Article title: Transgender men and Pregnancy
From Obstetric Medicine
Many transgender men who have the capacity to bear children are faced with barriers in the healthcare system as a result of a lack of training, argue the authors in this article. 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. While programs that provide health care for transgender people have ,grown in recent years, the healthcare system has failed to adapt to address this need, as the researchers explain: “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.”
Medicine as a whole has not incorporated gender diversity into routine care. This, coupled with news reports covering the pregnancies of transgender men sensationalizing what should be a personal experience, results in a harmful experience, one that can lead to increased experiences of gender dysphoria.
Transgender people have experienced significant advances in societal acceptance despite experiencing continued stigma and discrimination. While it can still be difficult to access quality health care, and there is a great deal to be done to create affirming health care organizations, there is growing interest around the United States in advancing transgender health. The focus of this commentary is to provide guidance to clinicians caring for transgender men or other gender nonconforming people who are contemplating, carrying, or have completed a pregnancy. Terms transgender and gender nonconforming specifically refer to those whose gender identity (e.g., being a man) differs from their female sex assigned at birth. Many, if not most transgender men retaintheir female reproductive organs and retain the capacity to have children. Review of their experience demonstrates the need for preconception counseling that includes discussion of stopping testosterone while trying to conceive and during pregnancy, and anticipating increasing experiences of gender dysphoria during and after pregnancy. The clinical aspects of delivery itself fall within the realm of routine obstetrical care, although further research is needed into how mode and environment of delivery may affect gender dysphoria. Postpartum considerations include discussion of options for chest (breast) feeding, and how and when to reinitiate testosterone. A positive perinatal experience begins from the moment transgender men first present for care and depends on comprehensive affirmation of gender diversity.
Review Article: Juno Obedin-Maliver and
Harvey J Makadon
Transgender men and pregnancy Obstetric Medicine: The Medicine of Pregnancy 1753495X15612658, first published on October 28, 2015 doi:10.1177/1753495X15612658