Resources for trans pregnancy a cause for optimism

Cover of the Trans and Non-Binary Experiences of Maternity Services report. Cover art depicts two Black transmasculine people - one standing and smiling with a visibly pregnant belly, and the other is kneeling next to them and has their face pressed against the belly, with their eyes closed and a peaceful expression on their face. The title text and clothing for the people on the cover uses the colours of the non-binary flag - yellow, black, white, and purple.

There have been some really exciting developments in England over the last couple of months for trans birth parents (that is: men and non-binary people who conceive, carry, and give birth to their own children).

In April, a groundbreaking report on Trans and Non-Binary Experiences of Maternity Services was published by the LGBT Foundation. I am really proud to have co-authored parts of this report with colleagues in NHS England and the LGBT Foundation, and to have supported the research which informs it.

The report, which was funded by NHS England, offers a sobering account of healthcare inequalities for trans birth parents. However, it also includes important examples of good practice and recommendations for professionals.

  • Trans people’s experiences of perinatal care are consistently worse across the board compared with cis women.
  • 30% of trans birth parents didn’t access perinatal healthcare at all during pregnancy – this compares to less than 2.1% of the general population.
  • Transphobia and racism in perinatal care intersect to produce particularly poor outcomes for trans parents of colour.
  • Recommendations include: supporting the delivery of personalised and trauma-informed perinatal care; proactively adopting inclusive language and targeting outreach to trans birth parents; and implementing IT and demographic monitoring systems to enable the sensitive collection of data about gender identity and trans status in perinatal services.

Excitingly, it appears that work is already underway on many of these points. For example, last year a fabulous series of resources for practitioners were published by Brighton and Sussex Gender Inclusion Midwives, and I have heard good things about progress on trans-inclusive data collection.

Best of all, NHS England now provide a range of tailored, accessible advice to trans parents as part of their new guide to having a baby if you’re LGBT+. This includes ways to become a parent, advice on testosterone and pregnancy, and chestfeeding/breastfeeding for men and transmasculine non-binary people.

These resources should really be seen as a starting point (for example, there is no advice for trans women who breastfeed). But equally, it is brilliant to see progress being made on the provision of practical advice that will help prospective and new parents. I am especially grateful to an NHS whistleblower who ensured their dissemination through revealing to The i that their publication had been blocked by some senior figures at NHS England for nearly a year.

This all serves as an important reminder that NHS England is not a monolith, and that concerted pressure from community groups and allies can have real long-term benefits.

It’s very easy to be cynical about our NHS given the poor overall state of trans healthcare, as well as opposition to equitable provision by some within the health service. However, all the positive moves I have reported in this post are also the result of hard work by numerous NHS midwives and members of the NHS digital team. Alongside community members who generously offered their time and knowledge, they have collectively fought to ensure that trans birth parents and the practitioners who work with them have access to resources and information.

All of this makes me feel hugely optimistic. These are difficult times, in which prejudice and disinformation are rife. Yet ordinary people are still fighting – successfully! – for positive change. This new research and guidance should be of great help to new parents and their children, and for that we can be grateful.

Trans Pregnancy: new articles on conception and pregnancy loss

Cross-posted from the Trans Pregnancy project blog.

We are delighted to announce that the first two peer-reviewed articles on findings from our research interviews are now available. Both draw on an analysis of 51 interviews with people who had concieved. One looks at experiences of pregnancy loss among a subset of research participants, and the other explores routes to conception.

More information on each of these articles can be found below, along with links to open-access versions which are free to read.

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Men, trans/masculine, and non-binary people’s experiences of pregnancy loss: an international qualitative study

Abstract text for the article. Follow the link to read it.

Published in BMC Pregnancy and Childbirth (BioMed Central). The article is fully open-access and free to read.

This article examines male, trans/masculine and non-binary gestational parents’ experiences of pregnancy loss, an experience that more broadly affects millions of people every year. We found that, like cisgender parents, our research participants often faced grief following a pregnancy loss, and like heterosexual cisgender men in particular, they often faced barriers to support.

However, the research participants also reported experiences specific to pregnancy loss among male, trans/masculine and non-binary gestational parents, including difficulties in accessing inclusive healthcare, and resistance to “failed” or “wrong” body narratives. We therefore make recommendations for healthcare providers regarding the importance of appropriate language, and the need to sensitively attend to emotions attached both to the loss itself and to the possible desire to attempt another pregnancy.

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Men, trans/masculine, and non-binary people negotiating conception: Normative resistance and inventive pragmatism

Abstract text for the article. This can be read by following one of the links to the full article.

Published in the International Journal of Trangender Health (formerly the International Journal of Transgenderism). An open-access version of the article can be read for free here.

This article explores how men, trans/masculine and non-binary people navigated different social norms and/or practical obstacles to conception. It shows that individuals engage in diverse practices that normalise their experiences of conception, while also highlighting the unique needs and challenges they can face.

The article will also form part of a special issue of the International Journal of Transgender Health that we are editing which will be published in full in early 2021. This special issue will more broadly explore issues of fertility, reproduction, and sexual autonomy among trans and non-binary people. Two other great articles from the special issue have also already seen advance publication:

Administering gender: Trans men’s sexual and reproductive challenges in Argentina, by Andrés Mendieta & Salvador Vidal-Ortiz.

“Just because I don’t bleed, doesn’t mean I don’t go through it”: Expanding knowledge on trans and nonbinary menstruators, by A.J. Lowik.

There is of course a lot more to come – watch this space for more new research findings from both ourselves and our colleagues in the field.

Seahorse screening and live Q&A in Leeds

Hyde Park Picture House are hosting a screening of the documentary film Seahorse tomorrow evening (Tuesday 27 August), in association with Leeds Queer Film Festival. I will be participating in a live Q&A session afterwards, representing the Trans Pregnancy project.

The film follows the experiences of Freddy as he becomes a father:

Freddy is 30 and yearns to start a family but this poses unique challenges. He is a gay transgender man. Deciding to carry his own baby took years of soul searching, but he was unprepared for the reality of pregnancy, both physically and challenging society’s fundamental understanding of gender and family. To him what feels pragmatic, to others feels confronting; this was not part of his plan.

Against a backdrop of increasing hostility towards trans people the world over, Freddy is forced to confront his own naivety, mine unknown depths of courage and lean on every friend and family member who will stand by him.

For the Q&A, I will be joining Freddy, director Jeanie Finlay, and Yuval Topper-Erez, a member of the Trans Pregnancy project Advisory Board who became famous in Israel following his own experience of giving birth. The discussion will be chaired by BAFTA-nominated producer Mia Bays.

You can reserve a ticket for the event here.