In July 2022 the Royal College of Obstetricians and Gynaecologists’ (RCOG) published new guidelines that aim to provide better support for trans and gender diverse parents.

While trans and non-binary people with uteruses exist, the discussion around medical issues, such as pregnancy and parenting, is still lacking trans-inclusive language. Although taking hormones can affect one’s fertility, trans men and non-binary people who were assigned female at birth can still get pregnant and have children. The choice to have children of one’s own and not remove the uterus is completely unrelated to one’s gender identity. Trans men who give birth are still men.

A step forward for gender-diverse obstetric care

In July of this year the Royal College of Obstetricians and Gynaecologists (RCOG) published draft guidelines which aim to improve trans, non-binary, and otherwise gender diverse people’s obstetric and gynaecological care. The Care of Trans and Gender Diverse People within Obstetrics and Gynaecology guidelines are in accordance with the latest clinical evidence regarding childbirth, contraception, fertility, gynaecological procedures, and other medical issues.

These guidelines include advice and support for trans people concerning gynaecological problems, fertility preservation like gamete storage (the freezing of one’s eggs or sperm for future reproductive use), as well as information on gender-affirming healthcare treatment. This is especially important considering the effects gender-affirming surgeries and hormone treatments can have on the patient’s fertility. Additionally, the RCOG is also recommending that healthcare professionals use respectful language and preferred pronouns, names and titles when addressing a trans or gender diverse patient.

The RCOG guidelines state that healthcare professionals need to be educated on the barriers that trans and gender diverse people face within healthcare and that steps should be taken in ensuring that better care and support is provided. One of the most notable recommendations is the equal and easy access to and information about fertility preservation options to all trans people before they commence gender-affirming treatment. This is regardless of their gender expressions. This includes liaising with gender specialists.

The RCOG has outlined guidelines in support of trans parents, from planning hormone therapy around conception, to feeding

Another key suggestion is that trans men who would like to conceive while taking masculinising hormone therapy should stop treatment as soon as possible. However, those who plan to conceive should stop treatment three months before conception.

Moreover, the RCOG recommends trans men need to be asked about their ‘preferred manner of feeding’ before their child is born, and the trans men who decide to chest feed their baby should be offered chest-feeding support in the same way that cis women do.

The RCOG states that they should offer ‘health screening in accordance with national public health policies and clinical guidelines’ to all trans and gender diverse people.

Medical conversations around pregnancy and parenthood should include trans and gender diverse people. This inclusion is long overdue. Providing support within obstetric and gynaecological care not only improves trans people’s lives, giving them access to adequate healthcare services, but also offers them the opportunity to have healthy children of their own.