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 homens que se descreviam como trans e que haviam engravidado e dado à luz após a transição preencheram uma pesquisa online entre março e dezembro de 2013.
• Antes da gravidez, 61% (25 de 41) haviam tomado testosterona; tomar hormônios não era exigido para participar.
• Em média, tinham 28 anos quando conceberam, e 88% (36) das gestações usaram os próprios óvulos da pessoa.
• Metade recebeu acompanhamento da gravidez por um médico, e 78% deram à luz em hospital.
• Em suas respostas escritas, as pessoas disseram que os profissionais de saúde sabiam pouco sobre as necessidades de homens trans grávidos e que queriam recursos para apoiá-los.
• Como apenas pessoas que de fato conceberam foram pesquisadas, o estudo mostra que a gravidez após testosterona é possível, mas não pode dizer com que frequência a fertilidade volta após a testosterona.

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.