Another pregnant man steps forward

Scott Moore and his husband, Thomas, have decided to follow in the footsteps of Thomas Beatie and Ruben Coronado by going public about Scott’s very much wanted pregnancy and impending delivery in order to raise awareness.

While pregnancy among trans men actually occurs with some frequency it has only recently been brought to public attention. And unfortunately the medical community is often just as startled, befuddled and prejudiced as everyone else.

In the article linked above Scott speaks to the difficulty he had obtaining appropriate prenatal care: “We didn’t want everyone to be shocked when a man turns up to give birth. We found it very difficult to get a doctor and midwife at first. It was hard when people didn’t want to treat me… No pregnant person should be denied healthcare just because they are a man.”

Now granted, a portion of the hesitation Scott encountered in finding a provider was likely related to the lack of established treatment guidelines for pregnant trans men, the inherently increased risks to both father and fetus and the medical-legal liability to be assumed by the would-be provider. Even the standards of care published by the renown World Professional Association for Transgender Health (WPATH) are silent on this issue. But the fact remains that few providers make the effort to educate themselves regarding the medical needs of individuals with atypical gender experience and there has yet to be published even one case report in the Medline (Ovid) primary literature database regarding trans men and pregnancy. Clearly medical providers have a long way to go in meeting the needs of this neglected population.

So what should a trans man considering pregnancy do? First of all, do your research early on and find a provider before you get pregnant. Second, testosterone should be discontinued at least 6 weeks prior to pregnancy in order to prevent its deleterious effects on a potentially female fetus. Elevated levels of androgens like testosterone can masculinize external female genitalia as well as brains with potential social, sexual and gender identity consequences. In the event that an inadvertent pregnancy occurs, testosterone should be discontinued immediately if termination is not desired.

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