Are you transgender or non-binary and wanting to start a family? Congratulations! You’ve taken the first step on a remarkable journey. There aren’t too many models out there of trans folks who have gestated babies or contributed their genetic material in order to become parents, and we have our work cut out for us because of transphobia and (cis)sexism. Luckily, there are more and more of us headed down this path, in spite of the oppression and microagressions we may face. This guide is for people who are unsure of where to start and are feeling overwhelmed with the process.
If you are or are planning to be a gestational parent, you will need to get clear on what feels important to you about your journey. Mapping out a timeline can be helpful, especially if you are taking hormones and need to stop so that you can start bleeding again. It can take some time for cycles to regulate themselves, so giving yourself more time than you think you need may be helpful.
PRO-TIP: You can get pregnant while on Testosterone. Even though T might have stopped your period, you can still ovulate, so making sure you are having protected sex until you are ready to be pregnant is really important if you are encountering sperm on the regular. Also, Testosterone and fetal development don’t mix, so if you do get pregnant while on T, please consult your healthcare provider.
You will want to begin thinking about what works for you in terms of tracking your cycle. Will you take your temperature every morning? How do you feel about the word “ovulation”? Think about what makes YOU most comfortable, which includes the words you want to use for your body.
In order to prepare your body, consider taking a prenatal vitamin and drinking pregnancy tea or taking a supplement to get ready. You may want to price all these out in advance so you can get a clear idea of what makes sense for your budget. Acupuncture can be very helpful in regulating cycles, and going to a community acupuncture clinic can make it more affordable.
If you want to contribute sperm to make a baby but are considering beginning feminizing hormones, you will want to bank your sperm before starting. Spironolactone and Estrogen can lower your sperm counts and make conception difficult.
PRO-TIP: Some transfeminine folks can lactate using medications and breast pumps! It’s a journey you want to do a lot of research on, but know that it is possible. Definitely consult your healthcare provider and discuss with others who have done it before.
Have a trans friend who has been on a fertility journey? Luckily, our communities are resourceful, and can be a wealth of knowledge. Listen for the names that come up again and again, and contact those folks. If you don’t have insurance or a lot of financial resources, consider asking about sliding scale offerings. Some birth professionals will do consults online so if you are located in an area with a lack of resources, this might be an option for you. Have a healthcare provider you trust who isn’t a birthing professional? Ask them. They are likely well-connected and may be able to find someone you can work with.
Don’t be afraid to ask your providers about their experiences working with trans and gender expansive folks around fertility. If a provider looks at you sideways when you ask this question, this probably isn’t someone you want to work with. It’s not your job to educate your providers about your experience, and only you can decide whether you have the energy to offer much needed education. If you feel uncomfortable with someone, you don’t ever have to go back to see them. Ever. It may take a little longer to get your ducks in a row, but you deserve competent and affirming care no matter what. If you feel up for it, you can tell a professional that they misstepped, or offended you, or you can email them later. But only if you have the energy. This is a demanding journey, and you want to feel empowered as you are imagining your little one into being.
Sometimes folks write up a card with information about their pronouns, what words they’d like professionals to use for body parts, what words they want people to avoid, what they plan to be called as a parent, and any other relevant information. You can give it to your provider up front, before any questions are asked. This can be helpful for you and can act as a reference guide for your provider. It can also alleviate awkward feelings if someone slips up because you have something to refer back to if you need to. Remember, pregnancy and birthing have been talked about in binary terms forever and ever, but things are changing, and you are a part of that!
Connecting to others who are going through this process or have been through it is super important. There are a few support groups online that can help to alleviate the feelings of loneliness, with people who understand that dysphoria crops up constantly around trying to get pregnant for trans and non-binary folks. Your nearest LGBTQ center may have some ideas about where to go for more support. No one should have to go through it alone if they don’t want to. Since we have to imagine alternate models of family building than the ones our straight and/or cis coworkers, friends, and family members do, we need to hold each other closely during this time. This goes for non-gestational parents too, whose mental health needs are often overlooked.
Finding a therapist to validate your experience, listen to your feelings, help you make sense of it all, and be with you through this time can be a game-changer (see above on navigating provider relationships).
Audre Lorde said “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.” Do what you need to ensure that you’re breathing, showering, eating, hydrating, taking it slow, and showing up how you need to show up. Having compassion for yourself is such a HUGE step in this process, even when it feels near impossible. You may experience some new feelings of dysphoria that haven’t shown up before. Roll with those. The tension around being a masculine birth parent or being a parent who lactates but isn’t gestating a child can be a challenging experience. Being super gentle with the feelings you’re having, finding support, and doing what your body needs to do can be an antidote to shame and frustration.
Consider what gives you life as you are trying to create life. Under our cis-centric, binary system, we might not feel like we have a lot of choice. Remember, no matter what kinds of changes you go through in this process, you do have choice and agency around your care. Being a parent does not have to be a gendered experience, and certainly doesn’t invalidate your gender.
If you are struggling to identify these things and finding the journey harder than you thought, feel free to get in touch with me at firstname.lastname@example.org. I am a trans therapist who is invested and involved in providing conception and birth support for transgender, non-binary, and gender diverse communities.