Preparing for Pregnancy as a Non-Binary Person

This article was originally written for Family Equality.

Preparing for pregnancy as a non-binary person will involve a few extra steps to ensure your mental and physical health is supported throughout the process.

Supports for Your Physical and Mental Health

You may not be able to obtain all of these supports in one place, but in order to emotionally survive the pregnancy experience (or maybe even enjoy it, but no pressure!), research shows that it’s helpful for you to have the following:

1. Affirmation of identity

Whether your pregnancy support team is able to be respectful of your identity or not, make sure you have access to community support throughout the process. Some non-binary people choose not to disclose their identity to providers (or choose to selectively disclose to the team members they think are most likely to be supportive). That’s totally okay and up to you to decide! But finding community affirmation, being surrounded by people who know and respect your identity, will be especially helpful as you weather the storms (internal and external) of pregnancy, labor, and postpartum life. Most trans and non-binary people who engage in a pregnancy process don’t do so in a place where in-person support is available. This is where online support systems become critical. When it comes to non-binary social support space, Facebook is currently being used more than other platforms, and a simple search for non-binary pregnancy groups should open you up to several options. If you have a partner, whether they are non-binary identified or not, they should be able to find partner groups for non-gestational parents so they can access supports as well. Reading through others’ experiences, asking questions, and getting advice or just commiseration is a critical aspect of an emotionally healthy pregnancy process. Additionally, if you plan to raise your child/ren gender-neutral or gender-free, there are groups for that as well!

2. Affirmation of pregnancy

Sometimes people have access to support around their identity as a non-binary person but not around their realities as a pregnant person! Making sure that you have resources committed to helping you have a healthy pregnancy is just as vital to your mental health as community support around your identity. For example, you or a friend can call local yoga studios to ask if their prenatal classes are non-binary inclusive. You can connect with facilitators of local pregnancy meet-ups to see if other non-binary people have had good experiences there. You can join due date groups on Facebook and ask if they are non-binary friendly. This can mean correcting people when they use “ladies” language, which you may or may not have the capacity to do. Decide for yourself what your capacity is, and ask for help from allies. Or opt out of situations where you’re unlikely to have the ability to educate and correct others.

3. A feeling of physical and mental safety

While it’s important to have affirmation of your identity as non-binary AND affirmation of your status as a pregnant person, it’s equally important to be (and feel) safe throughout the process. That may mean that at times, you choose not to come out to everyone around you—either as non-binary or as a pregnant person. It may mean that you choose not to correct every wrong pronoun or wrong assumption that you aren’t pregnant. That’s okay! Your job while pregnant is to put your own safety first, and when you take steps to ensure your safety, you may be able to reduce feelings of anxiety, panic, or depression. If you want to do more education of providers down the road, you may. But if you don’t feel up for it during the gestation period, that’s okay. Make decisions that keep you and your pregnancy safe, and later you can engage in activism.

Considering “Outness”

When planning a pregnancy, you’ll want to consider to what degree you plan to be “out” as non-binary throughout the process. If you’re someone who hasn’t taken hormonal steps towards a transition, you may have more options when it comes to this aspect of the process. But generally speaking, there are three options when it comes to outness. The research shows us that any choice, or combination of choices, can be utilized successfully as you navigate pregnant life as a non-binary person.

1. Blending as a cisgender woman

While emotionally difficult, some non-binary people choose not to share their identity with the public, strangers, and/or medical providers because it’s likelier that they will experience a higher level of safety in public and might, unfortunately, receive better medical care. Need two (affirmation of pregnancy) and need three (physical and mental safety) listed above are honored on this path but need one (affirmation of identity) often isn’t, and feelings of invisibility and dysphoria can be heightened.

2. Blending as a cisgender man, or attempting to go “stealth” for the pregnancy

Some non-binary people, particularly those who have taken medical transition steps prior to pregnancy, are able to spend most, if not all, of their pregnancy appearing to others as a cisgender man. Different body types make this option more of a possibility for some. For those who are able to blend as a cisgender man while pregnant, this option meets need one, as their identity as something other than female is usually being honored, and need three, as they are usually able to avoid being viewed as a transgender person in public. Need two, though, attaining affirmation of pregnancy, is often harder to obtain. Those who have remained stealth during pregnancy find it’s difficult not to have direct external support around the pregnancy, but they appreciate the ability to dodge sexist and/or transphobic violence.

3. Being out and visible as a pregnant non-binary person

In the best of worlds, if you live in a supportive community, this option allows for all above needs to be met — everyone knows you’re non-binary and pregnant, you can openly access support systems for both pregnant people and non-binary folks, and you feel safe and secure throughout your pregnancy. However, if you aren’t in a supportive environment, this option generally feels less safe to those who choose it, since the realities of trans pregnancy are still not considered “mainstream” by many in our culture.

Some topics to discuss with your provider, friends, and/or partner(s):

1. Plans to Feed the Baby

Whether or not you’ve had top surgery, your body may still produce milk. And whether or not you produce milk, you may still choose to use formula or donor milk. There are lots of options for feeding your baby! Formula is rigorously tested and has been shown to be a safe, nutritionally complete option for babies as early as newborn. If you have a partner, they may be able to induce lactation by taking a special regimen of hormones and supplements (transgender women are also able to induce lactation using the same protocols). Inducing lactation does not always result in a full milk supply, but it can still be pursued if it is of interest. If you are open to the idea of milk donations from others, some states allow for peer-to-peer milk sharing networks (these markets are unregulated, though, so make sure you understand the risks before entering into any agreement to feed someone else’s human milk to your infant).

2. Medical Transition Plans

Both hormonal and surgical options may impact your fertility and ability to carry a baby, so it’s great to know the impacts of transition steps. Many trans and gender non-conforming parents postpone medical transition so they can have a baby. The psychological impacts of postponing transition can be difficult, so it’s good to have support if that’s the route you choose to take. If you plan to take hormones after giving birth, regardless of whether you’ve taken them prior to conception, talk with your medical provider about when to start.

Pregnancy is a major event for anyone who experiences it, and healing from pregnancy and childbirth should be paramount. However, there are situations in which testosterone can actually aid with the healing process, just as there are situations in which it can hinder it. Work with a provider who understands your specific circumstances and can give advice as to when you may begin taking hormones following childbirth. Generally speaking, hormones should not be taken while nursing, so that will be an important factor for you to consider as well.

3. Gendering of the Baby

Some non-binary parents think creatively about the ways in which they plan to approach gender during their pregnancy and parenting journey. If you don’t want to know the sex of your baby before birth, make sure to tell your medical team. If you plan to use a gender-neutral name and pronouns, that’s another thing to talk with your social and medical community about.

4. Requests for your Providers

Think about what will help you feel affirmed during the medical aspects of your process. Do you want the clinic to provide gender-neutral gowns when you have exams? Do you have specific anatomical language you’d like them to use? Would you prefer a private waiting area between appointments? Do you want your medical chart to reflect your pronoun or name (if different from your legal/insurance paperwork)? If you are working with a doula, as many LGBTQ+ pregnant people do, can they come to your appointments to help with these advocacy elements?

Try to solidify your resources before giving birth. Once your sweet baby is born, they’ll take up a lot of time, space, and love in your life. Having a community around you that supports your identity as non-binary, as well as your new role as a parent, will ease your path to parenthood in ways that are hard to adequately describe. It’s been said before that it takes a village to raise a child. That village works best when it supports all of who you are as a parent and a person.

Trans Fertility Co. aims to be part of that village. Be sure to stay connected to us for more opportunities to be in community with other trans folks who are becoming parents!

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Trans Women and Fertility: What We Know, What We Don’t Know, and What You Can Do

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What Doesn’t Bend, Breaks: Resiliency Strategies for Trans Folks on Fertility Journeys