“Is society ready for this pregnant husband?” was the subheading of Thomas Beatie’s 2008 essay about his pregnancy. Mr. Beatie was considered the first pregnant trans man to come forward publicly; his story was hugely influential in terms of visibility but also the subject of hurtful jokes and discrimination (Barbara Walters, for example, referred to one of Mr. Beatie’s pregnancy photos as a “disturbing image” on live television). In the 14 years since then, trans pregnant people have become far more visible: a search on TikTok for #transandpregnant has 6.7 million views, and there are many trans activists who are documenting their pregnancies for the world to see. Despite this increasing visibility and activism, however, recent studies on pregnant trans people show that there is a large potential for disparities in health outcomes, the reasons for which are complex but are likely related to lack of resources, feelings of isolation, and lack of adequate education for healthcare professionals. Indeed, despite increasing visibility, there is a lot of work to be done – both in the culture at large and within the medical system itself – to ensure this quickly growing and vulnerable population gets the medical care and respect they deserve.
When Thomas Beatie first wrote an essay about his pregnancy for The Advocate in 2008, his story spread quickly around the world, even providing him the opportunity to appear on Oprah soon after his essay was published. In a 2021 interview reflecting on this period, Beatie explained, “When my story came out, there wasn’t a single person in the public eye as a transgender man — most people had never heard of it,” Beatie, 47 by then, said. “It was a first exposure for a lot of people. And then on top of that, they can give birth! I think exposing the importance of fertility for trans people was a huge eye-opener.”1 While Beatie became a figurehead for trans pregnancy, he was also the target of public abuse, from derogatory jokes to deadnaming. Beatie agrees that things have changed since 2008: “People were saying things on TV and in the media that if they came close to saying today, they would be immediately fired.”
Indeed, today there is much more visibility in the media for pregnant trans people. One TikTok star and activist, Danny Wakefield, whose page is titled “Danny the Trans Dad,” has 878,000 followers on TikTok and has made videos documenting his entire pregnancy and parenting journey. His most popular videos, usually featuring his pregnant belly, have garnered upwards of 65 million views. While Danny wants to educate people about pregnant trans people, he also simply wants to provide visibility: “I want people to see a happy trans person living their life with their beautiful family,” says Wakefield. Danny posts content about life with their baby, Wilder, as well as their struggles with postpartum depression and addiction recovery. “My target audience are the trans kids and people who have very little hope in life,” Wakefield says. “I want them to see it does get better.”
Another popular TikToker named Kayden Coleman also uses his platform for trans pregnancy visibility. He has shared his negative experiences during pregnancy, advocating for more education and awareness within the medical system. In a recent interview, Kayden explained, “There was a lot of trauma. Most of that came from inside the birthing world, with medical professionals. There was a lot of questioning about my identity, a lot of misgendering. Being told I shouldn’t be in spaces I was seeking care from because they were considered women’s spaces. I was offered an abortion a ridiculous amount of times.”
Research on the experiences of trans pregnant people has exposed rampant misgendering and discrimination from within the birthing world in particular and the medical system more generally. In one research study conducted by researchers at the University of California, San Francisco on trans pregnant men, negative experiences in the healthcare system were common, ranging “from improper pronoun use and rude treatment to being turned away from medical practices and denied treatment.” In an extreme instance, one participant even reported that “Child Protection Services was alerted to the fact that a ‘tranny’ had a baby.” Participants also reported that even if their specific healthcare providers were transgender-friendly, “this was not necessarily the case with the office staff, nurses, and other healthcare workers.” This makes it clear that not only does there need to be more training for providers, but also for the entire medical staff that works with pregnant transgender patients.
Another important element is the language used to talk about trans pregnant people. While part of the cultural shift that is underway has been driven by visibility in the media – such as through the work of the TikTok activists previously mentioned – another way that cultural dynamics shift is through language. For instance, the websites of both the Centers for Disease Control and Planned Parenthood now use the phrase “pregnant people” and “breastfeeding people” instead of “pregnant women” or “breastfeeding women.” And while the language used by the CDC and Planned Parenthood will not necessarily result, immediately, in greater public acceptance, these linguistic shifts have certainly stirred up a conversation and caused a lot of controversy – arguably a step in the right direction for, at the very least, making these issues a broader part of public conversation. In an article for The Atlantic, Emma Green explains that some people “see this kind of language as exclusionary because it erases women and mothers as worthy categories of identity” while others say it is a step in the right direction and makes trans birthing people feel more seen and heard. Louise Melling, the deputy legal director of the American Civil Liberties Union, adds, “If we’re talking about ‘pregnant people,’ that language says to people—to transgender men and to nonbinary people—‘we see you.’ It should do a fair amount of work to help address discrimination.”
Such recognition is indeed crucial. In a study conducted by researchers at the School of Medicine in Sydney, Australia, many of the trans men interviewed also brought up feeling unseen and unrecognized, a major source of strife and difficulty throughout their pregnancies. In that particular study, one participant commented on the “complete lack of resources,” and another on the “invisibility of trans men” in pregnancy literature. One particular participant expressed feelings of loneliness that stemmed from this lack of recognition and visibility: “I just felt so lonely, like ‘am I the only one?’ There was no one at the Drs [sic] or the clinic or in the pregnancy books or anywhere like me. I felt like a complete anomaly.” The researchers recognize that while there is limited research on perinatal depression in trans men, it is well known that experiences of loneliness and isolation during and after pregnancy have been linked to depression in cis women. The risk of perinatal depression might be quite high, then, for many trans men whose isolation is compounded by gender discrimination.
Despite the controversy that it can generate, inclusive language is one way of pushing society towards becoming more accepting of pregnancy even when it does not fit the ‘typical’ mold of what we expect. Of course, these language changes do not necessarily result in greater social acceptance; simply acknowledging that trans pregnant people exist is not enough to make change, and we can and must do more to push society forward. Many activists, in addition to the TikTok activists previously mentioned, are doing this work by creating increased educational and informational resources – for both trans pregnant people as well as the general public. One incredible set of resources can be found on a website called transfertility.co, which was created by non-binary gestational parent Trystan Reese. It provides a huge range of information for both trans parents as well as trainings for medical providers. Another is a forthcoming 2023 book called Baby Making For Everybody written by two queer midwives and focusing on fertility for LGBTQ+ and solo parents.
Indeed, we must take these steps – creating more resources specifically for trans pregnant folks, shifting the language we use to talk about pregnancy to be more inclusive, increasing visibility through social media and TikTok activism, and of course, increasing education within the medical system itself – to make pregnancy a safe and accessible space for all parents, no matter their gender identity. Indeed, in his recent interview, Thomas Beatie put it perfectly: “Being transgender, you shouldn’t have to lose your right of having a family. You’re entitled to be happy and have a family and be respected.”
- A.D. Light AD, J. Obedin-Maliver, J.M. Sevelius, et al. “Transgender men who experienced pregnancy after female-to-male gender transitioning.” Obstetr Gynecol 124 (2014): 1120–1127. ↑