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Obstetric, Antenatal, and Postpartum Care for Transgender and Nonbinary People

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Reproduction in Transgender and Nonbinary Individuals

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Abstract

Caring for transmasculine individuals includes caring for their reproductive needs and providing optimal preconception and pregnancy care. Pregnancy care of transmasculine individuals is similar to the care for cisgender women but includes some unique aspects. There is a paucity of data to guide healthcare providers on how to care for the pregnancies of transmasculine individuals. Guiding principles of care include ensuring that proper terminology is used when referring to anatomy and pregnancy, practicing trauma-informed care, and awareness of how gender and racial minority stress can impact the health and outcomes of this population. Preconception care of transmasculine individuals includes shared decision-making around when to stop gender-affirming hormones and pays particular attention to the health disparities that transmasculine people face that can affect their pregnancies and neonates. Antepartum care includes counseling around disclosure of pregnancy, psychosocial support around possibly increased gender dysphoria, and preferences around mode and location of delivery. Additional data is needed around pregnancy outcomes in transmasculine patients to determine risks of adverse outcomes. Postpartum care includes chestfeeding, restarting gender-affirming hormones, screening for postpartum depression, and ensuring contraceptive needs are met. We briefly touch on induction of lactation in transfeminine individuals. As with cisgender individuals, pregnant transmasculine individuals should be counseled on all their options regarding pregnancy, including providing access to abortion care.

To improve and optimize the care for transgender individuals, providers and clinic staff should be trained on how to provide sensitive and affirming care to transgender individuals. Intake forms and signage should be gender neutral and inclusive. By addressing barriers and stigma that transgender people face in society and in healthcare we can optimize the healthcare delivery and improve the health of our transgender patients.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Michigan Medical School, University of Vermont Medical Center, Burlington, VT, USA

    Gnendy Indig

  2. Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Women and Infant Hospital, Providence, RI, USA

    Sebastian Ramos

  3. Department of Obstetrics and Gynecology, Michigan Medicine, Ann Arbor, MI, USA

    Daphna Stroumsa

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  1. Gnendy Indig
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  2. Sebastian Ramos
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  3. Daphna Stroumsa
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Correspondence to Daphna Stroumsa .

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Editors and Affiliations

  1. Department of Obstetrics & Gynecology, University of Michigan–Ann Arbor, Ann Arbor, MI, USA

    Molly B. Moravek

  2. Obstetrics and Gynecology, Northwest Permanente, Portland, OR, USA

    Gene de Haan

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Indig, G., Ramos, S., Stroumsa, D. (2023). Obstetric, Antenatal, and Postpartum Care for Transgender and Nonbinary People. In: Moravek, M.B., de Haan, G. (eds) Reproduction in Transgender and Nonbinary Individuals. Springer, Cham. https://doi.org/10.1007/978-3-031-14933-7_6

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