Visiting an OB/GYN can be a little scary and intimidating at times. It's something that everyone feels. So, if you're a transgender man or a nonbinary person and you're thinking about getting pregnant, how important is it to find a doctor who understands your needs and respects you? Pregnancy should be a wonderful, exciting time in your life. Even if it's not always fun, you should at least feel like you're in a place where your opinions are heard and you're allowed to participate in your care. So, let's take a look at how to find an OB/GYN who respects your identity and supports you.
Let's get some online help first.
There are now a growing number of websites and social media groups dedicated to the LGBTQ+ community, providing health information. These can help you find the names and contact information of people who provide a variety of services. Especially when it comes to transgender pregnancies, you can search specifically for a gynecologist, a fertility clinic, or a birthing center.
Here are some things to try:
- Search Google: It's very simple. Try searching for terms like "trans-friendly OB/GYN in Sri Lanka" or "transgender-friendly pregnancy care ". Some hospitals and clinics will post information about this on their websites.
- Check out the websites of hospitals and clinics: Some of the major private hospitals in Sri Lanka have websites that mention the special services they provide to the LGBTQ community. If a website has information about LGBTQ or transgender families, that's a very good sign.
- Ask your insurance provider: If you have health insurance, you can call their customer service and ask for a list of gynecologists who serve transgender people.
Ask people you trust.
As helpful as the internet is, sometimes word of mouth is the best way to find out. Ask your friends, family, or someone you trust if they know of a doctor who has this kind of understanding.
Here are some more ways:
- Ask other doctors: You may already know people like your general practitioner (GP) or psychiatrist who understand these needs, such as gynecologists. Because doctors who provide these types of specialized services tend to have good relationships with each other.
- Join Community Groups: You can find information through LGBTQ+ groups on social media like Facebook. Also, ask other transgender parents who have gone through this experience. Their experiences will be invaluable to you.
How do you know if this is the right place for you?
There is still a long way to go to ensure equality in healthcare for people who are transgender, nonbinary, or have other gender identities. But the situation is much better now than it was in the past. There are several ways to gauge whether a place is a good fit for you and supports you.
The best first test is to use your preferred pronoun when introducing yourself. If everyone on the staff, from the doctor, to the nurses, to the front desk clerk, calls you by your preferred name, that's great.
| What you will see at a support clinic | |
|---|---|
| Intake Forms | These use gender-neutral language, not limited to gender. There may be a separate space for your preferred name and pronouns. |
| Staff behavior | Speaks to you with respect and understanding. Addresses you by your preferred name and pronoun. |
| Medical tests | They will consider your convenience. For example, the doctor may suggest an abdominal ultrasound instead of a transvaginal ultrasound. |
Testosterone and mental health
If you are already taking testosterone hormone therapy , you may need to temporarily stop taking it during pregnancy, as this hormone can be harmful to the growing baby. For most people, this temporary change is not a problem.
But for some people, stopping testosterone can cause or worsen gender dysphoria . This is a severe emotional distress caused by a mismatch between one's body and one's gender identity. If you have had this condition in the past, it's important to talk to your doctor about getting mental health support before you get pregnant.
What questions should you ask your doctor?
Asking questions is very important to find out if your doctor is a good fit for you. Try asking some questions like these.
| Questions to ask |
|---|
| What do you and the staff do to make a transgender or nonbinary person feel more comfortable when they come to the clinic? |
| Do you understand the health needs of transgender men, both those taking and those not taking hormone therapy? |
| How soon after giving birth or breastfeeding can I start taking testosterone again? |
| Have you and your staff received special training in transitional socio-behavioral health? |
| How many pregnant transgender people have you worked with before? |
Imagine, let's say a doctor hasn't worked with people like this much. That's not always a problem. The most important thing is to respect, learn, and be willing to adapt to what's needed.
Things a doctor may ask you
Your doctor will usually talk about prenatal vitamins, genetic screenings, and medications you should take. A doctor who understands your needs will also likely ask questions like:
- How would you like to learn about childbirth?
- Are you looking to breastfeed your baby? If not, would you like to learn about formula milk?
- Are you using your partner's sperm, or do you need donor sperm?
- Do you have a partner or other family or friends to support you?
- Is there a plan to prevent unwanted pregnancies after giving birth?
Remember, "Testosterone is not a form of birth control." This is something that is often not clearly communicated. So, talk to your doctor about birth control after giving birth.
When should we talk about future fertility?
It's a good idea to talk about your family planning early on, especially if you're taking hormone therapy. It's not yet proven that testosterone therapy will affect your egg quality or reduce your chances of getting pregnant later. However, it can stop your monthly periods and mask any signs of fertility problems.
If you're having trouble getting pregnant or have questions about hormone therapy, talk to your gynecologist. He or she can refer you to a reproductive endocrinologist . These are doctors who are specially trained to help people get pregnant. They have a very good understanding of how hormones and testosterone work.
Take-Home Message
- When you're pregnant as a transgender person, it's very important to have a medical team that understands and respects you.
- Seek help from the internet, trusted friends, and other doctors to find a gynecologist who can support you.
- You can understand how much support a clinic provides you by looking at their registration forms, the behavior of the staff, and the way they examine you.
- Before getting pregnant, talk openly with your doctor about stopping testosterone and the psychological effects it can cause (Gender Dysphoria).
- Don't be afraid to ask your doctor questions. The best doctor is one who respects you, listens to your questions, and is willing to learn.
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