When I started my transition over 13 years ago, the idea of having children was the last thing on my mind. That thought morphed into an impossibility when I began my medical transition and learned that prolonged testosterone use could lead to infertility. Honestly, that didn’t bother me. My priority was to feel comfortable in my own skin. Even when I identified as female, I never dreamed of having a family.
I’m a Black, gay transgender man and a proud seahorse dad. I welcomed my first daughter on January 9, 2014, four years post-transition, and then my second child arrived unexpectedly on July 21, 2020. I’m attracted to male-identified individuals, and both pregnancies were surprises rather than plans.
When I first discovered I was pregnant, it was five months in. I was regularly visiting my doctor due to extreme fatigue and other symptoms, yet no one suggested a pregnancy test. I eventually found out on my own. Once my pregnancy was confirmed, I was referred to an OB-GYN who had zero experience caring for trans individuals. I faced constant misgendering and awkward jokes from the staff, leaving me feeling defensive and on edge. My blood pressure spiked, leading to an induction due to preeclampsia.
Upon arriving at the labor and delivery unit, I requested a C-section, as I didn’t feel comfortable with a vaginal birth. I was told that I couldn’t have one because it was deemed too risky and that “all the women here prefer natural births.” For five days, I was stuck on a magnesium drip, unable to move or eat solid food, while a parade of students observed. I felt like a specimen rather than a person in labor. Finally, after days of pressure, I broke down and demanded a C-section. Thirty minutes later, I was on the operating table, but the trauma lingered long after.
My experience left me deeply traumatized, which I connected to my daughter. I faced severe postpartum depression, anxiety, and PTSD. For two years, I struggled to connect with my child while battling suicidal thoughts, all without proper postpartum care.
It’s crucial to note that Black cisgender women face the highest maternal mortality rates in the U.S. According to the CDC, in 2020, non-Hispanic Black women had 55.3 deaths per 100,000 live births—2.9 times that of non-Hispanic white women. But what about transmasculine individuals, especially Black ones? Unfortunately, we don’t have enough data on this group, as they remain largely overlooked in maternal health research. Thankfully, heightened visibility of transgender individuals has sparked conversations on transmasculine pregnancy, pushing providers to better understand our unique experiences.
Why Does This Matter?
As a Black trans man who has navigated the birthing process in the U.S. twice, I can attest that a lack of education often leads to traumatic experiences. Childbirth should be a joyous occasion, regardless of race or gender identity. The treatment one receives during pregnancy can significantly impact their postpartum journey.
What Needs to Change?
Education is key. The first step to improving care for transmasculine individuals is to educate yourself—hiring a qualified transmasculine person for training is a great start. Recognize that experiences are diverse; different identities require tailored care. For instance, a Black transmasculine person will face different challenges compared to someone who is non-Black due to systemic racism.
Representation is also vital. Using inclusive language like “birthing people” and “gestational parent” and ensuring that your intake forms reflect this inclusivity are steps toward creating a welcoming environment. Small changes can make a huge difference. I understand that change can be intimidating, and some may feel that inclusive language erases women’s experiences. However, inclusion does not equal exclusion—there’s room for everyone at the table, and we all deserve equitable care.
To My Transmasculine Friends
If you’re pregnant or considering this journey, empower yourself with knowledge. Remember, your body is yours, and you have complete autonomy over your pregnancy and birth. I highly recommend hiring a doula for emotional support and to act as a buffer between you and potentially problematic providers. Surround yourself with supportive family and friends.
Don’t let anyone convince you that you don’t deserve the life you envision. We all deserve happiness, no matter the political climate.
Resources
For those interested in at-home insemination, check out Make a Mom for their reusable options, or join the Make a Mom Facebook group for free sperm donor matching. Learn about how at-home insemination works here. If you’re looking to boost fertility, consider their fertility supplements. For more information on pregnancy, the CDC is a great resource, and you can also read about managing certain conditions like pica during pregnancy in our blog post.
Summary
Navigating pregnancy as a transgender man can be challenging, especially in a healthcare system that lacks understanding and inclusivity. It’s important to advocate for proper care and seek support, ensuring that your pregnancy journey is as positive as possible. Education, representation, and community support are crucial for making meaningful changes in maternal healthcare for transmasculine individuals.