Transgender men who become pregnant have an increased risk of depression and difficulty in obtaining medical assistance due to lack of knowledge among health professionals, according to a study by Rutgers.
The study, published in the journal Maturitas, examined health research on transgender men who become pregnant at 35 or later to determine their medical and mental health needs.
"Despite the greater visibility of transgender people – there are about 1.4 million who have passed through the United States – medical service providers are largely unprepared to care for them and most have had limited educational opportunities," he said. told the lead author Justin Brandt, an assistant clinical professor in the Department of Obstetrics, Gynecology and Reproduction Sciences at Rutgers Robert Wood Johnson Medical School.
Transgender men who have made a hormonal transition and take testosterone but keep their female reproductive organs have the potential to get pregnant. Since the US medical system has monitored these patients as women, there is no data on how many transgender men give birth each year, but Brandt said the number is probably higher than people realize. While some plans to get pregnant, research suggests that unwanted pregnancies occur up to 30 percent of transgender men.
According to the US Transgender Survey, nearly 40 percent of its 28,000 respondents reported having attempted suicide, almost nine times the national average. This risk can be increased in transgender men with unwanted physical changes resulting from pregnancy, according to Brandt. "The transition process is long and arduous and pregnancy, considered a female condition, forces these men to return almost completely to their sex assigned at birth, which can worsen gender dysphoria," he said.
The surveys used for screening pregnant and postpartum women for depression are not designed to assess the impact of pregnancy on gender dysphoria in transgender men.
The study also found that about 25% of transgender people reported negative health care experiences in the last year. This is related to the finding that about 44 percent of pregnant women in transgender seek medical care outside of traditional care with an obstetrician. Rather, they can look for non-medical providers, such as midwives nurses, with 17% delivering outside hospitals – a higher rate than women.
Although the data is limited on how transgender men give birth, the review found that 64% had vaginal births and 25% required a caesarean section.
The report also noted that transgender men who requested a caesarean section reported that they felt uncomfortable with their exposed genitals for long periods of time, while those who suffered labor reported that the delivery process vaguely exceeded any negative feeling they had with the female gender that had been assigned at birth.
"Although Rutgers' doctors have not yet had a transgender male patient in pregnancy, our health professionals are trained and ready," said Brandt.
The researchers also found that about 51% of transgender breast or chest men fed their babies even though they had undergone breast surgery.
Brandt recommended that transgender men who intend to conceive visit their doctor before becoming pregnant to deal with routine problems, such as folic acid supplementation and screening for genetic disorders, and to be informed about the risks of pregnancy in advanced age, such as infertility, miscarriage, gestational diabetes and pre-term delivery. Probably even transgender men will have to update health screenings that may have expired during the transition, such as pap smears and, when indicated for those who have not undergone chest surgery, mammograms.
After giving birth, Brandt said that doctors should turn to long-term and reversible methods of contraception if the individual is at risk of an unplanned pregnancy. "Transgender men who intend to restart testosterone after giving birth may decide to delay contraception because they perceive that their therapy with male hormones induces a state of infertility, which is not always the case," he said.
Co-authors include Amy Patel, Ian Marshall and Gloria A. Bachmann at Rutgers Robert Wood Johnson Medical School.
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