Q: How do I navigate my safety as a pregnant man?
A: Navigating safety is an incredibly prominent concern for many transmasculine individuals considering or currently experiencing pregnancy. While there is no one right way to go about it, it can be helpful to hear how other individuals have navigated these choices in their own lives in order to inform your own decisions. In a study of transgender men who had experienced pregnancy, it was found that there were three most common strategies used in navigating safety when interacting with the people in their lives (Hoffkling et al. 2017). Each of these strategies involve compromise of some sort, and so it is important to weigh the costs and benefits of each.
The first strategy is to try to present and pass as a pregnant cisgender woman. In doing so, it is likely that you will receive an increase in support surrounding your pregnancy. This strategy often allows for more comfort and feelings of safety, as well as a decrease in the risk of transphobic violence. However, you must sacrifice your own gender identity and risk feelings of dysphoria in being misgendered and perceived as a woman.
The second strategy is to try to present and pass as a cisgender man and to hide one’s pregnancy. While this strategy may minimize dysphoria and transphobic violence, it also decreases affirmation and benefits surrounding your pregnancy. Transgender men who have taken this route cite hardships in not being allowed the physical and social support often given to pregnant individuals.
Finally, the third strategy is to be out and visible as a pregnant transgender man. This strategy allows individuals to feel affirmed in their identity and pregnancy, however, this puts individuals at more of a risk of transphobic violence. While many individuals live in incredibly affirming environments and may not ever experience transphobic violence during their pregnancy, the risk still exists and should be taken into consideration while making these decisions.
To hear more about the lived experiences of transmasculine parents, check out our Oral Histories page.
Q: How do I find masculine pregnancy attire?
A: There are several guides that may help in providing you with ideas for masculine pregnancy attire. Trans Fertility Co. offers this helpful article written by Arlo Dennis that gives some ideas on outfits for individuals who would like to either camouflage or embrace their pregnant bellies. Moss the Doula offers this helpful guide on their website as well, which provides direct links to different neutral-ish pregnancy clothes. However, many of them are marketed on their websites in a gendered way, and so discretion is advised.
Q: How do I seek respectful, inclusive prenatal care?
A: Seeking respectful, inclusive prenatal care is a concern for many individuals. For those who have the capacity to self advocate, calling clinics or doctors ahead of time and explaining your situation may help you receive more thoughtful and intentional care. By asking someone at the clinic to take the lead in informing their coworkers about you and what your needs are in advance, this may help give them time to prepare for your arrival and make whatever changes are necessary to provide you the best care possible. If you have a difficult time vocalizing your needs, you may want to consider asking a partner or a loved one to make the call on your behalf. It may also be helpful to recruit a partner or a loved one to accompany you to your appointments in order to help advocate for you and your needs.
For trans-affirming resources offering clinical care relating to pregnancy, please visit our Fertility Centers & Health Care resource page. For emotional and educational support regarding pregnancy, visit our Family Centers, Support Groups & Webinars resource page. For more options regarding clinical, non-clinical, and emotional support, visit our Directory of Trans-Affirming Care. For resources regarding substance use, visit our Pregnancy & Substance Use Resources page. For more information on queer and trans family rights and law, visit our Legal Resources page. To hear more about the lived experiences of transmasculine parents seeking pregnancy-related care, check out our Oral Histories page.
Q: Where can I find emotional support around my pregnancy?
A: For emotional and educational support regarding pregnancy, visit our Family Centers, Support Groups & Webinars resource page. For more options regarding clinical, non-clinical, and emotional support, visit our Directory of Trans-Affirming Care. For therapeutic or psychiatric help, visit our Mental Health Resources page.
Q: Where can I find support around abortion, miscarriage, or infant loss?
A: For emotional and educational support regarding pregnancy termination or loss, visit our Abortion, Miscarriage & Infant Loss Resources page. For abortion and pregnancy loss doulas, visit our Directory of Trans-Affirming Care under the “Doulas, Midwives & Perinatal Care” section.
Q: Is it safe to be on PrEP (pre-exposure prophylaxis) or ART (antiretroviral therapy) while pregnant?
A: It is recommended that individuals who may have been exposed to HIV while pregnant talk with their doctor about starting ART as soon as possible in order to prevent one’s fetus from contracting the virus (NIH’s Office of AIDS Research).
Research has found that people who became pregnant while using TDF/FTC (tenofovir disoproxil fumarate/emtricitabine) may continue taking it throughout their pregnancy. TDF/FTC has been found to prevent the acquisition of HIV at rates higher than 90%, and may provide protections for the fetus as well. The risk of contracting HIV during the process of conception, pregnancy, and up to 6 months postpartum may be higher, with the most common risk factors including non-protected sex with an individual whose HIV-RNA levels are detectable or not known, the use of injectable drugs, as well as recent contraction of an STI (sexually transmitted infection) (NIH’s Office of AIDS Research).
Regardless of whatever form of PrEP or ART you are interested in, it is important to get tested regularly and talk with your doctor about what is right for you before making any decisions. For more information, visit the United States Government’s website on clinical information relating to HIV.