Fertility care has opened more doors for trans people to have biological children

SLICE OF LOVE PHOTOGRAPHY, COURTESY OF TRYSTAN REESE

This excerpt is from article on trans fertility that was written for Quartz.com as a member-only exclusive. Trans Fertility Co. provided interviews and background research to the journalists. To read the full article, you can join Quartz here.

Trystan Reese had been taking testosterone for over a decade, but he still had the anatomy necessary to have biological children. After going to a LGBTQ+-friendly OB/GYN clinic in Portland, Oregon, where he lived, he learned that he could safely conceive once he stopped taking his regular hormones. His partner Biff took some convincing—he wanted kids, too, but was concerned about Reese’s safety walking through the world as a pregnant man.

Eventually, though, the couple agreed to get pregnant. They didn’t have to navigate the complex landscape of fertility care many LGBTQ+ couples have to. Biff’s body produced sperm, Reese’s body had healthy eggs, and on July 14, 2017, the couple welcomed a son named Leo.

Reese, who is now 37, was open about his experience while he was pregnant. He’s given countless talks about his experience being pregnant and being a father, and he’s booked to address the American Society for Reproductive Medicine at its upcoming conference this fall. He hopes that by sharing his success story, he can inspire other transgender folks to realize that they, too, can conceive. Yet he still feels overwhelmed by the work left to do for the community. These things keep him up at night, he told Quartz.

I truly wanted to create life, and to have that experience be a physical manifestation of this love that I never thought I’d find out in this world.

In vitro fertilization (IVF) and the fertility market that has developed around it have revolutionized the way all kinds of people can have children. In 1982, the Sperm Bank of California opened its doors to lesbian couples looking to become pregnant with the help of a sperm donor. In 1999, the first trans man gave birth in the US. That year, a gay couple living in California became the first to have both fathers’ names on their child’s birth certificate. Queer people have been having children for decades out of the public eye, but these public cases helped pave the way for future same-sex parents.But one area of the field that has lagged distinctly behind others is fertility care for the transgender and nonbinary community, says Rafat Abbasi, a reproductive endocrinologist and infertility specialist with Columbia Fertility Associates in Virginia. Abbasi has specialized in family planning for the LGBGT+ community for nearly 30 years.Part of the reason is a lack of representation in fertility care itself. For decades, there was an accepted belief in the medical community that taking either estrogen or testosterone to align with gender identity would render someone sterile—completely unable to have children.

As a young adult, Reese assumed that he would have to make a trade between taking testosterone or having a family. When he learned that testosterone didn’t do long-term damage to his ovaries, though, he was elated. “In a world where it continues to be so difficult to survive as a trans person, one of the ways we create safety and love is through a family,” he says. “It’s one of the ways we’re able to survive, but right now most trans people think that’s not possible for them.” More trans people are publicly out and having families of their own, inspiring others to do the same. This increased visibility is likely to prompt fertility care providers to realize that this kind of care needs to become standard. The difficult part will be figuring out how to make that care accessible to everyone.

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Through his work at Trans Fertility Co., Trystan has designed a three-hour digital course for birth workers who are interested in becoming more trans competent. The more centers that can provide trans folks with a good experience, the more people will flock to them. Ideally, the visibility among the trans community can then show others that it’s possible to have the kind of love that manifests itself in children.

“That was my light,” says Trystan. “I followed that through the ups and downs.” Now, Trystan and Biff’s son Leo is two-and-a-half years old. “He’s just started saying ‘I love you, Daddy,’” Trystan says. “Those moments are just unrestrained desire and connection and love, and I want that for everyone who wants that.”