41 de bărbați trans au născut după tranziție: 61% luaseră testosteron, iar majoritatea au conceput cu ovulele proprii

Bărbați transgender care au trăit o sarcină după tranziția de gen de la femeie la bărbat

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 de bărbați trans auto-descriși care fuseseră însărcinați și născuseră după tranziție au completat un sondaj online între martie și decembrie 2013.
Înainte de sarcină, 61% (25 din 41) luaseră testosteron; luarea hormonilor nu era necesară pentru participare.
În medie aveau 28 de ani când au conceput, iar 88% (36) dintre sarcini au folosit ovulele persoanei.
Jumătate au primit îngrijire pentru sarcină de la un medic, iar 78% au născut în spital.
În răspunsurile scrise, oamenii au spus că personalul medical știa puțin despre nevoile bărbaților trans însărcinați și că și-au dorit resurse pentru a-i sprijini.
Pentru că au fost chestionate doar persoanele care au conceput, studiul arată că sarcina după testosteron este posibilă, dar nu poate spune cât de des revine fertilitatea după 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