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
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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
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
Resources for healthcare providers and advocates:
FTM International: http://www.ftmi.org/
World Professional Association for Transgender Health: http://www.wpath.org/
Gender Identity Research and Education Society: http://www.gires.org.uk/
Transgender Health Action Coalition: http://www.critpath.org/thac/