Transgender pregnancy
Transgender men and nonbinary people who are or wish to become pregnant face social, medical, legal, and psychological concerns.
[1] Regardless of prior hormone replacement therapy (HRT) treatments, the progression of pregnancy and birthing procedures are typically the same as those of cisgender women.
[2] It has been shown that historical HRT use may not negatively impact ovarian stimulation outcomes, with no significant differences in the markers of follicular function or oocyte maturity between transgender men with and without a history of testosterone use.
[2] 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] For this reason, it is important for patients and healthcare practitioners to comprehensively discuss fertility goals, family planning and contraceptive options during gender-affirming care.
[7] Testosterone use in trans men and other transmasculine individuals affects the ovaries, leading to an increased amount of ovarian cysts, which is also seen in cisgender women with PCOS.
Individuals studied also displayed follicular atresia, overgrowth of the stroma, and the replacement of ovarian tissue with collagen.
However, observation of trans men and studies on lab mice reveal that testosterone treatment does not affect the number of available gametes (eggs/sex cells).
[13] Chestfeeding is possible for many trans men who medically transition, but it is rarely discussed by doctors who prescribe testosterone or complete chest masculinization surgeries.
While chestfeeding can be a dysphoric activity for some trans men and nonbinary people, some find it fulfilling and a practice that connects them to their baby.
It has previously been shown that transgender individuals often experience higher rates of suicidality than cisgender people and lesser degrees of social support from their environment and familial relationships.
Dying was a better alternative to forced pregnancy.According to the National Transgender Discrimination Survey, postpartum rates of suicide and depression in trans individuals has been found to be higher than the adult average.
Additionally, trans people experience minority stress and may be at higher risk of substance use than the general population.
Unintended pregnancies can result in transgender men or nonbinary people considering or attempting self-induced abortion.
[23] 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.
As of 2019, in cisgender women, more than 42 UTx procedures had been performed, with 12 live births resulting from the transplanted uteri as of publication.
The exclusion of trans women from candidacy is justified by the lack of research to determine how to conduct the surgery, rather than an inherent bar.
[34] Non-binary people who have written or been profiled about their experiences of pregnancy include Rory Mickelson,[35] Braiden Schirtzinger,[36] and Mariah MacCarthy.
