Pregnant Men: An International Exploration of Trans Male Experiences and Practices of Reproduction

Lead Research Organisation: University of Leeds
Department Name: Sociology & Social Policy


Many male transgender people (hereafter termed 'trans men') transition without undergoing surgery to remove their reproductive organs or reconstruct their genitals. Gender transition from female to male, then, does not necessarily take away the ability or, importantly, the desire to reproduce. The overall aim of this project is to gain an in-depth understanding of the practices, experiences, and health care needs of the growing number of men who may seek to, or become, pregnant and give birth after gender transition. The project will use a range of qualitative methods including interviews, focus groups, virtual analysis and visual methods. In order to consider the significance of national and international care standards and health practices, divergent welfare regimes and differing legal frameworks of recognition for trans people, the project will include the UK, US, Australia, Poland and Italy.

Trans male pregnancy shows how shifts in gendered and intimate practices occur within changing social institutions, technological advances and developing cultural understandings. Vice versa, such social, technological and cultural transformations impact on how individuals live their gendered, bodily and intimate lives. Diversification of gendered, sexual and intimate practices, and advances in health care practices and reproductive technology, have significantly altered contemporary experiences of pregnancy and birth. Changing social and cultural attitudes about gender and sexual diversity, and legal advances around sexuality and parenting, have enabled the recognition of same-sex and gender diverse partnerships and allowed equal access to fostering, adoption and assisted reproductive technology. Over the last decade, same-sex parenting practices have received increasing social and cultural visibility, while legal shifts have foregrounded the rights of same-sex people to parent. Moreover, lesbian and gay parenting has emerged as a central site of inquiry within the field of sexuality studies, and in sociological studies of intimacy, kinship and personal life. Transgender practices of parenting, however, have received much less attention across social, cultural, legal, and academic spheres.

Aspects of Hines' (PI) earlier work (2007; 2010) have considered the impact of gender transition on parenting relationships-thus exploring parenting through gender shifts. This project takes a different, and uncharted, turn in exploring the experiences of trans people who become parents after transition. In considering the relationship between gender identity, the gendered bodily, and masculinity and femininity at subjective levels, the project seeks to examine how trans male narratives of pregnancy and birth bring new understandings to the embodied and gendered processes of parenting.

Legal and policy change pertaining to gender diversity has brought some levels of parity in terms of the relationship and parenting rights of gender diverse people. This project will examine the extent to which law and policy at international levels supports the health needs of this group of trans men and will consider the degree to which legal and policy frameworks impact upon decisions to become pregnant. Health care is a key area of trans campaigning organisations. It will explore the extent to which trans men feel supported and understood by health care professionals at pre and neo natal stages. At academic and practitioner levels, shifting family practices are linked to changes in reproductive technology. The project will address developments in reproductive technology and consider the level of which such advances impact on trans male pregnancy.

Findings will be disseminated to interdisciplinary academic audiences, policy makers, health and medical professionals and practitioners, and stakeholders at international levels.

Planned Impact

Impact is central to the project from design stage through to dissemination. Consultation about potential areas of benefit was carried out at design stage with key transgender campaigning organisations and support groups in the UK, Europe, US and Australia, and consultation findings were built into the research aims, questions and methodology. The project consultants, 'Gendered Intelligence', 'Trans Bare All', represent major international stakeholders. They will organise and run focus groups with the PI and UK Co-I to ensure that stakeholder impact is built into the project's methods of data collection.

Alongside, senior academics with extensive research experience in areas related to the project, the International Advisory Board comprises members of stakeholder groups (see CfS). Together these represent key transgender lobbying, health and educational organisations who will further the project's impact and dissemination through their membership and broader networks, including government ministers, policy makers, and medical and health professionals.

The project website, blog and twitter feed will ensure stakeholder and public impact through regular project bulletins and on-line newsletters throughout the project. Impact will be maximised through the making of a documentary film (See CfS), which will be shown at academic and stakeholder dissemination events in the UK, in Europe and in the US. It is envisaged that the film (produced by an experienced film maker and producer) will be later shown at international film festivals. The interactive website, blog and twitter will be maintained to ensure continued impact throughout and after the project.

Key findings will be released at different stages of the project via press releases, non-technical summaries, and through the website and blog. It is anticipated that the project will generate much media and non-academic interest. The PI has considerable experiences with media dissemination (including on BBC radio and Channel 4 news). The end of project conference seeks to bring academic, stakeholder and community groups together, thus maximising impact.

The focus groups with representatives from relevant health professional organisations in each country will embed impact and dissemination into the project at all stages in each of the geographical sites. Project consultants will organise two health practitioner training events, which will be co-coordinated with Public Health England. Key target audiences here will be midwives organisations and general practitioners. Dissemination events with health professionals are planned in the UK, US, Australia, Poland and Italy, and are costed into the project's broader impact strategy. Information Sheets for health practitioners will be developed to impact on care standards, and guidelines will be drawn up for policy makers at UK, European and international levels.

The project report will be widely distributed to stakeholders, health practitioners and government bodies to inform policy formulation on issues of the recognition of transgender families and care standards pertaining to transgender people through conception, pregnancy and birth. Project findings will be of use to government ministers, civil servants, policy makers and medical professionals in relation to claims for gender and relationship recognition (See 'Impact Statement'). Members of these groups will be addressed through stakeholder's dissemination workshops, press conferences and articles targeted at the media.

The project will impact on transgender people, their partners and family members, and transgender support and self-help organisations, who will be addressed through stakeholder's dissemination workshops. In addressing the experiences of others, the research will enable more informed choices about trans male pregnancy and parenting, and the social and legal processes of recognition, as well as highlighting potential issues of stakeholder concern.
Title Documentary Film 
Description The documentary film 'A Field Guide to the Pregnant Men of the UK' was made by Jason Barker and Rachel Meyrick for the project. The film follows Jason, who has been a pregnant man, as he meets other trans masculine pregnant people from across the UK to talk about their experiences of pregnancy and birth. Participants talk about their bodies, feelings and health through pregnancy and birth and the positives and negatives of the medical care they received. 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact Raised awareness amongst academic and non-academic audiences. Has been used as a training resource by midwives in the UK. 
Description Findings Summary:

1. Young trans men are increasingly considering pregnancy and birth as part of their future plans
2. While some trans men who have given birth had positive experiences of the health care they had received, the majority had experienced discriminative practices - health provision was very patchy at national and international levels.
3. Experiences of health care services were greatly impacted by social class and race.
4. Experiences of stigma and discrimination were frequently reported at social, cultural and inter-personal levels by trans men who had been pregnant and given birth.
5. The law on gender recognition and parenting rights continues to discriminate against trans men who have given birth in many countries - including the UK.
6. Community support - on and off line - was key to positive experiences of pregnancy and of positive mental health.
7. The support of family and friends was key to positive mental health through pregnancy and was often spoken about as a 'buffer' to external discrimination - those without support spoke about isolation and were more likely to have poor mental health.
8. There is a great need for, and desire from, health care professionals for education and training in trans reproduction.
Exploitation Route 1. To bring greater visibility and awareness of trans reproduction
2. To agitate for legal change
3. To provide educational and training resources
Sectors Communities and Social Services/Policy,Education,Healthcare

Description Impact Summary: 1. Findings fed into Brighton and Sussex NHS Trust's Gender Inclusive Perinatal Care Guidelines. 2. The findings influenced court judgements in strategic litigation. For example, Hines was called as Expert Witness in the 2018 High Court case of TT v The Registrar General for England and Wales n a challenge to the existing law which did not allow a trans male birth parent to register as 'father' or 'parent' on his child's birth certificate (rather than 'mother'). In 2019, Hines was invited, by Transgender Europe, to make a third party intervention in a closely related case before the European Court of Human Rights (ECHR) concerning (O.H. and G.H. against GermanyHines was granted permission from the ECHR to submit a written intervention based on project policy reviews and empirical findings. 3. Findings were disseminated to organisations such as 'The Scottish Transgender Alliance' (STA) 'Gendered Intelligence' (GI) and 'Trans Bare All', the UK trans sexual health service 'Clinic Q' , 'Proud Trust' Mermaids' and 'Educate and Celebrate' who used evidence from the findings to strengthen their awareness raising and campaigning activities. for example, fact sheets and recommendations were used. 4. Practitioner focused organisations invited the team to address findings to their members or example at the Better Together Nursing Conference and the Public Health Speciality Registrars Training Day and the Danish Committee of Obstetrics and Gynaecology Professional organisations also distributed research findings to their member networks or websites including the Royal College of Midwives and the Association of Radical Midwives and Gender Identity Services. 5. The range of practitioners engaged in workshops included sex and relationship practitioners and educators; youth workers; social workers; charities and voluntary organisations, Healthcare services, professional and government organisations. Participants at these workshops fed the project findings back to their organisations. 6. New capacity was created by bringing researchers and practitioners face to face in the research dissemination process. For example, a new professional network was launched by participants at the project final conference in 2020. 7.The research impacted on guidance and good practice. For example, a 2018 Department for Education report on Transgender awareness in child and family social work education cited Hines research on care to flag the lack of professional knowledge about transgender needs, NHS England invited the project to participate in the commissioning process for a new trans health service which resulted in launch of a three year pilot based in Greater Manchester. 8. An independent documentary film, produced from the pregnancy project, was also utilised in professional training 9. Practice guidelines from the Trans Pregnancy project, co-produced with practitioners and health care providers, informed the 'Reproduction' Chapter of the 8th edition of the World Professional Association of Transgender Health (WPATH) Standards of Care (SoC) 10. The project had media impact. For example, Hines was invited by BBC Radio 4's Woman's Hour as a featured discussion guest in 2018 (c.3.7m listeners). This kind of attention stimulated wide, often controversial, public debates on social media. Sky News launched its own 'Off Limits' investigation into issues raised by the research as a direct consequence of such public social media engagement.
First Year Of Impact 2018
Sector Communities and Social Services/Policy,Education,Healthcare
Impact Types Cultural,Societal,Policy & public services

Description Midwifery Training
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact Project findings adopted by professionals training midwives in the UK
Description PI acted as Expert Legal Witness
Geographic Reach Europe 
Policy Influence Type Membership of a guideline committee
Impact Led to legal and policy change around gender recognition in the UK and Europe
Description Project Documentary used as midwifery training guide
Geographic Reach National 
Policy Influence Type Contribution to new or Improved professional practice
Impact Used in the delivery of best practice training for health professionals.
Guideline Title WPATH Standards of Care
Description WPATH Standards of Care (SOC) for the treatment of individuals with gender dysphoria (8th edition).
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact WPATH Standards of Care (SOC) for the treatment of individuals with gender dysphoria (8th edition). Chapter on reproduction ( These internationally accepted guidelines (in 18 languages) are designed to promote the health and welfare of transgender, transsexual and gender variant persons in all cultural settings. The Standards of Care are 'updated and revised as new scientific information becomes available'.
Description Workshops with Community Groups
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Fact sheets and recommendations from the project were used by community groups to educate stakeholders around equality and diversity issues, reproduction and inclusion policy.
Description Workshops with Professional Organisations and Networks
Geographic Reach Multiple continents/international 
Policy Influence Type Contribution to new or Improved professional practice
Impact Improved professional practice and service profession in relation to trans pregnancy. New capacity was also created by bringing researchers and practitioners face-to-face in the research dissemination process. For example, a new professional network was launched by participants at the pregnancy project final conference in 2020.
Description International Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact Conference presentation at Flinders University to academic and non-academic audiences.
Year(s) Of Engagement Activity 2021
Description Interview for national press 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact 4 articles in international media (The Guardian, VICE, MEL, The Economist)

Research Report designed and disseminated to non-academic audiences through the project activities, impact and KE strategies.
Year(s) Of Engagement Activity 2018,2019
Description Invited keynote paper given to midwives conference in Finland 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 100 midwives attended the annual midwifery conference in Finland where I gave the invited key note on issues around trans male pregnancy.
Year(s) Of Engagement Activity 2018
Description Papers presented at the World Professional Association for Transgender Health (WPATH) and the European Professional Association for Transgender Health (EPATH) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Papers presented at key practitioner conferences in Argentina (WPATH) and Rome (EPATH)
Year(s) Of Engagement Activity 2018,2019