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Pregnant Trans People Need Care, Not Media Circus

By Erin Wilkins, Family Tree Clinic

May 15, 2008 - 7:00am

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The media circus that greeted Thomas Beatie, a pregnant trasgender man in Bend, Oregon, and his wife, Nancy, turned the subject of transgender pregnancy into spectacle. Beatie's reflections on conception and pregnancy for The Advocate spawned a flurry of media attention, from an appearance on Oprah to an article in People Magazine and numerous mentions on national and regional news around the country. Some of the coverage was respectful, but much of it was not. For many in the transgender community, and specifically trans health advocates, this media activity highlighted the urgent need for increased education and support surrounding transgender pregnancy and trans awareness and health care.

Because of social stigma and oppression, transgender patients have typically been an underserved medical population. Experiencing transphobia leads many transgender people to stay closeted, particularly to their health care providers. In The Advocate, Beatie describes the discrimination and disrespect he experienced during the process of conception and pregnancy, explaining that "doctors have discriminated against us, turning us away due to their religious beliefs. Health care professionals have refused to call me by a male pronoun or recognize Nancy as my wife. Receptionists have laughed at us." It is this kind of discomfort and misunderstanding that often leads transgender patients to avoid healthcare altogether, even for routine and preventive medical care. It is important for trans allies in the healthcare community to create networks and partnerships, and to increase visibility within the greater trans community so that patients feel invited to seek care with qualified clinicians.

Because there is not one definitive transgender experience, there is not a singular appropriate approach to care for providers to follow. However, there are certain guidelines that can be used as a framework by health care providers who are interested in providing competent, compassionate care for transgender patients.

Health care providers working with the transgender community must have an understanding of transgender psychosocial issues, and should also be familiar with basic sensitivity practices. These include using the preferred name and gender pronoun of the patient, reassuring the patient about confidentiality, and discussing their preferences and concerns regarding potentially sensitive physical exams and tests, such as pap smears or mammograms. The clinic staff, from receptionists to medical assistants and nurses, should also be educated on transgender issues. Providers should also be aware of and savvy about the healthcare and social services systems their transgender patients are navigating. Outreach and networking with other providers and advocates in the transgender community is key to providing proficient care.

In terms of reproductive health in particular, it is important for health care providers to become proficient about the concerns that are unique to transgender pregnancy. For many, the notion of pregnant men is not always easy to understand or imagine, and yet it is a real and significant occurrence that should be openly addressed and responded to appropriately.

While the mainstream media has portrayed Thomas Beatie's pregnancy as a medical anomaly, he is certainly not the first transgender man to become pregnant, and he will not be the last. In light of the recent media attention on transgender pregnancy and parenthood, we should also remember that the topic of transgender pregnancy applies not only to pregnancies that result in birth, but also pregnancies that result in abortion or miscarriage. As a counselor at a reproductive health clinic, I have talked with people of many gender variations about their reproductive health decisions, including female-to-male transgender people (FTMs) seeking pregnancy termination. This phenomenon is often overlooked not only in the healthcare community but also in the trans community. Outward and internalized transphobia can make the process of seeking prenatal care or pregnancy termination a difficult, even shameful experience for transgender patients. Pregnancies, both planned and unplanned, definitely happen to trans folks and it is imperative for reproductive healthcare providers to seek appropriate education and training in order to provide comprehensive care to these patients.

Gender is complicated, and so it is to the benefit of our patients, clients, partners, friends, and family to network and partner with community allies, and to also seek accurate information and understanding in order to provide them with excellent healthcare, reproductive and otherwise.

 

Resources for healthcare providers and advocates:

FTM International: http://www.ftmi.org/

World Professional Association for Transgender Health: http://www.wpath.org/

Gender Identity Research and Education Society: http://www.gires.org.uk/

Transgender Health Action Coalition: http://www.critpath.org/thac/

 


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5 comments
thank you
for writing this, and giving the links for all to see.
Submitted by Harry834 on May 15, 2008 - 4:12am.
I don't follow...
This is the first time I have heard of this story, so forgive me if I missed something important. I don't understand why a transgendered male would get pregnant in the first place, and then expect doctors to treat him as a male. It sounds to me like this person is terribly confused. Male-identifying individuals are looking to experience life as a male - unless I missed a major medical breakthrough that doesn't include getting pregnant. I think it is incredibly important to provide the best and most respectful healthcare to all individuals, regardless of belief, gender, etc. However I think that given how little the general public (and healthcare professionals) seem to know about the needs of the transgendered community, perhaps this was not the best way to bring attention to it.
Submitted by Anonymous on May 15, 2008 - 11:54am.
Reasons
My understanding of this case is that his wife was unable to conceive, and they wanted children, so he intentionally refrained from having surgery so that they could conceive thier own biological child(ren). It is not unheard of, just outside the realm of many people's experience. I think this case is a good way for people to start wrapping their heads around the reality of transpeople's lives, when it is handled in a matter-of-fact way.
Submitted by rachelpea on May 15, 2008 - 12:42pm.
Yes
Pregnant trans people need the same kind of care as pregnant anorexic people.
Submitted by Michael Ejercito on May 15, 2008 - 11:55am.
Thank you!
Thank you for this article. I am a FTM who has been pregnant twice, given birth once (naturally!), breastfed, and coped with a miscarriage - all post-transition. I was a bit dubious when I started seeing the articles about the man in Oregon and his family, but I think that the craze that has ensued has raised awareness and, at very least, brought the topic to the table. I also think that many transmen want to give birth and that his public example may help them know that it is an option. Trans people face enormous hostility from the medical establishment and from within "our" communities. It is the norm to hear comments like the one above: "pregnant FTMs must be really confused, must not be real men, must be x, y, or z". Other trans people are often hostile because they are trying to fiercely defend the shred of legitimacy that they have gained as "real" men or women. Trans people acting outside of traditional gender roles and behavior may be a threat to their credibility, but an approach to gender that reinforces the binary because "that's how it is" at the expense of recognizing the dignity and legitimacy of each experience is useless. People who fancy themselves progressives and simultaneously regurgitate arbitrary gender rules set a bad example for other progressives and narrow the already stiflingly small circles in which trans families can just -be-. Non-trans people who are critical of families like mine have nothing to lose by being kind, understanding, polite, or at least tolerant. We need access to medical care. It is true. We also need access to a smile at the park when we are there with our kids, rather than to have other kids pulled away from ours. We need parent-friends for ourselves and playmates for our kids who delight in human variation. Please be on the lookout for trans and queer families and please say hello!
Submitted by Anonymous on May 15, 2008 - 2:17pm.