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Transgender Pregnancy And Lactation: All You Need To Know

A transgender is someone whose gender identity does not align with assigned sex at birth. With the advancement in medical science and societal acceptance, transgender health and healthcare have gained growing interest, including their role in conception and pregnancy.

Transgender men (those with female sex assigned at birth) are the ones who despite their conversion, want to retain their reproductive organs (ovaries and uterus) to retain the ability to have children.

According to a study, preconception counselling is very important for transgender men which may include discussion on stopping the hormonal therapy while trying to conceive and some important recommendations on lactation.

In this article, we will discuss details of transgender men and pregnancy. Take a look.

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Is It Possible For Transgender Men To Get Pregnant?

Though there are sufficient studies to document how many transgender men worldwide have had successful pregnancies, the list provided by health care service providers suggests that the number of transgender seeking for family planning, fertility and pregnancy services is quite high.

So, before explaining details on transgender men and pregnancy, let's know the basics of gender identity. In the acronym ‘LGBTQ', "T" stands for transgender with LGB and Q for lesbian, gay, bisexual and queer.

Each of these groups is quite different from one another in terms of gender identity (internal sense of gender), gender expression (emotional or sexual attraction for others) and biological sex (sex assigned at birth). [1]

Lesbian and gay are people who have romantic or gender expression towards people of the same sex while bisexual has an attraction towards both male and female or say, more than one sex or gender.

As aforementioned, a transgender is someone whose inner sense of gender does not match with the assigned sex. It includes transwomen and transmen. The prior refers to people who consider themselves as female but have male genitalia (penis and scrotum) and the latter recognise themselves as male but have ovaries and uterus.

This makes transgender men eligible to consider for the option of conception and pregnancy as they have ovaries and uterus to help them conceive, carry the baby in the womb and give birth.

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Transgender Men And Pregnancy

A study says that, unlike transgender women, most of the transgender men do not go for sex reassignment surgeries. This is because, in spite of the differences between their gender expression and biological sex, they want to consider the option of bearing children someday.

Some people who have been assigned female sex and identify themselves as genderqueer (not exclusively masculine or feminine‍), also consider the possibility of a pregnancy.

Transgender men who opt for hormone therapy with testosterone can face problems in fertility and faecal development. This is why, discussion of family planning is important among such group, especially if they desire for genetically related children or planning to conceive before starting on testosterone hormone therapy. [2]

However, there is no much data on parents who have had genetically related children. Also, there are cases in which transgender men have conceived even after using testosterone. In cases where transgender men have undergone hysterectomy or removal of the uterus, gestational pregnancy is not possible.

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Transgender Pregnancy Complications

The mode of delivery (either vaginal or cesarean) is the first complication in transgender pregnancy. Some reports suggest that many transgender men who were on testosterone opted for cesarean delivery compared to those who have not used testosterone. [3]

The second associated complication is reduced birth weight due to prior testosterone use. However, there is no or very little information associated with it. Some of the self-reported complications include high blood pressure, placental abruption, preterm labour and anaemia.

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Lactation Or Breastfeeding In Transgenders

A study says that lactation and pregnancy are viable processes which are independent of sex. Though people may think that pregnancy needs one to be a woman, the fact is one only needs to have reproductive organs (such as ovaries and uterus) which are capable of gestation to produce children. [4]

Transgender men who have given birth can successfully breastfeed their child with specialised support. Problems are mainly faced by transgender women, who are adoptive mothers or whose children are born through gestational surrogacy.

Though breastfeeding is not possible in transgender women naturally, there are protocols to promote mammogenesis (growth of mammary gland) and lactogenesis (ability to secrete milk) in trans* women.

A study says that trans* women can also become capable of breastfeeding by the development of breast tissues though reproductive techniques. The study talks about a 30-year-old transgender woman who wanted to breastfed her adopted child.

She has received feminizing hormone therapy for six months which include implementation of domperidone, estradiol, progesterone, and breast pumping. After six months, she was successfully able to produce breast milk to provide nourishment to her child. [5]

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To Conclude

Even though transgenders have gained significant progress in their social acceptance, including health services, there is a lack of training in healthcare that needs to be filled. This can be done by educating nurses and other healthcare providers to support transgender patients during pregnancy and lactation. The healthcare system needs to examine the growing needs of gender diversity and work towards fulfilling those needs.