Pregnancies, both planned and unplanned, happen to trans folks, too. It is imperative for reproductive health care providers to seek appropriate education and training in order to be able to provide comprehensive care to these patients.

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.

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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.