Twelve years ago, a married couple decided to use a sperm donor to get pregnant. After a fairly typical pregnancy, the couple welcomed their child, a daughter. Happy as can be, the couple went on to have two more children. Their story seems typical on the surface, and in many ways is the story of an average American family. Until you realize that Thomas is both the father and the one who carried and delivered their children. Thomas Beatie was the first transgender man to become pregnant and give birth - the first in the world! Since then, more than a few other transgender men have become pregnant. Along their journey, each man has learned exactly how difficult it is for transgender people to receive comprehensive healthcare. Add a transgender pregnancy to the mix and the whole system collapses.
Even though medical doctors should be the most unbiased professionals, their personal feelings can crop up in their work. The fear that they’ll be discriminated against can prevent some men from seeking proper prenatal treatment. Even the American College of Obstetricians & Gynecologists admitted transgender men face multiple barriers to care. Their study found one transgender man who was harassed by their care provider.
“Child Protection Services was alerted to the fact a ‘tranny’ had a baby.”
ACOG recommended a few simple changes to better reach and treat transgender pregnant people. Most importantly, it’s imperative that care staff use the patient’s preferred pronouns or titles. Transgender men also require specialized fertility discussions after birth, as well as access to therapy tailored to their needs.
While transgender men might be intimidated by the medical burdens of transgender pregnancy, their struggle is made all the more difficult by matters of legality. Some insurance plans are quite limited in their accommodations for transgender people. In some circumstances, the issue is as “insignificant” as having certain procedures coded only for female clients. When a transgender person legally changes their gender, their insurance company follows suit. Unfortunately, that means some transgender men simply can’t find coverage for their pregnancy and prenatal care. After the baby is born, some transgender men struggle to find consistency on the birth certificate. Some municipalities require the mother on the birth certificate to also be the person who has physically birthed the child.
Emotional Isolation and Body Dysphoria
According to ACOG's study of transgender pregnancy, men who experience the physical phenomenon of pregnancy, labor, and delivery also deal with unique emotional challenges. The very state of being pregnant can be isolating in and of itself. It’s doubly so when you’re experiencing pregnancy in a way few others have! Public reaction can be quite harsh, creating a gulf between the pregnant person and their support system.
Naturally, transgender pregnancy carries a high incidence of reported body dysphoria. Some men have stated that being pregnant was a masculine experience for them; that growing larger made men feel stronger. Others felt uncomfortable with their changing body. Hayden Cross, a British transgender father, said that having a child had been a lifelong dream. Still, the thought of delivering a baby vaginally was traumatic and upsetting. He opted for a scheduled c-section delivery. Because all transgender men must stop testosterone therapy during pregnancy, they notice a shift in their physical being. At least one man reported a sense of ease with his breasts for the first time while breastfeeding, noting that his breasts now had purpose.
Some describe pregnancy as empowering, others uncomfortable. In the same way, transgender men have varying experiences of pregnancy. As transgender pregnancy becomes more commonplace our medical providers - and our society as a whole - must learn how to meet the unique needs of gestating men.