Can trans women have children? The most frequently asked question answered

Can trans women and their partners have children? This is one of the most frequently asked questions by parents and friends of cisgender men who are dating transgender women. Many are accepting of their son’s or friend’s romantic partner – until the relationship becomes serious and committed, and the question of starting a family and having a “normal life” arises.

Today, we’ll discuss this topic and explore whether transgender individuals can become parents and the options available to make it possible.

Transgender women and parenting

When it comes to becoming parents, every couple decides if they want to pursue this role and considers how they can achieve it. Just like cisgender couples, trans women and their partners can consider the following options:

Surrogacy
In vitro fertilization (IVF)
Fostering
Adoption

In the case of surrogacy, the following options are available:

Use stored eggs or sperm (If a trans woman has already started hormone therapy, her sperm may become unsuitable for fertilization. In this case, frozen sperm from the individual or donor sperm is used.)
Use a donor egg
Use a partner’s egg (If a transgender woman has a female partner, she can use her partner’s egg.)
Use a sperm donor

Many couples live under pressure because society often expects every couple to have children. First, it’s important to remember that having children is a personal choice. Secondly, even cisgender women may not want to become parents or may be unable to due to infertility. Third, there is no specific timeline for parenting.

Being a parent isn’t about the ability to bear a child. It’s about giving unconditional love and support, caring for your kids in everyday life, and filling their hearts with joy. Transgender women can be the most loving parents, and that’s the only thing that truly matters.

When you meet a trans woman and her partner, avoid asking if they want to have children. These questions can be inappropriate. Chances are, the couple may already be working through complex issues related to fostering or surrogacy, and your curiosity could touch on sensitive feelings.

Having children from previous relationships

It’s also important to note that some transgender individuals may have bioloical children from previous relationships. Many transgender people experience gender dysphoria for years before revealing their gender identity, and some may conceive children naturally and become parents long before they transition. After transitioning, they continue raising their children and fulfilling their parental roles.

Children may take time to adjust to the changes in their transgender parent’s appearance, but in most cases, they love their parents regardless of any changes in gender identity.

A great example is Gabbi Tuft, a wrestler and TikToker. She has an eleven-year-old daughter from a previous marriage who has accepted her in her new gender identity. Gabbi’s daughter is positive about the changes in her mother and reports little negativity from peers. The bond between Gabbi and her daughter is strong, and they share a trusting and loving relationship.

Gabbi talks with her daughter about whether she accepts her in her new identity

Uterine transplantation: Will transgender women be able to carry a pregnancy in the near future?

Many trans women are hopeful for new medical solutions that will enable them to carry a pregnancy themselves. Scientists, doctors, and medical researchers in the field of human reproduction are actively exploring the possibilities of uterine transplantation.

Uterus transplants have already been successfully performed in cisgender women whose reproductive health has been compromised by conditions such as cancer or trauma. Now, researchers are considering the use of uterus transplantation for transgender patients who want to consolidate their female identity. More research is needed to analyze whether prior testosterone will affect the fetus and whether such procedures are safe in genral.

While this approach presents many challenges, there is optimism that, when paired with adequate hormone treatment, it may be a viable option in the future.

There is significant differences between using uterine transplants in genetic female and male patients. Along with uterus transplantation, ovarian tissue and ovarian stimulation will be necessary. Surgeons will need to create additional space in the abdomenen to accommodate the uterus transplant. Additionally, it will take a considerable amount of time to heal before a transgender woman can use assisted reproductive technology to achieve pregnancy and eventually give birth via C-section.

Even though this type of surgery is expected to be more complicated and invasive than sex reassignment surgery, it is likely to be in demand among trans people. Many individuals dream of becoming transgender parents and are aware of the available fertility preservation options, so they may be willing to navigate this challenges.

Some couples are extremely optimistic about these upcoming changes. They freeze embryos created via in vitro fertilization, hoping that an uterus transplant will soon become available at reproductive medical centers.

Pregnancy in transgender men: Today’s options

While clinical trials and studies of uterus transplantation are ongoing, and transgender women may soon have opportunities to bear children, transgender men already have this possibility.

Trans men who haven’t completed a full medical transition and have retained their female reproductive organs can become pregnant and bear children. By pausing testosterone therapy and starting ovarian stimulation, transgender men can often restore their fertility. Hormone therapy cannot be continued during pregnancy, as high levels of exogenous testosterone can be harmful to the embryo and may affect fetal development.

Even though many trans men are capable of becoming biological parents, pregnancies among trans men are relatively uncommon. Gender dysphoria can intensify during pregnancy, which means that pregnant trans men are at higher risk of depression and other mental health-related issues.

Considering the risks, many transgender individuals opt for surrogacy, adoption, or other fertility preservation options – they don’t want to stop hormone therapy which will take them a step back in their transition journey. That explains why most people have never met a pregnant man in their lives and believe that it’s fiction.

Genital removal surgeries and fertility preservation

Different transgender people have different transition journeys. Some choose to preserve ovarian or testicular tissue, while others opt for genital surgery that includes gonad removal.

The removal of ovarian tissue and the uterus in transgender men, and testicular tissue in transgender woman, is an irreversible method of sterilization. In other words, transgender patients who undergo this type of surgery lose the opportunity to become biological parents.

Unfortunately, many transgender men and women proceed with gender reassignment surgery without considering available fertility preservation options, such as sperm or oocyte cryopreservation. Some transgender individuals later regret their choices.

Choosing a gestational carrier for surrogacy

Surrogacy is an assisted gestation technology number one among transgender men and women. It’s the safest and most researched option and is currently in high demand.

The primary task for transgender individuals who want to become parents is to find a cis woman to act as the gestational carrier. This carrier can be found through a surrogacy agency or maybe a friend or relative who already has her own children and is ready to help the couple make their dream about parenting come true.

The embryo created via in vitro fertilization will be transferred to the body of the gestational carrier. It’s important to remember that the gestational carrier will not have a genetic link to the child. The newborn will be the biological child of a trans person whose testicular function hasn’t been compromised by hormone therapy or of a donor.

Is breastfeeding possible for transgender individuals?

Yes, some transgender people can breastfeed their babies, although every situation is unique. Trans men and women face different challanges and have different options to navigate them.

Breastfeeding in Trans Women

Transgender people who were assigned male at birth can nurse their children. There are two possible ways to achieve this:

Some transgender women who undergo hormone therapy over an extended period may develop breast tissue and produce milk. This is a reality, not science fiction. Although the milk supply in breast feeding transgender women is typically limited and lower than that in cisgender women, it still holds significant value.
If breastfeeding doesn’t start naturally, it can be medically induced. Through a combination of hormone therapy and the use of lactation-promoting products (such as herbal teas with fennel, vervain, green anise, or cumin), it’s possible to increase milk supply. Although this may not be sufficient on its own, and supplementation will likely be needed, it still provides bonding and nutritional benefits for a child.

Breastfeeding in Trans Men

Transgender men can also be capable of breastfeeding. If they have not had chest (top) surgery and still have breast tissue, they may be able to breastfeed. In some rare cases, transgender men retain the ability to breastfeed even after surgery, though it may be more challenging.

While transgender men may produce milk, their supply is often limited, and formula supplementation is typically needed. According to the World Health Organization, breast milk is the preferred feeding option for babies, so every drop counts when it comes to breastfeeding ability and potential benefits. So, it’s important to support trans men in their choice to nurse their newborn babies.

Medical discrimination that affects the parenting choices of transgender people

Most companies do not offer insurance coverage for reproductive services for transgender individuals. Why? Because fertility preservation and assisted reproduction services are costly and associated with significant health risks. As a result, most insurance companies do not prioritize plan options that meet the reproductive needs of transgender men and women.

This is already a pressing issue, and it may become even more significant in the future. It’s highly unlikely that insurance companies will cover uterus transplants and related medical treatment, even after successful clinical trials of these surgeries. Due to high risks and ethical feasibility, uterus transplants are unlikely to become widely accessible. They will probably only be available to a small number of transgender individuals with high-income levels.

But there is no doubt that there will be demand for such surgeries and related medical treatment. Transgender people often take risks when they decide to have surgeries to make their bodies match their gender identity. And if they want to become parents, they may take a risk again, opting for a uterine transplant or temporarily pausing anti-androgen and oestrogen therapy. So, let’s hope that authorities and healthcare providers will regulate this issue and make fertility preservation options affordable for transgender persons.

Transgender individuals and social stigma

There is a misconception that a transgender man or woman can’t become a parent because of their gender identity. The truth is, everyone deserves the chance to pursue the role of mom or dad, whether with the help of a gestational carrier or other medical options.

Every trans person has the right to become a parent and to fill their life with the joy of caring for a child, sharing in their smiles, and celebrating their milestones. Remember this when you meet a transgender man or woman who is starting their journey to parenthood. Offer them moral support and reassure them that they have what it takes to be great parents.

The path to parenthood of a trans person

The world of medicine and fertility preservation technologies is developing rapidly, which means transgender individuals may have access to new solutions within the next five to ten years. From utilizing uterus transplants to making reproductive services more accessible, many advancements on the horizon could lead to more positive pregnancy outcomes in the transgender population.

As of today, transgender men and women can opt for surrogacy, adoption, or fostering to begin their parenting journeys. Regardless of whether a person was assigned female or male at birth, they can become loving moms and dads and raise kind-hearted, open-minded children.

Friends and family of individuals in relationships with transgender people should support their loved ones and refrain from giving unsolicited advice regarding family planning. They should also avoid asking intrusive questions about the influence of surgical transition and testosterone therapy on transgender health.

It’s important to remember that gender identity does not define someone’s ability to be a great parent. Whether a child is adopted or born via a surrogate mother, they can develop strong bonds with their parents.Copy text