41 transmannen die na transitie beviel: 61% had testosteron gebruikt en de meesten raakten zwanger met eigen eicellen

Transgendermannen die zwangerschap ervoeren na vrouw-naar-mantransitie

Authors: Alexis D. Light, Juno Obedin-Maliver, Jae M. Sevelius, Jennifer L. Kerns
Journal: Obstetrics & Gynecology
Year: 2014
Source: https://doi.org/10.1097/AOG.0000000000000540

Summary

Researchers at the University of California, San Francisco ran an online survey of 41 trans men who had become pregnant and given birth after transitioning. They asked about hormone use, fertility, pregnancy care and birth. About six in ten had taken testosterone before the pregnancy, most used their own eggs, half had a doctor for pregnancy care, and most gave birth in hospital. People described health workers who knew little about their situation and wished for better support. The authors concluded that trans men can and do get pregnant after transition and that services should adapt. It was one of the first studies of its kind and is often cited to show fertility can return after stopping testosterone. But it only asked people who did get pregnant, so it cannot say how often testosterone users stay fertile. All answers came from a small, self-selected online group.

Key findings

41 zichzelf als transman beschrijvende mensen die zwanger waren geweest en bevallen na te zijn getransitioneerd, vulden tussen maart en december 2013 een online enquête in.
Vóór de zwangerschap had 61% (25 van de 41) testosteron gebruikt; hormonen gebruiken was geen vereiste om mee te doen.
Gemiddeld waren ze 28 toen ze zwanger werden, en bij 88% (36) van de zwangerschappen werden de eigen eicellen van de persoon gebruikt.
De helft kreeg zwangerschapszorg van een arts, en 78% beviel in een ziekenhuis.
In hun geschreven antwoorden zeiden mensen dat zorgverleners weinig wisten over de behoeften van zwangere transmannen, en dat ze hulpmiddelen wilden om hen te ondersteunen.
Omdat alleen mensen die wel zwanger werden zijn bevraagd, laat de studie zien dat zwangerschap na testosteron mogelijk is, maar kan ze niet zeggen hoe vaak vruchtbaarheid terugkeert na testosteron.

Abstract

OBJECTIVE: To conduct a cross-sectional study of transgender men who had been pregnant and delivered after transitioning from female-to-male gender to help guide practice and further investigation.

MATERIALS AND METHODS: We administered a web-based survey from March to December 2013 to inquire about demographics, hormone use, fertility, pregnancy experience, and birth outcomes. Participants were not required to have been on hormone therapy to be eligible. We used a mixed-methods approach to evaluate the quantitative and qualitative data.

RESULTS: Forty-one self-described transgender men completed the survey. Before pregnancy, 61% (n=25) had used testosterone. Mean age at conception was 28 years with a standard deviation of 6.8 years. Eighty-eight percent of oocytes (n=36) came from participants' own ovaries. Half of the participants received prenatal care from a physician and 78% delivered in a hospital. Qualitative themes included low levels of health care provider awareness and knowledge about the unique needs of pregnant transgender men as well as a desire for resources to support transgender men through their pregnancy.

CONCLUSION: Transgender men are achieving pregnancy after having socially, medically, or both transitioned. Themes from this study can be used to develop transgender-appropriate services and interventions that may improve the health and health care experiences of transgender men.

Conclusion

Transgender men are achieving pregnancy after having socially, medically, or both transitioned. Themes from this study can be used to develop transgender-appropriate services and interventions that may improve the health and health care experiences of transgender men.

Methodological limitations

Only success stories counted: Only trans men who had conceived and given birth could take part. So the study cannot say how many testosterone users stay fertile or become infertile.
Self-selected online group: People were recruited for an online survey, probably through trans community networks. They may differ from other trans men in education, connections and experience.
Very small group: 41 people (25 of whom took testosterone) is too few for reliable figures on subgroups, such as type of birth or time taken to get pregnant.
Nothing checked: Hormone use, when testosterone was stopped, pregnancy problems and birth results were all self-reported and not checked against medical records.
Memory may be wrong: Some pregnancies may have been years before the survey, so people may not recall timings and doses accurately.
No comparison group: There was no comparison with non-trans pregnancies or with trans men who never took testosterone. So the effect of testosterone on pregnancy and on babies cannot be judged.
Testosterone use varied: How long, how much and when people took testosterone before conceiving varied, and with only 25 users this could not be analysed in a useful way.
Out of date: Data were collected in 2013, before the big rise in teens transitioning. So they say little about people who started testosterone (or puberty blockers) as teenagers.

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Summary

Key findings

Abstract

Conclusion