“Wanting to have a biological child is neither a male nor female desire, but a human desire” – as Thomas Beatie, a prominent transgender man, put it. We typically see pregnancy as an exclusively female act, but male identify and appearing individuals are also capable of this. Individuals born with female sex characteristics and reproductive capacity that identify as male and have made a physical transition to this thus subvert our expectation of gender in our binary societal views. Pregnant transgender males are not the norm in Australia or any Western country. It’s imperative that the law recognises the existence of these individuals and offers them the same rights and protections relating to pregnancy as cis-women.
The medical eld regards transgender people as suffering from a condition called ‘gender dysphoria’ where they have continual and strong feelings of discomfort associated with their gender identity not being consistent with their biological sex. Pregnant transgender males often struggle with an even stronger sense of gender dysphoria as they feel detached from their chosen male identity in doing something society considers an inherently female act – giving birth.
A recent study by A.D. Light took surveys of 41 transgender males who had experienced pregnancy and delivered a baby after they had commenced their transition from female to male. Falling pregnant required them to stop their hormone replacement therapy for the period leading up to the pregnancy and throughout, which often led to the reemergence of their gender dysphoria as their bodies became more feminine again. The men recorded various responses to pregnancy. Some nally felt happy and at peace knowing their bodies were doing something useful that other men’s bodies couldn’t do: “It was relieving to feel comfortable in the body I’d been born with.” But for most, the experience of pregnancy heightened the feeling of gender dysphoria as pregnancy is a “bizarrely feminized world” increasing the gap between some transgender men’s psychological identity and their biological sex: “Heavy time, having a baby, not passing as male, all the changes and a society telling me to just be happy.”
The study found that unfortunately the majority of the men reported negative experiences with the healthcare system. Hostile looks, suspicion and double takes were moderate and typical experiences reported by the respondents. In an extreme incidence one participant was reported to Child Protective Services for being a “tranny with a baby.” There were also instances of transgender men being turned away from doctors and healthcare professionals refusing to use correct pronouns. This negative, discriminatory and irresponsible response from the healthcare system needs reform including establishment of specialised ethics committees. If a patient presents with the capacity and desire to have children (a uterus, fertile eggs, donor sperm) then there is absolutely no reason to deny them this vital service.
The United Nations Universal Declaration of Human Rights article 16 provides everyone with the right to marry and found a family. Although equal marriage rights are strongly advocated for, transgender issues do not receive the same widespread support or attention. This right to marry and found a family should be no different for transgender people as article two dictates that the Declaration applies to all people without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. The provision for health and wellbeing in the declaration makes special reference to motherhood as needing additional assistance and care. This reference to ‘motherhood’ is clearly outdated in the current social climate where our society sees fathers taking a greater role in parenting, and in particular instances of entering ‘motherhood’ themselves. The UN would do well to change this reference to ‘motherhood’ to the broader term ‘parenthood’ to ensure adequate and equal recognition of this.
Transgender men have been discriminated against for expressing the wish to have children or merely retaining the capacity to do so. In the case of Western Australia v AH , the WA Court of Appeal denied two female-to male applicants the right to be issued gender reassignment certificates on the basis they had not undergone invasive surgery to remove internal female reproductive organs and create male genitalia. The applicants did not see these organs as disruptive to their gender identity, and did not think surgery was an appropriate response to their existence. Phalloplasty, the artificial creation of a penis is not performed in Australia due to an extremely high risk factor with low success rate.
The decision in WA v AH has since been overturned by the High Court of Australia replacing this with the requirement that they only be socially rep- resented as male. Unfortunately the preference for female-male transgender people to be permanently and irreversibly infertile still lingers in many countries around the world. This approach condones the surgical ‘mutilation’ of transgender bodies. So it might be shock that most of Australia’s state legislation is yet to re ect this precedent.
All states and territories excepting Western Aus- tralia and the ACT still require a ‘sex-affirmation’ procedure to correct the sex on one’s birth certif- icate. It is unclear in the legislation what exactly a ‘sex-affirmation’ procedure entails, but it is defined in South Australia as a procedure that alters the genitals and other sexual characteristics of a person.
Overwhelmingly, the denial of adequate healthcare to transgender men seeking or undergoing pregnancy leads to discrimination, significant health risks, and a significant impact on general wellbeing. This flies in contravention of international human rights, although there is some necessary progress needed in that area. Domestic legislative reform in line with improved representation and education of gender and sexual identity would help spearhead a change in how we view non-binary conforming and transgender individuals and their reproductive rights.