Transgender Pregnancy in 2025: Breaking Barriers and Myths with Affordable Care Options

Understanding transgender pregnancy is essential for the health and happiness of transgender parents and their families. It’s time to acknowledge the journey so far and envision the future of inclusive care.

Pregnancy has long been associated exclusively with women, but people of all gender identities around the world experience pregnancy and childbirth.

Medical advancements are nearing the possibility of transgender women carrying children through uterus transplantation, a breakthrough that could redefine reproductive health.

While uterus transplants have been successfully performed on cisgender women from both living and deceased donors, most transgender individuals who give birth today are those assigned female at birth—such as transgender men, nonbinary, genderfluid, genderqueer, and Two-Spirit individuals—who retain their uterus.

Dispelling Myths: Transgender Pregnancy Is Achievable

Many transgender men have been misinformed that testosterone therapy causes permanent infertility, leading to unexpected pregnancies or the misconception that pregnancy is unattainable.

However, a 2019 study on female-to-male transgender individuals undergoing in vitro fertilization revealed comparable egg quality and quantity to cisgender women.

Testosterone typically halts ovulation within 6 to 12 months, but ovarian egg reserves remain intact.

When testosterone is paused, menstruation often resumes within approximately six months, with no current evidence of adverse long-term effects.

Reproductive endocrinologist Dr. Sara Pittenger Reid has noted that limited data indicates prior testosterone use does not negatively impact baby health.

Trystan Reese, who transitioned in his twenties, was once told his uterus would be “uninhabitable” due to testosterone, yet he successfully gave birth to a healthy child in 2017.

Reese emphasizes, “I am not an anomaly—hundreds, perhaps thousands, of transgender men worldwide have given birth or contributed eggs to pregnancies.”

Research from Rutgers University suggests up to 30% of transgender men have experienced unplanned pregnancies, highlighting the importance of informed reproductive care.

Beyond physical health, societal stigma remains a significant barrier for pregnant transgender and nonbinary individuals.

Overcoming Social Barriers and Gendered Expectations in Pregnancy Care

Pregnancy-related language and care environments are heavily gendered, often alienating those who do not identify as women.

Common terms like “maternity ward” and “women’s health,” as well as assumptions from strangers, can cause distress for transgender pregnant people.

Ethan Clift shared with NBC News the challenges of being repeatedly misgendered during prenatal care, underscoring the need for respectful communication.

Reports of ridicule, refusal of care, and denial of lactation support are unfortunately common, contributing to 30.8% of transgender patients delaying or avoiding medical attention, according to a 2016 study.

One transgender man expressed the emotional toll of being perceived as a pregnant woman after years of affirming his male identity.

Another highlighted healthcare providers’ discomfort and fear of making mistakes as obstacles to receiving appropriate care.

Transforming Pregnancy Care Through Respect and Inclusivity

Enhancing the experiences of transgender pregnant individuals begins with respect for their gender identity and avoiding assumptions.

Healthcare providers and the public can adopt these best practices:

• Use gender-neutral terms like “pregnant people” instead of “pregnant women.”
• Refer to anatomy specifically, such as “uterus and ovaries,” avoiding gendered language.
• Consistently use a pregnant person’s stated pronouns.
• Address patients by their preferred names, which may differ from legal names.
• Include gender identity questions on intake forms and ensure staff review them prior to interaction.
• Provide single-stall, gender-neutral restrooms.
• Train all staff in cultural competency and inclusive care practices.

Numerous resources support both pregnant transgender people and healthcare providers, including:

• FertilityIQ’s “Trans Masculine Fertility” online course
• Family Equality’s “Family Building for the Trans Community” handbook and “Preparing for Pregnancy as a Non-Binary Person” guide
• Trans Fertility Co.’s “All Pregnant People” digital training for birthworkers
• Podcasts such as Family Equality’s “Trans Dads” episode
• Recorded webinars on trans fertility and gender-affirming care from Family Equality and Fenway Institute
• Trevor MacDonald’s book “Where’s the Mother? Stories from a Transgender Dad”

Dr. Sara Pittenger Reid affirms, “As more individuals receive support through their pregnancy journeys, comfort and access to care will improve.”

Providing competent, affirming care benefits both the pregnant person and their child, a goal that should unite all healthcare efforts.

Sarah Prager is a celebrated author whose work has appeared in The New York Times, The Atlantic, and National Geographic. She has written youth books highlighting LGBTQ+ historical figures and lives in Massachusetts with her family.

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