Visiting an obstetrician and gynecologist can make you feel weak. Everyone should have a doctor who comforts them. But if you are a transgender man or a non-binary person who is pregnant or trying to be, it is essential that your doctor knows and respects your medical needs.
“Pregnancy should be an exciting time,” says Amanda Kalin, MD, an ob-gyn at Yale University. “Maybe it doesn’t have to be fun all the time, but you should feel like you have a voice and are able to participate in your own care.”
Here’s how to find an OB/GYN that confirms adult sex.
Find online resources
There are a growing number of helpful health websites geared towards the LGBTQ+ community. These resources provide the names of many different types of service providers. When it comes to transgender pregnancy care, you can search for details such as an OB/GYN, a fertility clinic, or birth support.
To learn more:
Do a quick internet search. Just type in terms like “OB/GYN near me” or “transgender friendly pregnancy care” and see what you find.
Use your LGBTQ+ provider guides. They are not usually made by doctors or hospitals. But nonprofit groups like Family Equality only list providers who have taken special courses in how to provide comprehensive medical care to people in the LGBTQ+ community.
Try searching for a confirmed OB/GYN by:
Check with your insurance provider. Your health plan’s website may not have a LGBTQ+ search tool. But someone in customer service may be able to give you a list of OB/GYNs who work with transgender or nonbinary people.
Look at doctor or hospital websites. Many clinics state that it is an all-encompassing space. Mindy Christianson, MD, medical director at Johns Hopkins Fertility Center and assistant professor of obstetrics and gynecology at Johns Hopkins School of Medicine says.
Get referrals from people you trust
The internet can be of great help. But there is a low-tech approach that could be very valuable: word of mouth. Ask your friends, family, or colleagues if they’ve gone or know of a confirmed OB/GYN.
You can also:
Consult the folks in your local LGBTQ+ community. Talk to other transgender parents about their pregnancy experience. Or tap into your local network through Facebook groups or personal encounters.
Check with other doctors. Your regular doctor may know about an obstetrician-gynecologist who may be a good fit. This is because it is common for transgender compatible medical providers to know each other. “I get a lot of referrals,” Kalin says.
Look for signs of support
There is still a long way to go when it comes to health equality for transgender, non-binary, or gender-extended people. But you may find medical care more welcoming than it used to be. There are ways to gauge whether you are in the right place.
A good first test, says Kalin, is to introduce yourself and use your pronouns. Everyone in the office must respect the way you ask to be addressed. Includes OB/GYN, nurses, and login staff.
You will also need to search for intake models using:
- Gender neutral language
- A place for your favorite name and pronouns
- Spot your gender identity
When it comes to exams and tests, an obstetrician-gynecologist experienced in transgender healthcare will think ahead. For example, Christianson chose to give a transgender man an abdominal ultrasound rather than the transvaginal type. And this patient did not have to ask for it first.
“After that, he was so grateful,” Christianson says,[He told us], “Thank you for making me feel comfortable.” “
Your OB/GYN should also help you plan for any health effects that may occur. For example, if you are taking testosterone, you will need to stop taking it during pregnancy. (Testosterone may harm a growing baby.) Many people do just fine with this temporary adjustment, but for some, not taking testosterone to get pregnant and have a baby can cause or worsen gender dysphoria. “If this is something you’ve struggled with in the past, it’s a good idea to line up with mental health support early on,” Kalin says.
Who can you see for pregnancy care?
Most obstetricians and gynecologists can treat transgender people throughout pregnancy. But this can be an emotional and stressful time. It is important that you feel safe with your entire medical team. While all clinics should offer supportive care, Christianson says, “some may be better for transgender men.”
You can ask your OB/GYN questions to see if it’s right for you. Here are some questions to get you started:
- How do you make visits more comfortable for transgender or non-binary people?
- Are you aware of the needs of transgender men on and off hormone therapy?
- When can I go back to testosterone after pregnancy or breastfeeding?
- Have you and your staff received special training in transgender healthcare?
- How many transgender pregnant women have you worked with?
If your OB/GYN doesn’t work with a lot of transgender people, it’s not always a problem. “Some people may disagree with me, but I think the most important thing is a willingness to be respected, to learn, and to absorb,” Kalin says.
Questions Your Transgender Confirmation OB/GYN May Ask You
There are general issues your doctor will address, including your prenatal vitamins, genetic testing, and the medications you’re taking. “Everyone should have a pre-conception visit,” Kalin says.
When it comes to caring for a transgender pregnancy, it’s a good sign if your doctor also asks questions like:
- How do you want to know about labor and delivery?
- Do you know where to look for a safe place for prenatal and childbirth care?
- Are you planning to feed your baby with milk from your breast?
- If you’re not breast-feeding, do you want to know more about formula?
- Do you plan to use sperm from your partner, or do you need sperm from a donor?
- Are you taking sex-affirming hormones or planning to take them in the future?
- Do you have a partner or other support system?
- How do you plan to prevent unwanted pregnancy after childbirth?
They may also discuss how you plan to prevent pregnancy after giving birth. “Testosterone is not birth control,” Kalin says. “This is not always clearly communicated.”
When do we talk about fertility in the future
Review your family-building goals early on, especially if you’re taking sex-confirming hormones. Testosterone therapy does not appear to harm egg quality or reduce the chances of pregnancy at a later time. But it can stop your period and mask the signs of fertility problems.
Tell your obstetrician-gynecologist if you’re having trouble getting pregnant or have questions about hormone therapy. They may refer you to a reproductive endocrinologist. These are doctors who have been specially trained on how to help women get pregnant.
“We are very comfortable understanding the different relationship between hormones and how testosterone plays a role,” Christianson says.