence are not covered for trans guys or nonbinary people.
Brown believes that doctors have a chance to advocate for their transgender and nonbinary patients with insurance companies. It will take a concerted effort from the healthcare community as a whole, but as Brown points out, “providers and care networks do have the voice and ability to change the way that insurance companies categorize patients and procedures.”
The authors note that doctors who are truly committed to being allies to the LGBTQ population will advocate for modifications to the design of electronic health records. Every data collection software and hardware must be able to support gender identities outside of the binary. This paves the way for people to be addressed with the name and pronouns of their choice. When someone is treated with such deference, it’s much easier to have the kind of open and trustworthy discussions about health that are essential. This also serves to confirm our fundamental identity.
Freddy McConnell, a transgender man, lost a court challenge in 2018 in which he sought to have his name included on his child’s birth certificate as the father. McConnell has passed as a guy for quite some time, yet he utilized his sperm and eggs to have a child in 2018. McConnell is a man in every sense of the word, yet he was denied the right to claim paternity of his child because another person thinks pregnancy is the same as motherhood.
Trystan Reese isn’t the first transgender man who has spoken up about his pregnancy and parenting experiences in the media. What Reese has to say about it “The fact that something has always been done in a certain way does not guarantee that it is the correct, optimal, or even the most beneficial method. I think it’s interesting for people to observe the various alterations to the traditional family unit over history.”
I understand that bringing about these alterations will take time. And I believe a cultural revolution will propel language towards a more progressive, nonbinary sphere. And as people become more aware, they will begin to view the seemingly impossible as perfectly ordinary. The birth of a kid to a transgender or non-binary parent will be another testament to motherhood’s miraculousness and the strength of a family.
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