Better Understanding of Pregnant Transgender Men is Needed

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trans_sign_smCourtesy of the National LGBT Health Education Center of Fenway Health

There has been little research on the topic of transgender people and their desire to become parents. In a commentary for the Journal of Obstetrics Medicine, LGBT Health Education Center Director Harvey Makadon, MD, and his co-author Juno Obedin-Maliver, MD, MPH argue that many transgender men who wish to become parents and to be genetically related to their children, have the capacity to bear children. But they face barriers in the healthcare system as a result of a lack of provider training.

In recent years, transgender people have experienced significant advances in social acceptance, which has led many organizations to look at their policies, programs, and educational materials to ensure that work with their sphere is both affirmative and inclusive. This social acceptance has even led to greater examples of cultural depictions of parents who are transgender―both real and fictional―though they are largely limited to people who transition after they have become parents: Caitlyn Jenner; Laverne Cox as Sophia Burset on the Netflix series “Orange Is the New Black”; and Jeffrey Tambor as Maura Pfefferman on Amazon.com’s Golden Globe-winning series “Transparent.” [pullquote]While programs that provide health care for transgender people have grown in recent years, the healthcare system has failed to adapt to address the need of transgender men who wish to become pregnant, or who have become pregnant.[/pullquote]

The one notable example of the media portraying a transgender person on the journey to parenthood is coverage of Thomas Beatie’s heart-rendering social, legal, and medical struggles through each of his three pregnancies, which resulted in his becoming the first legally recognized man in the U.S. to give birth. While press coverage of Beatie’s experience portrayed him as one-of-a-kind, there is evidence through documentaries, social media list-servs, and the recent establishment of lists of health service providers with experience supporting transgender people through pregnancies, that Beatie is far from alone.

While programs that provide health care for transgender people have grown in recent years, the healthcare system has failed to adapt to address the need of transgender men who wish to become pregnant, or who have become pregnant. “This leaves many health professionals unprepared to provide quality care, with many needing to ‘catch up’ or refer (possibly delaying care) to someone else, when a transgender person presents for care,” Makadon and Obedin-Maliver write. [pullquote]“This leaves many health professionals unprepared to provide quality care, with many needing to ‘catch up’ or refer (possibly delaying care) to someone else, when a transgender person presents for care,” Makadon and Obedin-Maliver write.[/pullquote]

Most healthcare providers and staff are often unaccustomed to caring for any transgender people, let alone ones who may be pregnant, which results in obstructions in the vital care transgender men need during pregnancy. This care is not limited to medical treatment throughout pregnancy. It must also include the way that patients are treated by receptionists: “Our experience is that however unintended, a rigid encounter with a registrar who does not understand [explanations why] one’s name (and gender) vary from previous medical records or legal documents and questions patients publically about this, can lead to dismay and bring an abrupt and unfortunate end to one’s visit,” the researchers write.

Makadon and Obedin-Maliver conclude that: “All staff from the front line receptionists to clinicians will need training to understand why gender affirming polices and behaviors are important. […] Every health care system needs to introspectively examine how they can comprehensively meet the needs of the gender diversity we have amongst our patients and community.”

The article, “Transgender men and pregnancy” is available online at the Journal of Obstetrics Magazine.

[From a News Release]