Friday, November 29, 2013

Four Points on Trans Male Pregnancy

Shout out to Heather McNamara for reminding me of this subject.

In the reproductive health and justice quadrants of my life there is an increasing campaign to degender the language used to refer to what are typically considered women's issues:  Pregnancy, childbirth, birth control, abortion, etc.  This is both because they're not relevant to all women and because there are people of all genders (including men) who require these services.  I'm pretty well aware of this; after all, I am a man who has sex with other men, and I can get pregnant.  My own access to birth control, reproductive healthcare, and abortion are very important to me, and by principle the right of trans men to give birth if we choose is also important.

But it's really not as simple as "make sure people constantly bring up that trans men can get pregnant!"  There are pros and cons to this advocacy. Four of my personal pros and cons (two pros, two cons) are as follows, and while I don't speak for the rest of the community by any means, it's something to think about if you're planning on creating a reproductive health campaign and including trans men so you can hopefully avoid some of the more offensive ways of going about this.

1. Trans men have died because their doctors were to freaked out to work on our genitals or they were too embarrassed to seek proper care. Advocating for doctors to know a thing or two is paramount.

My first pelvic exam was by a nurse practitioner who noticed the odd back-and-forth my medical system was doing with my name change (they couldn't figure out if I was going from Jackie to Jack or vice versa), figured out from the context that I was transitioning, and asked if I'd ever had a pap smear, explicitly explaining that she was aware a lot of trans men do not seek that kind of care.

I know there would not have been a chance in hell I'd have asked for this, so having a doctor who was sympathetic to those issues was extremely important to me.

Although it's thankfully happening less and less, one need only watch the documentary "Southern Comfort" to recognize why this isn't something that should just be ignored.  Trans men who still have our reproductive organs might have access issues preventing us from receiving lifesaving care, just as Robert Eades was denied cancer treatments for no reason other than he was a trans man.

So that goes on the "pro" side.

2. The idea of pregnancy gives a large chunk of trans men extreme anxiety.

Case In Point
Con: After the Thomas Beatie "Pregnant Man" story came out, one of the first pieces I saw written by a trans man was called "I Hate Thomas Beatie."  He didn't actually hate Beatie, but was expressing discontent that after his story broke his mother will not stop pressuring him to get pregnant, a concept which is a huge dysphoria trigger for him.

Although I support the right of trans men to give birth (and be open about it), I often wish people understood how much the media attention given to pregnant trans men has negatively affected some of us.  My grandma, for instance, decided to lecture to me about how I "gotta give birth at least once while I still can" while I was fixing her computer a few weeks ago.  Even pre-T she never would have said this were it not for the media attention implying that giving birth is something trans men as a whole desire.

It's important to recognize that most trans men don't want to give birth... many of us don't even want to be reminded that we can give birth.  Trans men who do want to give birth are a minority, and by overemphasizing our ability to get pregnant we're feeling more and more pressure from relatives to do so.

Dysphoria exists on a spectrum.  Take the poster featured to the left, there.  It's a great thought, but for somebody with extreme dysphoria it's like shoving a sign saying "YOU HAVE A UTERUS" in his face.

3.  There's a tendency for people to use trans men to decentralize women from issues largely affecting them.

Most of the people I personally witness engaging in this advocacy are doing it from a feminist or womanist standpoint, so this isn't a huge concern (not as an intentional thing, anyway).

It's important to remember that trans men are still men, and that what connects trans men to these issues is female lived history, female perception, and biology... not our manhood.  Trans men are affected by these issues (with some exceptions) as an extension of misogyny.

That said, emphasizing trans men can edge dangerously close to a "what about the men" argument if it's not done carefully or if it's done in opposition to feminist efforts.  When somebody brings up a topical, serious issue affecting pregnant people, zeroing in on their having said "women" is derailing rather than enlightening.  The fact that trans men (or cis men for that matter) are affected by something doesn't automatically mean it's not best framed as a women's issue.

I think it's reasonable to believe that one day we will be at a point where not defaulting discourse about pregnancy on cis women will be a viable option.  That said, I do invite you to start using that language now.  I usually do, too.  Be the movement so to speak.  As it stands right now, though, I do worry about the potential to derail.

4.  Pregnant trans men are probably more common than people think they are, and they deal with a lot of unique issues.

Another pro... it's easy to assume that trans male pregnancies are ridiculously rare, so rare that they don't require any unique attention at all.

Personally I wouldn't be shocked if this was mostly a problem of media attention.  Thomas Beatie, who was marketed as the "first pregnant man," wasn't even close to the first trans guy to get pregnant, even after hormones (he wasn't even the first pregnant man who got media attention... Matt Rice was in The Village Voice several years earlier).

This number is likely increasing if for no other reason than now people know it's do-able.  This is part of a major cultural shift... for a long time trans folk were almost universally expected to be perfect specimens of our lived genders if we wanted treatment, so male pregnancy would have been out.  Thanks to those pregnant trans pioneers, there absolutely are more trans men who want to have biological children in this way.

And that brings up a host of problems.  Trans men who do get pregnant can expect to be treated unfairly by their health insurance companies (which may see a client labeled "male" getting services typically associated with women and get suspicious) and denied social services available to pregnant women.  I believe it was Thomas Beatie who had medical staff request he shave his face and pretend to be a woman to make other pregnant people more comfortable.

Bringing up trans male pregnancy, then, can lead to an increased cultural understanding of this issue and the removal of these barriers.