In 2022, Reese, a transgender man, had seen friends lead healthy pregnancies as trans men, and he knew such a scenario was possible. The couple did their research, and in doing so, they realized transgender men can lead perfectly healthy pregnancies. And so that’s exactly what Reese did: He gave birth to the couple’s son, Leo.
While Reese’s hormonal therapy gave him a beard and a deeper voice, his uterus and ovaries continued to function. The process of getting off testosterone hormones wasn’t so different from what most women face when they stop taking birth control before conception… and about five months later, Reese was pregnant. Reese insisted that he’s not a pioneer for this issue—those transgender men carry out successful pregnancies more often than people tend to think.
Many transgender individuals express specific desires for parenthood, such as biological relatedness and barriers to parenthood, such as physical limitations or lack of legal protections, which influence how transgender individuals choose to become parents in the future. Reproductive medicine has seen definitions of motherhood expand to embrace egg-donor mothers and adoptive mothers, in addition to the gestational, or birth, mother. Today there is a fourth category: the transgender mother.
This can mean, among a variety of possibilities, a man with a uterus who has transitioned from a woman, and who stops taking hormone-replacement therapy to conceive; or a woman who has transitioned from a man using frozen sperm with a surrogate. Simply put, ‘motherhood’ and ‘fatherhood’ is no longer defined only by the chromosomes and sex organs with which we were assigned at birth but by the gender with which we choose to identify.
In India as the first case in India, Ziya and Zahhad, a transgender couple from Kerala, are expecting their baby in March, Ziya announced in an Instagram post claiming that this is the first case in India that a transman has conceived. Ziya, born as a man and changed into a woman and Zahhad, born a woman and transformed into a man, have been living together for the last three years. Zahad conceived the baby amid his transition process from a woman into a man, which was stalled for the baby. The decision of the baby was taken when Zahhad’s breasts were already removed but doctors said as the uterus was there, it would be possible.
Zahhad, an accountant from Thiruvananthapuram and Ziya, a professional classical dancer, both are excited to have a child in their life. Most transgender people giving birth are those born with a uterus — transgender men, non-binary people, gender fluid people, genderqueer people, two-spirit people, and others with uteruses who do not identify as women. According to health professionals, it is a misconception that taking testosterone will make transgenders “sterile” and potentially unable to conceive.
A recent study that researched female-to-male transgender people receiving in-vitro fertilization found that egg quality and quantity were similar between transgender men and cisgender women. While taking testosterone, ovulation may stop but egg reserves continue to be there. So, if a transgender man stops taking his testosterone, his menstrual cycle often returns, reportedly within about six months.
Even though there are no exact records, according to news reports collected by Rutgers University, nearly 30 per cent of transgender men across the world have had unplanned pregnancies. Transgender men, who take testosterone therapy do so to suppress the effects of estrogen while stimulating the development of masculine secondary sex characteristics, however, many doctors suggest that for transgenders, getting and carrying a pregnancy has to come with more care, as there are higher chances of placental abruption, preterm labour, anaemia, and even hypertension. Transgender men and non-binary people assigned to females at birth may also be encouraged to freeze their eggs before any medical transition. However, some researchers and doctors are also exploring experimental cancer fertility techniques to retrieve gametes in individuals who transition early.