One of the most common misconceptions about transgender people is that they cannot or do not want to have children. Contrary to this rather misleading popular belief, many transgender people desire to have children, with rates comparable to the cisgender population (Auer et al., 2018). Transgender individuals have multiple options for parenthood just like cisgender people. Although transgender parenting is often misunderstood by many, the aspiration of all parents is to have a healthy baby and be a loving parent despite how one may identify.
Types of Childbirth in the Transgender Family
There are numerous ways in which trans people may conceive or have a child:
Transgender Men Who Give Birth: Transgender men are individuals who were assigned female sex at birth yet self-identify along the masculine spectrum. Some transgender men may decide to (temporarily) refrain from surgical removal of female reproductive organs and retain the possibility to become pregnant. They may conceive naturally or with the help of fertility treatments. They may give birth vaginally or by cesarean section.
Transgender Women Who Parent: Transgender women are individuals who were assigned male sex at birth yet self-identify along the feminine spectrum. Some transgender women may decide to preserve their sperm before undergoing medical transition and use it to conceive a child with a partner or a surrogate. They may also adopt a child or become a parent through other means.
Non-Binary People Who Give Birth or Parent: Non-binary people are individuals who do not identify exclusively as men or women. They may have a fluid or diverse gender expression. Some non-binary people may decide to use their own reproductive organs to conceive or carry a child or they may pursue other options.
Additional options: Adoption, co-parenting, fostering, IVF, using a gestational carrier, egg donor, insemination with a sperm donor, or penis in vagina sex.
Feelings of Transgender People During Childbirth
Transgender people who decide to conceive or carry a child may have different experiences and feelings during pregnancy and childbirth. Some of these experiences may include:
Gender affirmation: Gender affirmation is the process of recognizing and supporting the gender identity and expression of transgender people. Some transgender people may feel that pregnancy and childbirth affirm their gender identity and expression, as they may see themselves as parents who can nurture and care for their children.
Gender dysphoria: Gender dysphoria is the distress that some transgender people experience when their gender identity does not match their sex assigned at birth. Some transgender people may feel that pregnancy and childbirth worsen their gender dysphoria, as they may feel uncomfortable or disconnected with their bodies or their social roles as parents.
Gender creativity: Gender creativity is the ability of transgender people to challenge and transform the norms and expectations of gender and sexuality. Some transgender people may feel that pregnancy and childbirth allow them to express their gender creativity, as they may create new ways of being parents that reflect their identity and values.
How is the Child Affected?
You may have questions about sex and gender of a child born to trans or gay parents as well. Having trans or gay parents does not mean the child will also be trans or gay. Gender identity and sexual orientation are different aspects of a person’s identity. One is the internal sense of being male, female, or non-binary, and the latter is one’s attraction to people of the same or different genders. Both gender identity and sexual orientation are influenced by a complex interplay of biological, psychological, and social factors. Thus, having trans or gay parents does not determine or cause a child’s gender identity or sexual orientation (Paterson, 1992).
How Can You Support Transgender Parenting?
If you are a healthcare provider, you may eventually experience parenting structures that are new to you. The best practice is to remain just as open-minded and caring as you would be to cisgender parents. Trans parents often face a great deal of discrimination in healthcare (Kirubarajan et al., 2022). It is therefore our duty to support them in a nonjudgmental manner during their childbirth and child rearing process despite how their parenting role may look in our eyes. Seeing the bigger picture of everyone wanting to love and care for a child as the ultimate desire is key here. Trans parents are no different. They, too, want to love and care for their child in the best way possible. They also want to be wonderful parents and raise an amazing human just like cisgender people do. We all want incredible humans who are fulfilling the best expression of themselves no matter who parented them because in the end, that is what matters most.
- Auer, M. K., Fuss, J., Nieder, T. O., Briken, P., Biedermann, S. V., Stalla, G. K., … & Hildebrandt, T. (2018). Desire to have children among transgender people in Germany: A cross-sectional multi-center study. The Journal of Sexual Medicine, 15(5), 757-767.
- Kirubarajan, A., Barker, L. C., Leung, S., Ross, L. E., Zaheer, J., Park, B., … & Lam, J. S. H. (2022). LGBTQ2S+ childbearing individuals and perinatal mental health: A systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 129(10), 1630-1643.
- Patterson, C. J. (1992). Children of lesbian and gay parents. Child development, 63(5), 1025-1042.
Dr. Shannon Whittington she/her DNP, MSN, CCM, LGBTQ+ Health Certified, is the author of the bestselling book: LGBTQ+: ABCs For Grownups. She is a certified speaker spreading the message of LGBTQ+ Patient-Centered Care and LGBTQ+ Workplace Inclusion. Her mission is to squash homophobia in the workplace and transform how healthcare is delivered to the rainbow community. For bookings contact Dr. Whittington at hello@WhittingtonConsulting.com