From Erasure to Opportunity: The Needs of Transgender Men Around Conception, Pregnancy, and Birth [28J]

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Abstract

INTRODUCTION:

There are likely 750,000 transgender men in the US individuals who identify as male but were assigned female sex at birth. Some of these men retain their uterus, are getting pregnant, and are giving birth. However, there has been little investigation into what the perinatal needs of transgender men are. Specific needs around conception, pregnancy, and newborn care could arise from the psychosocial experience of gender nonconformity, the medical experience of exogenous testosterone exposure, and or from having had surgery to affirm gender identity. We undertook a systematic qualitative study to understand the needs of transgender men who had given birth.

METHODS:

Using a grounded theory approach, we interviewed 10 transgender men who had been recruited for a recent online cross-sectional survey (previously published) of individuals who had given birth while identifying as male. Interviews were transcribed and coded by two researchers with code corroboration by two other researchers. Analysis used 35 a priori and emergent codes to identify emergent themes and form conceptual theory.

RESULTS:

Emergent themes centered on areas of potential needs, including: decision-making, structural factors influencing participants' experience, positive and negative elements of interactions with healthcare providers, and psychological dimensions of participants' experience.

CONCLUSION:

Findings suggest a form of institutional erasure that can create barriers to transgender men getting routine perinatal care. Simple ways to support and bring visibility to the experience of transgender men were also identified. Improving cultural competency in caring for this group will likely enhance patient comfort and improve comprehensive utilization of perinatal healthcare services.

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