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Transgender pregnancy

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Transgender pregnancy is the incubation of one or more embryos or fetuses by transgender people.

Trans men

Transgender activist Diane Rodríguez with her pregnant husband.

Pregnancy is possible for transgender men who retain a functioning vagina, ovaries, and a uterus.[1][2][3] Regardless of prior hormone replacement therapy treatments, the progression of pregnancy and birthing procedures are typically the same as those of cisgender women.[citation needed] However, some trans men who carry pregnancies subjected to discrimination, which can include a variety of negative social, emotional, and medical experiences, as pregnancy is regarded as an exclusively feminine or female activity. According to the study "Transgender Men Who Experienced Pregnancy After Female-to-Male Gender Transitioning" by the American College of Obstetricians and Gynecologists,[4] there is a lack of awareness, services, and medical assistance available to pregnant trans men. Inaccessibility to these services may lead to difficulty in finding comfortable and supportive services concerning prenatal care, as well as an increased risk for unsafe or unhealthy practices. Additionally, the study also exposed that some individuals reported having gender dysphoria and feelings of isolation due to the drastic changes in appearance which occur during pregnancy, such as enlarged breasts, and due to changes in public reception of their gender identity. Researchers also found that prior use of testosterone did not affect pregnancy.

Testosterone therapy affects fertility, but many trans men who have become pregnant were able to do so within six months of stopping testosterone.[5] Future pregnancies can be achieved by oophyte banking, but the process may increase gender dysphoria or may not be accessible due to lack of insurance coverage.[5] Testosterone therapy is not a sufficient method of contraception, and trans men may experience unintended pregnancy,[5][6] especially if they miss doses.[5]

Statistics

According to figures compiled by Medicare for Australia, one of the few national surveys as of 2020, 75 male-identified people gave birth naturally or via C-section in the country in 2016, and 40 in 2017.[7]

Non-binary people

Non-binary people with a functioning vagina, ovaries and uterus can give birth.[8] Not all non-binary people (or trans people of any gender identity) medically transition through hormone replacement therapy (HRT) or any kind of surgeries due to various factors ranging from medical conditions, accessibility and/or expenses, but those that do have to interrupt their HRT in order to carry the pregnancy.[citation needed] Unintended pregnancies by non-binary people on testosterone therapy may be more common if they are on a low dose of testosterone.[5] Non-binary parents choose parental titles such as "mom" and "dad", or utilize invented gender-neutral or non-binary titles.[9]

Non-binary people who have written or been profiled about their experiences of pregnancy include Rory Mickelson,[10] Braiden Schirtzinger,[11] and Mariah MacCarthy.[12]

Trans women

Further information: Uterus transplantation

Transgender women do not naturally have the anatomy needed for embryonic and fetal development. As of 2008, there were no successful cases of uterus transplantation concerning a transgender woman.[13]

Uterine transplantation, or UTx, is currently in its infancy and is not yet publicly available. As of 2019, in cisgender women, more than 42 UTx procedures had been performed, with 12 live births resulting from the transplanted uteruses as of publication.[14] The International Society of Uterine Transplantation (ISUTx) was established internationally in 2016, with 70 clinical doctors and scientists, and currently has 140 intercontinental delegates.[15] Its goal is to, "through scientific innovations, advance medical care in the field of uterus transplantation."[16]

In 2012, McGill University published the "Montreal Criteria for the Ethical Feasibility of Uterine Transplantation", a proposed set of criteria for carrying out uterine transplants, in Transplant International.[17] Under these criteria, only a cisgender woman could ethically be considered a transplant recipient. The exclusion of trans women from candidacy may lack justification.[18]

See also

References

  1. ^ Obedin-Maliver, Juno; Makadon, Harvey J (2016). "Transgender men and pregnancy". Obstetric Medicine. 9 (1): 4–8. doi:10.1177/1753495X15612658. PMC 4790470. PMID 27030799.
  2. ^ "Labor of Love website". Archived from the original on 2010-01-23..
  3. ^ Beatie, Thomas (April 8, 2008). "Labor of Love: Is society ready for this pregnant husband?". The Advocate. p. 24.
  4. ^ Light, Alexis D.; Obedin-Maliver, Juno; Sevelius, Jae M.; Kerns, Jennifer L. (1 December 2014). "Transgender men who experienced pregnancy after female-to-male gender transitioning" (PDF). Obstet Gynecol. 124 (6): 1120–1127. doi:10.1097/AOG.0000000000000540. PMID 25415163. S2CID 36023275.
  5. ^ Jump up to: a b c d e Berger, Anthony P.; Potter, Elizabeth M.; Shutters, Christina M.; Imborek, Katherine L. (2015). "Pregnant transmen and barriers to high quality healthcare". Proceedings in Obstetrics and Gynecology. 5 (2): 1–12. doi:10.17077/2154-4751.1285.
  6. ^ Light, Alexis; Wang, Lin-Fan; Zeymo, Alexander; Gomez-Lobo, Veronica (2018). "Family planning and contraception use in transgender men". Contraception. 98 (4): 266–269. doi:10.1016/j.contraception.2018.06.006. PMID 29944875.
  7. ^ Hattenstone, Simon (April 20, 2019). "The dad who gave birth: 'Being pregnant doesn't change me being a trans man'". The Guardian – via www.theguardian.com.
  8. ^ Toze, Michael (2018). "The risky womb and the unthinkability of the pregnant man: Addressing trans masculine hysterectomy" (PDF). Feminism & Psychology. 28 (2): 194–211. doi:10.1177/0959353517747007. S2CID 149082977.
  9. ^ King-Miller, Lindsay (March 13, 2020). "Not All Parents Are "Mom" Or "Dad"". Ravishly. Retrieved June 4, 2020.
  10. ^ "I'm Pregnant, But I'm Not a Woman". www.advocate.com. 2018-11-13. Retrieved 2020-03-10.
  11. ^ "Non-binary, pregnant and navigating the most gendered role of all: Motherhood". Washington Post. Retrieved 2020-03-10.
  12. ^ "I'm Nonbinary. I Loved Being Pregnant. It's Complicated". Narratively. 2018-09-03. Retrieved 2020-03-10.
  13. ^ William Leith (2008-04-10). "Pregnant men: hard to stomach?". Telegraph. London.
  14. ^ Jones, B. P.; Williams, N. J.; Saso, S.; Thum, M.-Y.; Quiroga, I.; Yazbek, J.; Wilkinson, S.; Ghaem‐Maghami, S.; Thomas, P.; Smith, J. R. (2019). "Uterine transplantation in transgender women". BJOG: An International Journal of Obstetrics & Gynaecology. 126 (2): 152–156. doi:10.1111/1471-0528.15438. ISSN 1471-0528. PMC 6492192. PMID 30125449.
  15. ^ "History of ISUTx".
  16. ^ "About - 'Vision'". ISUTx.
  17. ^ Lefkowitz, Ariel; Edwards, Marcel; Balayla, Jacques (2012). "The Montreal Criteria for the Ethical Feasibility of Uterine Transplantation". Transplant International. 25 (4): 439–47. doi:10.1111/j.1432-2277.2012.01438.x. PMID 22356169. S2CID 39516819.
  18. ^ Lefkowitz, Ariel; Edwards, Marcel; Balayla, Jacques (Oct 2013). "Ethical considerations in the era of the uterine transplant: an update of the Montreal Criteria for the Ethical Feasibility of Uterine Transplantation". Fertility and Sterility. 100 (4): 924–926. doi:10.1016/j.fertnstert.2013.05.026. ISSN 0015-0282. PMID 23768985. However, it certainly bears mentioning that there does not seem to be a prima facie ethical reason to reject the idea of performing uterine transplant on a male or trans patient. A male or trans patient wishing to gestate a child does not have a lesser claim to that desire than their female counterparts. The principle of autonomy is not sex-specific. This right is not absolute, but it is not the business of medicine to decide what is unreasonable to request for a person of sound mind, except as it relates to medical and surgical risk, as well as to distribution of resources. A male who identifies as a woman, for example, arguably has UFI, no functionally different than a woman who is born female with UFI. Irrespective of the surgical challenges involved, such a person's right to self-governance of her reproductive potential ought to be equal to her genetically female peers and should be respected.
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