Free resources: Perinatal care for trans people

On 8 February 2021, Brighton and Sussex University Hospitals NHS Trust published a series of groundbreaking resources on perinatal care for trans people, written by their Gender Inclusion Midwife team. As of March 2025, the Trust no longer exists, the midwives in question work elsewhere, and the resources page was sadly taken down – a sadly all-too common experience with NHS guidance for working with marginalised peoples.

Given the importance of these materials, for which I was part of a large team of expert reviewers, I am reproducing them on my website today for Trans Day of Visibility 2025, alongside some related resources.

I hope these will be of interest and use to anyone interested in improving perinatal care for trans people, including midwives, nurses, doctors, policymakers, commissioners, advocacy groups, and of course also families and prospective parents.

Professional guidance and protocols by the Gender Inclusion Midwives

Perinatal Care for Trans and Non-Binary People

Gender Inclusive Language in Perinatal Services


Information, forms, and materials for birth parents by the Gender Inclusion Midwives

Support for trans and non-binary people during pregnancy, birth and the postnatal period

Referral to Gender Inclusion Midwives

My language preferences

Pronoun stickers

Poster: Gender Inclusive Perinatal Care


Additional materials

It’s been a long four years since the Gender Inclusion Midwives resources were published. Here, therefore, are a few additional materials that may be of help to people working in this area.

National Maternity Survey data on trans birth parents
Since 2021 the Care Quality Commission has collected data on gender modality as part of its annual National Maternity Survey. The most recent findings indicate a significant rise in the number of men and non-binary people giving birth since 2021, with 1.58% of 2024 respondents indicating a gender that differs from the sex they were assigned at birth. This shows that hundreds of trans people are giving birth in England every year. See: Open data > 2024 Maternity survey National tables > page g9.

Inclusive language statement from the Royal College of Midwives
2022 statement affirming both that a majority of RCM members and service users are women, and that diverse gender identities should be recognised in midwifery.

Improving Trans and Non-Binary Experiences of Maternity Services (ITEMS)
2022 report published by the LGBT Foundation, looking at the findings of an English study on the experiences of 121 trans people who conceived and gave birth. It found that many trans birth parents do not feel safe sharing their identity in perinatal services, with a large proportion not feeling comfortable to access any support at all from an NHS or private midwife.

Trans Pregnancy Project website
I reviewed the Gender Inclusion Midwives resources as part of my work on the Trans Pregnancy Project, which was an international study of trans people’s experiences of pregnancy and childbirth. This year we launched a new website. This includes links to all our peer-reviewed publications, on topics including conception, pregnancy loss, midwifery, gender and embodiment, domestic violence, racialisation, and media representation.

Caring for Everyone: Effective and Inclusive Communication in Perinatal Care
One of the key recommendations of the Gender Inclusion Midwives’ guidance on Gender Inclusive Language in Perinatal Service is the adoption of “additive” language. This approach acknowledges male and non-binary birth parents alongside mothers, rather than simply replacing woman-centred language with a gender-neutral approach. This 2025 academic article by Matthew Cull, Jules Holroyd, and Fiona Woollard provides advice on a “pluralist” approach to language, which builds upon the additive model by offering a more contextual approach. It includes clear examples of what best practice can look like.

Image of poster on gender inclusive perinatal care. For version accessible to text reader, see download link above titled Poster: Gender Inclusive Perinatal Care.

Trans Visibility, Modelling Possibility

Lost for words

The first time I knowingly met someone who was almost certainly trans I didn’t have the language to understand what was happening. It was pretty awkward for us both.

I must have been 15 or 16 or so, circa 2002. I was at a house party where I didn’t know many people. I felt awkward and out of place. I’d turned up with a small group of friends who all seemed far cooler than I’d ever be, and they’d mostly wandered off to Do Gender and make out with each other heterosexually. I awkwardly wandered around, quietly observing people, far too shy to start a conversation. I have blurry memories of dark corridors, drunken teens, a small living room full of scary-looking hairy people listening to System of a Down.

And then I came across this…person.

I read her voice and appearance as male – but her friends used a female name and pronoun for her. Looking back, I’m pretty sure she was a trans girl early in transition, and all her cis mates had her back – as mine would a mere year or so later.

I saw something in her which I immediately recognised, but didn’t know what to call it. I desperately wanted to speak with her, but didn’t know what to say.

I think what I wanted to express was, “I am like you”. But dozens of awkward online searches for phrases like “boy who wants to be a girl” hadn’t quite yet led me to the magic word, transgender. So what I actually said was,

“So what’s with the boy-girl thing?”

Understandably, she didn’t really want to chat. If someone said the same to me after I came out to myself properly a few months later, I probably wouldn’t have wanted to speak with them either.

Portrait of the Artist as an Egg


Gerroff my lawn

The present moment is pretty awful for trans people. Here in the UK, we are now about four years into an extended moral panic over our very existence. It’s like a continual background noise we can never escape: constant misinformation from politicians and the press; attempts to ban us from sports, public toilets, women’s shelters, and rape crisis centres; unrelenting attacks on affirmative healthcare for trans people, especially trans youth.

I therefore often feel quite cynical about recent innovations such as Trans Day of Visibility (or TDOV, for those who enjoy a sexy acronym). As so many trans writers have observed, visibility is not always a positive thing for trans people, especially those such as Black trans women who face multiple marginalisation. The context of our visibility is shaped by neoliberal economics and the violent legacy of colonialism.

Visibility means danger. Visibility means we are seen by those who would cause us harm in the streets and in the halls of power. Visibility puts a target on our back.

Events such as TDOV can also serve as a site of tokenism and appropriation. Trans visibility all too easily becomes a commodity for those who wish to sell us ideas or products, or sell the idea of us to other people. For example, this morning Labour and the Women’s Equality Party released short, empty statements to “celebrate” TDOV, despite having allowed virulent transphobia to fester within their structures.

In the midst of all this, it can be easy to lose sight of just how far we have come – and how important visibility can be for our liberation.


Choosing visibility

When I first came out, I was lonely beyond words.

Part of the reason it took me so long was that there weren’t really any visible examples of trans lives available to me, let alone examples of trans art, culture, writing. It was so hard to find myself because it was so hard to find community. When I was at that party, and met that other trans girl, I knew I was something but it was hard to find what out what that thing was. We didn’t hear about people like us in school or on TV – unless I was somehow meant to be the pathetic sex-change taxi driver from The League of Gentlemen or the glamorous but deceptive villain from Ace Ventura.

Of course, vibrant trans communities long pre-dated the early 2000s, but there was no way for me to know that. They simply weren’t visible for me – until I finally stumbled onto transvestite and transsexual communities on the internet, and then eventually found other trans teens.

Online communities were a lifeline for me – but I still didn’t knowingly meet other trans people until several years into my transition (it did later turn out that one of my best friends was also trans, but that’s another story). I felt very held by the people around me, but also felt there was no-one to talk with in person who truly understood what was happening for me and why. When I turned to the NHS for help, I was refused a gender clinic referral until I was 18. It’s no wonder so many people from my generation who knew they were trans as kids didn’t come out until a lot later.

At 19, I went to university – and went stealth. I thought it was what we were supposed to do. I thought it was what I wanted. To be seen as a “real” girl, for no-one to know I was trans. In practice, it was…complicated. I certainly felt a lot safer, and experienced a lot less harassment. But I still didn’t get access to hormones until I was 20, and found it really scary hiding my body and my history when living in student halls. I disclosed my trans history to a few close friends, but was constantly worrying about who else “knew” and what that might mean for me.

One of the few places I disclosed my trans status was the student LGBTUA society. I joined as the only known trans member, and agreed to be a point of contact for other trans students on condition of anonymity. That, it turned out, was enough for me to finally find community.

I was barely visible – but visible enough. Other trans people made contact and started coming out on campus. We began to run our own events and put up posters with the trans symbol and an email address, emblazoned with the slogan “YOU ARE NOT ALONE”. I went to NUS conferences and met more trans people and we started campaigning for all-gender toilet provision and legal protections. The more visible we were, the more people came out, and the more people became involved in our communities and activism, which meant we became more visible again.

At 21, I decided to disclose my trans identity to everyone in my life. It was a personal decision – to move past the paranoia and shame of stealth and instead embrace trans pride. But it was also a political decision – to be more visible to other trans people.

Possibility models

Trans actress Laverne Cox has spoken extensively about “possibility models” – the idea that seeing other trans people shows you that trans life is possible. Not just in terms of being out, but in terms of doing things while trans. Unlike a “role model”, a possibility model gives people space to find their own path, their own possibilities, rather than base their ambitions directly on the achievements of another.

Leeds Pride 2019

For me, the real power of trans visibility lies in the potential we hold to build community, and to act as possibility models. To know we have value to one another. To know we have the potential to create and inspire: to write, to draw, to paint, to act, to speak, to love, to be loved, to simply be.

This isn’t about our potential value to cis culture, as scapegoats or inspiration porn. It’s about our actual value to one another.

This has to be a collective movement. If trans visibility is just about individual “success”, then inevitably many of the most visible trans people will be those who are more privileged. We have to lift one another up – and those of us who benefit from whiteness or citizenship or being middle-class or being abled need to think about how we can account for that, signal boost other people from our communities, or sometimes step aside from an opportunity. The whole point of trans visibility is for every trans person to see themselves as possible.

This is where the real potential lies with Trans Day of Visibility. I will never forget the overwhelming awkwardness of trying to speak yourself into existence when you simply don’t have the language available to you, when you don’t see anyone like you in the world to show that your future is possible. In spite of everything, the world has changed for the better for trans people over the last two decades. It’s no wonder that more of us are coming out than ever, at earlier ages too.

Let’s carry on changing the world together.

Trans Day of Visibility events

I am doing a couple of events for Trans Day of Visibility (Wednesday 31 March).


Katy Montgomerie’s TDOV livestream

I’ll be joining Katy Montgomerie‘s TDOV livestream, in which she will “talk to a load of cool trans people about whatever!” I’m dropping by for the start of the event at circa 19:00 BST (British Summer Time) – join us for chill times, and stick around for conversations with a load of great trans thinkers, writers, and Youtubers. You can watch through the link below:


Spectra Interview

I did an interview with Joanne Espada for Spectra’s Trans Programme. We spoke about the Trans Learning Partnership, the background to my research work, and my decision to become “visibly” trans in my mid-20s after several years living stealth. You can watch the full thing through the link below!

QUEERPOCALYPSE

QUEERPOCALYPSE

Today is Trans Day of Visibility, apparently. I have felt very strange about this day since it became a Thing over the last decade, as visibility is double-edged sword for many of us. With visibility comes community, and increased access to trans and queer arts, culture, politics, ideas. But in the last few years this has met with a cultural and ideological backlash. We are more visible to those who hate us, those who fear us, those who would cause us harm.

Last year I wrote some lyrics about this dichotomy, which are now part of a new song from noise/punk band Dispute Settlement Mechanism. It’s called Queerpocalypse.

 

One of the great things about being in a band is that the process of creation is always  collaborative. I like that this enables us to express ourselves, be that as queer, as trans, as woman, as people, in different ways that come together as a whole. Communicating through riffs and percussion which tell their own stories alongside lyrics and vocal performance.

This, at least as much as my research and formal writing, is the visibility that matters to me in 2020.

I fear your hate inside
I fear the turning tide
I fear your time will come
I fear you think you’ve won

moral panic
moral panic
moral panic
moral panic

you fear with desperate pride
you fear the turning tide
you fear our time will come
you fear that we have won

well guess what?

this world is ours
this world is ours
this world is ours
this world
is ours

Queerpocalypse is available as part of the compilation album Songs From The Vaults. All proceeds from digital sales of the album (available from £5) go towards supporting important Coventry venue and community centre The Tin Music and Arts through the COVID-19 crisis.