Transgender Men, Pregnancy, and the Role of Health Care Providers

Transgender men and other gender nonconforming individuals who retain their ovaries and uterus may have the ability and the desire to become pregnant; however, there exists very little research on the needs and values of these individuals.

A 2017 study in BMC Pregnancy & Childbirth examined the experiences of transgender men around pregnancy and reproduction, including their healthcare needs and the external factors that impact their experiences. The authors found tremendous diversity in participants’ identities, reproductive intent, gamete sources, level of social support, need for identity affirmation, degree of outness, and the extent to which they valued transition or pregnancy.

Additionally, the authors described the barriers that participants faced in healthcare settings, which include a lack of provider training in relevant areas, a lack of cultural competency that results in negative effects like using incorrect pronouns or ignoring gender identity on intake forms, transphobia, inappropriate medical care such as asking intimate questions that are not relevant to a given procedure, and institutional erasure in settings that “feel like they only cater to women giving birth.”

The authors conclude that providers must “actively work to ensure that their teams and institutions are comfortable and competent in working with transgender patients.” They provide a list of recommendations for clinical encounters, including:

  • Reflect the language patients use to describe their reproductive organs and bodies (e.g., chest feeding rather than breast feeding; or “front hole” instead of vagina)
  • Plan to educate yourself, rather than relying upon your patient to teach you

  • Be open to your patients’ expertise and learning when they want to share

  • Explain why sensitive questions are relevant; ensure these questions are clinically meaningful and not motivated by idle curiosity

  • Continue to maintain good medical care and judgment, do not attend so entirely on being gender savvy that you neglect routine protocols

You can access the full text in BMC Pregnancy and Childhood here: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1491-5