Trans men and non-binary trans masculine people have many options for having kids. Of course, there is adoption and fostering. Maybe you will become a step-parent. Or maybe your path will involve pregnancy, yours or someone else’s.
I’m writing this blog post to share some practical information on my experience of becoming a dad through fertility treatment and pregnancy. This might relate specifically to your situation or not, but whatever questions or family plans you have, have confidence in them. They are valid.
I guarantee that you are not alone and that there will be advice and community out there for you, even if it’s hard to find at first.
When I first started my transition, I believed that taking the hormone, testosterone (T) would make me infertile. I also thought I would need a hysterectomy after 5 years due to a heightened risk of certain cancers. Luckily, after about 2 years on T, I discovered by chance that neither of these ideas is evidence-based and that pregnancy was still an option for me.
After a few years of soul searching, I decided that carrying my own child was my best option. I felt I could cope with coming off T because transition itself had given me such confidence and inner peace. I also felt the risks of going through pregnancy alone were lower than those of trying to navigate adoption or foster processes as a single, gay, transgender man. It felt simpler and safer not to put myself up for other people and organisations to potentially judge.
I felt comfortable becoming a single dad because I’m lucky to have lots of family and friends around. At that stage, I still feared that T might affect my fertility over time and that I should not risk waiting too long. I now understand that there is no evidence for this either and that trans men on T for over 15 years have paused to successfully have kids.
The private fertility clinic I attended was welcoming and professional throughout. I was never misgendered in person, even if I had to correct the language on lots of forms by hand.
After 6 months off T shots, I conceived on the second attempt at IUI, which is where sperm (in my case defrosted donor sperm) is placed inside the uterus. It was very uncomfortable but thankfully quick. I had a friend with me, which really helped. I feel like I got really lucky, conceiving relatively quickly. How quickly you conceive will likely depend on what method you are using (I went to a clinic but you can also do this at home with “fresh” sperm) and your body. There might also be other fertility issues in play, unrelated to being trans, that affect the timeline.
The biggest challenge for me during pregnancy was the impact of my body changing and not having testosterone in my system. The baby bump itself was not the problem though. Feeling my baby move and kick did not feel weird. I actually loved it. It helped to remind me why I was going through such a tough time.
I prepared myself by talking to friends and family who had given birth, reading a few books and watching a hypnobirthing playlist on YouTube. You don’t need all the bells and whistles. Just inform yourself however feels right to you. Lately, I’ve discovered a growing community of inclusive doulas and midwives on Instagram, so that is definitely worth exploring.
I always think that if I could have been on T and pregnant, I would have enjoyed the experience a lot more. However, it is vital not to be on testosterone while pregnant because it is known to be harmful to foetuses. At the same time, T is not an effective contraceptive and so it is possible to conceive while on it. If this happens, talk to a doctor straight away. There are many people who have done this and had totally healthy pregnancies.
I also felt sick for most of my pregnancy, which I had not realised might happen. I learned that there is a lot about pregnancy you do not know or understand until you experience it. This was quite humbling to learn as someone who had become used to living in the world as a man. I realised that because pregnancy is usually something women experience, there’s so much of it that is not talked about, explored or celebrated.
Since my bump was small, I was never read by strangers as a pregnant trans man. I think this helped me feel safe in public. However, all bodies are different and everyone’s experience of this will be different. Towards the end of pregnancy, I started to be misgendered again because of my overall body shape, the fact my facial hair got thinner and even the quality of my voice changed. I had not expected that and it was hard to deal with. That and the complete lack of comfortable clothing that suited my style and preference.
Scans and birth
Where I live in Kent, we have a great community midwife team. This meant I saw the same midwife for the whole 9 months. She was also happy to do my appointments at home, which was a huge relief. It meant I didn’t have to worry about encountering new or ill-informed people every time I had an appointment.
When it came to scans, my community midwife made a couple of phone calls to ensure that I’d have a welcoming sonographer at the local hospital. She always tried to lay the groundwork for me like this. She did not have any special training or experience. She just sensed and asked me what might help. I was so grateful for her thoughtfulness and care.
She also helped me prepare for birth and write my birth plan, which was a lot more detailed than I had realised it could be. I saw my birth plan as a tool to introduce myself to anyone who might be involved in labour and delivery. It was a chance to explain a bit about pronouns and language, without having to have face-to-face conversations. This might not be everyone’s approach but it helped put my mind at ease.
I visited the midwifery-led unit where I hoped to give birth about 2 weeks before my due date. I also found that reassuring and got the sense that I’d feel welcome when the time came to actually deliver.
In the end, I found birth an incredible and empowering experience. I was very lucky that everything went to plan and I had the birth I wanted, with my mum as my birth partner. There were also 2 midwives and 1 healthcare assistant, none of whom I’d met before. They made me feel safe and used appropriate or gender-neutral language. They mostly just called me by my name, which helped me feel like they saw me for who I was.
Again, I know I got lucky in some ways. Many people, whatever their identity, don’t have positive birth experiences. This is especially true of Black women and trans people. There is still much work to do on this front. Yet I take heart in the fact that it is possible to have a positive birth experience as a trans man. It simply takes a small amount of extra care and thoughtfulness.
If I have not covered your question or concern, get in touch on Instagram @freddy.mcconnell and I can point you in the direction of community groups dedicated to these topics.