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What It’s Like to Experience Pregnancy as a Trans Man

Trystan Reese gave birth to his son, Leo, on July 14th in Portland. And Reese isn’t the only transgender man to have a child this summer. Hayden Cross, 21, became Britain’s first pregnant man after his daughter Trinity-Leigh was born in June. And more than 50 men in Australia have given birth in the last year alone.

Stateside, 40 trans men gave birth in the first half of 2014, according to Obstetrics and Gynaecology, while a 2014 NPR article suggested “thousands” more are trying to and/or becoming pregnant.

But what are the social, legal and health-care implications of doing so?

Sally Hines, an associate professor of sociology and gender studies at the University of Leeds, is about to embark on a three-year study to find out. While same-sex parents have become widely accepted in the West and legal shifts have benefited the rights of same-sex people to parent, transgender parenting, Hines says, has received far less attention. She and four co-investigators are conducting seven international focus groups — in London, Manchester, Italy, Poland, New York, San Francisco and Sydney — with 50 young trans men (aged 18–25) who have conceived after transitioning.

I recently spoke with Hines about the greatest challenges facing trans men who become pregnant, what the nursing/breastfeeding implications are for trans men who’ve had mastectomies, and whether you call the man who gave birth to you “Mom.”

Do most trans men transition without having surgery to remove their reproductive organs and reconstruct their genitals?
I don’t know and wouldn’t like to estimate regarding “most.” The increase in trans men wanting to become pregnant after transition, though, suggests that surgery isn’t the be-all, end-all of gender transition. Many trans men transition without undergoing surgery to remove their reproductive organs or reconstruct their genitals, so gender transition from female to male doesn’t necessarily take away the ability, or, more importantly, the desire to reproduce.

Your project is just getting underway. What’s the goal?
This is the first study to address the social and health-care implications of the reproductive practices of people who become pregnant and/or give birth after transitioning from female-to-male. The overall aim of the project is to gain an in-depth understanding of the growing number of men who may seek to, or become, pregnant and give birth after gender transition. Specifically, we’re interested in the practices (how pregnancy “happens” — i.e., reproductive technologies and family networks); experiences (how pregnancy is “felt” — i.e., in relation to identity, the body or wider society); and health-care needs (what pregnant men need from health care providers — i.e., professional training and awareness).

Why are you conducting the study in these seven specific cities — London, Manchester, Italy, Poland, New York, San Francisco and Sydney?
The higher population of trans men in the U.S. and Australia mean more access to participants who’ve been pregnant. These countries also represent a useful comparative in terms of geographic range, divergent welfare regimes and differing legal frameworks of recognition for trans people. Australia, for example, is one of the world’s trans-friendliest countries, allowing intersex individuals to list their gender on their passports as “X”rather than male or female. Poland, on the other hand, scores second to lastwithin the EU when it comes to recognizing the human rights of LGBT people, and President Andrzej Duda vetoed a major transgender rights bill in 2015.

What’s the greatest social challenge to trans men who become pregnant?
Since pregnancy is so essentially linked to being a “woman” and seen as a signifier of womanhood, it presents a huge challenge to the identity perceptions of male-embodied people who are pregnant. It raises the question, How can one be a man and be pregnant? This means that men who are pregnant are “misgendered” (read as female) in everyday life and their male identity becomes a subject for “debate.” I don’t have specifics yet other than to say that these men are often seen as women and no longer as men.

How about the physical and legal challenges?
Being visible physically as a pregnant man often means being socially and culturally unintelligible.

As for legal challenges, parental roles are underwritten with gendered assumptions about who is a man/woman, mother/father. So it’s very hard to socially and culturally separate parenting roles from gender. This has impacts on law (i.e., parental recognition on birth certificates) and on health care, education and welfare structures that may not recognize the parental role (as father) of a man who has given birth. This is also hugely complicated in relation to different laws around gender recognition more broadly. Also lack of understanding equals stigmatization. The phenomenon of male pregnancy brings challenges to law not just around gender recognition but around recognition of family diversity. Legislatively, these issues vary hugely across countries.

What are examples of extremes on either side?
In many countries surgical intervention is required before gender recognition is granted; in others (the U.K., for example), it is not.

What about medical challenges?
Medical practitioners and professionals (e.g., GPs and midwives) don’t know how to deal with trans men who are considering pregnancy. They’ll often ask, “How can you want to become a man if you also want to be pregnant?” Medical discourse cannot separate pregnancy from the female body, and medical practitioners are unable to offer adequate advice (e.g., about hormone use if considering pregnancy).

What happens next then? How do trans people find medical practitioners who won’t stigmatize them?
This is why we believe the project is so important. There’s a lack of knowledge among medical practitioners at every level. We need to ask men about their experiences of health and reproductive care in order to see what the most significant issues are in terms of developing training and awareness programs for medical practitioners and best practice guidelines. Medically, this is an uncharted field and so practice is inadequate.

What are the nursing/breastfeeding implications? Have most of these men had mastectomies?
Many trans men have mastectomies, but not all. Some trans men may breastfeed, but not all. Breastfeeding is raised as an example of why male pregnancy is deviant and unnatural. The important point here, I think, is that not all women want to or are able to breastfeed their babies; actually, lots of women do not breastfeed their babies for a number of reasons.

Your study also seeks to examine trans male practices of pregnancy with regard to “best practice” standards in reproductive science and technology. What does that mean exactly?
Ethical practices in reproductive technology vary hugely across — and within — countries, as do the welfare regimes that structure access to “treatment” (i.e., more or less a standard version of IVF). Who has access (and who doesn’t) to these practices very much depends upon social and economic capital: Do you meet the “criteria”? Are you a good citizen? Do you deserve it? Can you afford it? One of the central questions of the project will be to explore how structural factors, especially around race and class, impact on access to these reproductive technologies. Or better put, who is “allowed” to reproduce/be reproduced?

Do these men prefer to be considered the “mother” or “father” of their child?
New familial terms (for example, a nickname or a deviation of “mum,” “dad,” “mamma,” “pappa,” etc.) will often be used rather than “mother” or “father,” which presume a traditional gendered experience/relationship between parent and child that trans men who give birth fall outside of. New practices bring the need for new terminology.