GRSJ224/transparents

Transgender Parents

In 2007, Thomas Beatie became the world's first widely recognized pregnant man, and maternity pictures of his growing belly were shared across the globe. Beatie, a transgender man, chose to carry his child due to his wife's infertility, and the baby was conceived through artificial insemination. Since then, Beatie has given birth to a total of three children, and pregnancy among transgender men is increasingly common, although the official numbers continue to be low because trans men are registered as female in records of hospital births. Many transgender people are raising children, and the circumstances surrounding the prevalence of transgender parenthood are diverse. The complexity of gender identity, transition, and the potential fertility problems related to hormone therapies mean that trans parents and trans families come in all shapes and sizes.

Social Media

Image of two men, one who is visibly pregnant and holding his belly.

Several trans men have documented their pregnancy journeys on social media. Thomas Beatie published a novel, Labor of Love: The Story of One Man's Extraordinary Pregnancy, and he has appeared on several television shows and in news articles to share his story. Trystan Reese, a trans man who gave birth to a child who was conceived through intercourse with his husband, Biff, shares stories about his pregnancy on Instagram and Youtube. Another trans man, Jason Barker, recorded every step of his pregnancy journey and produced a film titled A Deal With The Universe (2018). The 2017 documentary Womb of Their Own follows several trans men and nonbinary people who discuss their pregnancies and experiences breast-feeding.

Gender, transition, and reproduction

Options for Transgender People to Have a Biological Child

There are a myriad of methods that transgender people can use to have a biological child. Each possible method depends on the physiology the person was born with, as well as their current physiology, taking into account possible gender-affirming surgeries that may have an impact on an individual's fertility. Gonadectomies (removal of tests or ovaries) have immediate impacts on fertility, and the effects of hormones on fertility may be long term or permanent. In order to allow transgender people to have full and informed consent prior to undergoing hormone replacement therapy or gender-affirming surgery, it has been recommended that physicians must explain to patients what the possible effects may be on their fertility.

Fertility preservation options may include cryopreservation of sperm, oocyte, embryo, ovarian tissue or testicular tissue, which means that reproductive cells are removed from the body while being preserved for future use. Cryopreservation is a way of allowing transgender patients to undergo gender-affirming treatments which may render them sterile while also having viable gametes to have a biological child in the future.

Despite the possibility of sterility related to hormone replacement therapy, many transgender people conceive children through intercourse, without medical intervention or assistance. Transgender men who have a functioning womb are able to carry a child -- often after several months of ceasing their hormone treatments to allow their bodies to resume menstruation. Transgender women, who are not born with a uterus, are currently medically unable to be pregnant, but the development of uterus transplants in humans by Dr Mats Brännström suggests that it may be possible in the future. Transgender women are able to conceive children biologically by providing their sperm, whether pre- or post-vaginoplasty, as long as their testes remain intact, and can conceive a child through intercourse pre-vaginoplasty or through cryopreservation before or after a vaginoplasty.

Conception, fertility

Trans pregnancy

Currently, many trans men and non-binary people with uteruses can and do get pregnant. There are many options for conceiving a child, including artificial insemination, conception through intercourse, and in vitro fertilization (IVF), each of which is possible when a trans person with a functioning uterus is to carry the child. The genetics of the child will be dependent upon the partner of the trans person: if the person carrying the child supplies the egg, their partner would need to supply sperm, or they would need to use a sperm donor to fertilize the egg and conceive.

Interest in being a parent

Many trans men report that their relationship to parenthood shifted during their gender transition, with the desire to become a parent developing only after they had come out as transgender or had started transitioning. The shift of hypothetical parental identity from mother to father was a powerful experience for the trans men involved in a 2018 study, allowing them to imagine themselves as parents within the gendered parental role which aligned with their gender identity.

Fertility

Fertility among trans people is largely dependent upon two factors: 1) use of hormone replacement therapy, and 2) surgical status of reproductive organs. While some of the long-term effects of hormone replacement therapy are unknown, there is a possibility of permanent sterility. However, for many trans men seeking to carry a child, they are able to conceive a child within 18 months of ceasing hormone replacement therapies.

In relation to some trans men's disinterest in becoming parents prior to transition, there is the chance that they may undergo gender-affirming surgeries which permanently render them incapable of pregnancy, such as hysterectomy, oopherectomy, metoidioplasty, or phalloplasty. In these cases, pregnancy is no longer an option for the transgender man, but there are other ways of conceiving a child, such as a surrogate pregnancy, adoption, or a partner carrying a child. Among trans youth in a 2018 study, the vast majority had no hesitation regarding adoption as an alternative to raising biological children.

Trans childbirth

Trans people can face difficulties accessing adequate reproductive healthcare, including obstetricians with existing knowledge of transgender people and trans pregnancy. Some pregnant transgender men who required obstetric services during their pregnancies found it difficult to book appointments and access these services because of how booking and computer systems were managed. This barrier to reproductive and perinatal healthcare may compromise the health of the child. Difficulty finding a doctor knowledgeable about transgender pregnancies is an additional discomfort, particular during labor and birth, as several trans men who have given birth report.

Trans parents and adoption

For many trans people, adoption is an attractive and viable option to start a family and raise a child. At this time, there are no legal barriers in the United States or Canada which could prevent a transgender individual or couple from adopting a child, although there are also very few legal protections for transgender applicants who wish to adopt a child.

Children of trans parents

Role-relational ambiguity

Children whose parents come out as transgender during their lifetime commonly experience role-relational ambiguity. Role-relational ambiguity refers to the uncertainty that may arise as a result of changes in the roles and relational status that may accompany another person's gender transition. In families with parents who transition after having a child, this means that the child experiences the transition of their mother into their father, or their father into their mother, the transition may confuse the child's relationship to the parent, and rifts in the relationship may occur. Some of the challenges related to a parent's transition include lack of clarity on how to address a trans parent, which pronouns to use, and how to view a parent who had fundamentally changed in the eyes of the child. Despite some people's belief that all people with transgender parents will suffer as a result of their parent's transition, studies have shown that even in the face of challenging adjustments, children of trans parents often resolve the role-relational ambiguity over time and continue a relationship with the parent. The majority of people with trans parents involved in a recent study were actively engaged in attempts to radically restructure and redefine relationships with their parent despite the difficulties of role-relational ambiguity.

Stages of life

Evidence shows that there are different relationships between children and their trans parent(s) depending on the timelines of their trans identity and transition. Role-relational ambiguity most often impacts children whose parent came out as transgender and/or began transitioning during the child's lifetime.

For children whose parents identified as transgender prior to the child's birth, such as children whose parents already identified as trans during the child's pregnancy or early infancy, the relationship is radically different. As Trystan Reese explains, parents can guide their children's ideas about gender and about families. This means that a child whose initial relationship to their transgender parent was as a transgender parent, there would be no distress relating to role-relational ambiguity. It is not the transgender identity itself which creates role-relational ambiguity, but the changing aspect of a parent's transition and the changing roles and relationships related to such a transition.

Development

Children raised by a transgender parent or transgender parents have been demonstrated to develop and function on a level comparable to those from traditional cisgender and heterosexual families, and additionally develop particular strengths linked to having LGBTQ+ parents.