This is it, I thought as I sat in my doctor’s office, almost trembling with anticipation. I can finally start testosterone.
I’d awaited this moment for too long, it seemed, since I’d come out as a trans man and acknowledged to myself that hormone therapy was part of my personal, medically necessary healthcare.
My doctor sat across from me smiling warmly. “Take your time,” he said as he slid a packet of papers across the desk for me to read and sign.
My eyes hit the words “Informed Consent,” where they sat underlined atop the form’s first page and began to move downward, hardly stopping to put an “X” next to the first paragraph.
See, I’d done my research diligently. I knew testosterone’s well-documented effects on the body. No surprises here. Until…
I understand that it is not known exactly what the effects of testosterone are on fertility. I have been informed that if I stop taking testosterone, I may not be able to become pregnant in the future. I have been advised to undergo gamete (egg) banking if this is a concern of mine.
I paused. Then I reassured myself: I know plenty of men who became pregnant after taking, then pausing, their T. I wrote an “X” and kept on moving until I scribbled my signature across the bottom.
“Is there anything you want to discuss?” Something in my doctor’s voice said he sensed what I was thinking. I nodded.
We talked about my reproductive aspirations — something I’d only ever mentioned to my partner and loved ones.
“Well, if and when you get to a place where you want to try to get pregnant, let me know, and we can help you with that,” he said to wrap up our conversation.
It was what I needed to hear to feel seen for the complex human I am — to know that it was okay that someday I may be a pregnant man.
Why had I worried that he just wouldn’t “get it?” Why had I internalized the belief that it might not be acceptable to both be a man and to desire pregnancy?
This is a question that needs multiple perspectives to answer, but I can begin to parse out some common invalidating responses to male pregnancy I’ve encountered from acquaintances or in pop cultural conversations in the media.
In response to each, I offer some realities that deepen or nuance knee-jerk assumptions, so we can better tell the trans men in our lives that pregnancy is a valid option for them within a lifetime of possibilities.
1. “Only Women Want to Get Pregnant”
Being pregnant is simply a bodily function that roughly half the human population has and the other half does not.
Possessing this capability does not inherently make anyone more or less “womanly.”
It might be easy to think this is the case, though, after being hammered by a patriarchal society with the notion that the desire to carry a child is only one that female-identified people have.
That belief is so hard-wired in culture that pregnancy is coded as “ultra-feminine,” which is reflected in, as fertility anthropologist Michelle Walks points out, how pregnant bodies are both considered public property for touching and commentary, as well as “cherished icons… understood to be fragile, and in need of protection (provided by men).”
Yet many men, as well as masculine women, desire to become pregnant (and many feminine women do not desire to become pregnant or treated as fragile, public property once pregnant).
Society simply does not give us a similar cultural “narrative” to help us make sense of “masculine pregnancy.”
That could be a good thing, though, if we use it right! We can make new narratives by opening space for multiple ways for “masculinity” or “manhood” to exist.
Consider Before You Speak:
A. Body parts and gender identity are not directly correlated.
While a doctor looks at a newborn’s body and declares, based on their bits, that they are either “male” or “female,” the lived complexity of gender tells us the equation is not so simple.
We can, for instance, separate the fact that the majority of people who seek pregnancy are cisgender women from the belief that pregnancy is only a “woman’s thing” easily when we consider that cis women who cannot become pregnant or who desire to never become pregnant are still women.
In the same way, we can acknowledge that trans men who desire to use their reproductive organs are still men.
B. Individual men live out their genders differently, all while being able to share the common identifier of “man.”
And the same goes for women and non-binary people.
While society may ask us to disparage men who do not fit a certain ideal, this does not mean they’re not men — it means the criteria we’ve been given to understand their gender is too limited.
The takeaway? There is a multitude of ways for male-identified people to live out their gender, and there’s no reason that pregnancy cannot be a part of this.
2. “You’re Still a Man, But Pregnancy Is Emasculating”
Just as pregnancy is not inherently a “female” experience, it is also not inherently a “feminine” experience — but it can be, if a man finds value in expressing his own femininity this way (after all, not every trans man identifies as masculine). “Feminine” is not a negative characteristic.
Still, for men who are masculine, we cannot assume that pregnancy is automatically experienced as masculinity’s opposite.
Trans men are diverse in their personal understandings of their own gender identities.
In fact, many men report that pregnancy is gender-affirming. The experience confirms their body’s masculinity (however they define it) or makes them proud to be a man who’s able to do things with his body that cisgender men cannot.
Then again, some men do experience body dysphoria when pregnant—a distressing dissonance between their personal gender identity and its expression.
Some bear children as a practical means to achieve their goal of fatherhood, but may feel dissatisfied with how it affects their body’s shape. This is okay, too.
Consider Before You Speak:
A. What makes someone a man? Identifying as a man.
Gender identity is an internal knowing; the individual is the expert.
Yet trans men receive cultural messages that either having certain parts (like a cisgender penis) or having the absence of others (like not retaining a uterus) is what truly “makes a man.”
But the “parts makes the man” rhetoric is damaging to transgender and cisgender men alike. The “bigger is better” phallus myths, for example, can harm any man’s self-esteem and ability to form a healthy body image.
B. Trans men need space for their feelings about reproduction to be complex.
Maybe a trans man you know wants to give birth, but also experiences gender dysphoria or fears being misgendered.
Trans people often face pressure to always be decisive and not express any “gray” feelings about our body’s changes — otherwise, we risk being labeled “impostors” or face questions about whether we “regret” transitioning.
Recognize that pregnant men could use support and acceptance for all their feelings, even if they seem to conflict.
Male pregnancy, and men’s relationships to their bodies and gender throughout, is more complex than “one size fits all.”
There are other activities that are similarly gender-affirming for some folks and less so for others — for instance, taking part in a sport or wearing particular clothes.
3. “Transitioning Means You Can’t Give Birth”
There’s a common pop cultural idea about trans people that goes something like this: “All trans people always seek the ‘fullest extent’ of medical transition options.”
In other words: When someone identifies as trans, this means they will always want to undergo hormone therapy and every transitional surgery available, including a removal of internal sex organs (which results in sterility).
If, as the myth goes, all trans men seek hysterectomies and oophorectomies to remove their uteruses and ovaries, then no man would ever think about using these parts for reproduction.
But that simply isn’t the case.
Many men retain their reproductive organs and try to become pregnant; many others retain them and do not reproduce; and many others know that sterilizing surgery is something they may want down the road after they explore their reproductive options.
Consider Before You Speak:
A. There’s no single “medical transition” path for every trans person.
Being trans does not always mean “seeking hormones and surgery.” If a trans person does have medical needs for their transition, that doesn’t always mean they plan on reaching for them right away — or they may not be able to afford them.
Transition-related healthcare is still prohibitively expensive for many trans people, particularly if their health insurance plans do not cover necessary procedures.
B. Testosterone therapy is not instantly sterilizing.
In fact, there’s very little definitive research currently on the effects of testosterone on fertility over time, but a small 2014 study of 41 trans birth fathers found that each one who tried to get pregnant after ceasing testosterone therapy was able to do so.
The takeaway? Knowing someone’s transitioning — much like anything else in their medical history — doesn’t instantly fill you in on their reproductive goals.
4. “Being a Pregnant Man Is Too Rare for Birth Fathers to Matter”
Remember in 2008, when an American trans man named Thomas Beattie gained international media attention for openly discussing his pregnancy?
After he told his story, male pregnancy became “news worthy” for a hot second, and tales of pregnant men in a few other countries like Canada, Israel, and Chile (as well as a couple more in the US) popped up. But the novelty quickly faded, and so did male pregnancy’s “pop culture” moment.
Does that mean there is only one pregnant man per country, if that? Nope.
But if we listened to the media, it might be hard to imagine that pregnant men are anything but an ultra-rare fluke or some fascinating oddity.
Certainly, we could say that pregnant men are statistically uncommon.
Transgender people are estimated to be 2-5% of the world’s population; trans masculine people take up roughly half that number; and among this group, only a certain number desire to become pregnant.
But no official data exists, and many of the reactions on this list contribute to a culture where men may not feel safe being open about their pregnancies.
Consider Before You Speak:
A. Pregnant men have existed before and after the media frenzy.
Trans men seeking to give birth is not a “new” thing, even while assisted reproductive technologies have recently allowed some access-privileged men with more options.
Men, though, do not always give birth with technological assistance or donor gametes. And historically, male-identified people were giving birth before language or medical options around gender transition were developed.
B. “Rarity” pronouncements feed into health disparities.
Trans men have unique medical needs and need healthcare providers to relate to them in gender-affirming ways.
Yet sometimes this necessary care is presented as “special treatment” — a request for cultural competency is seen as burdening a healthcare provider.
So, the logic goes, if a population (like pregnant men) is negligible, perhaps the practitioner doesn’t need to spend the time to get it right — right?
The issue with this, though, is that when intolerance is present or suspected from a healthcare provider, trans people are less likely to get the care they need.
A doctor’s job, in part, is to meet each of their patients where they’re at.
The takeaway? Every pregnancy is equally worthy of social value and sensitive medical care.
The next time you encounter a pregnant man in the news, in your personal life, or in conversation, you can pause and think where some of your instinctual responses may be coming from.
Is it from a lack of knowledge about medical transition?
A presumption that body parts equate to gender identity?
Maybe even an assumption that trans people do not partake in family-building or parenting?
If you’ve responded to a pregnant man before with one or several of these assumptions, there’s still time to learn more and change your tune.
And rather than asking pregnant men to explain themselves, a great way to show your support is to use books or online articles like this to do some research.
Let’s set an example for those around us by not perpetuating limited definitions of what is “acceptable” for a man to do in order to have his gender identity respected.
This will help more trans men be able to unashamedly contemplate the full range of their reproductive goals, whether they ultimately conclude that they want to try to become pregnant or not.
In the end, this practice is all about opening space for others to explore the full extent of who they can be and what they can do with their own life and body.
That’s something we all want and need to be whole.
Mitch Kellaway is a Contributing Writer for Everyday Feminism and queer, biracial, transgender reporter, writer, and assistant managing editor for Transgress Press. He is the co-editor of Manning Up, an anthology of personal narratives by trans men. In addition to covering trans news for Advocate.com, Mitch’s writing has appeared in the Lambda Literary Review, Huffington Post, Mic, and Original Plumbing magazine, and has been published in several journals and anthologies including Jonathan: A Journal of Queer Men’s Fiction, Cliterature, RE*COG*NIZE: The Voices of Bisexual Men , Man the Yards, and Best Sex Writing 2015. He holds a degree in gender studies from Harvard University and lives with his wife in Somerville, MA. He can be reached at MitchKellaway.com or @MitchKellaway. Read his articles here.
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