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Journalist, activist, and dad Freddy McConnell has announced that he’s pregnant for a second time – and we could not be happier.

Doting father Freddy came to the attention of the world when he gave birth to his first child SJ. After a predictably sensationalist media storm, Freddy decided to take control. He gathered a team and set about producing a documentary to share his journey as a pregnant trans man. The result was Seahorse: a movingly honest story of a man’s journey to become a father and give birth to his own child.

Freddy always thought that having a child might be a possibility, and it was this belief that helped him decide which Gender Affirming Treatment (GAT) would be right for him.

Each trans or gender diverse person (TGD) makes their own choices as to what kind of Gender Affirming Treatment they want – or if they want any treatment at all. There is no one-size-fits-all solution. This is no less true for trans men and trans masculine people, who have a full range of future possibilities, including pregnancy.

 

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Around 55,000 hysterectomy operations are carried out in the UK each year. A hysterectomy is an operation to remove the uterus (womb), and is performed on both cisgender and transgender people for a variety of reasons (although the majority of hysterectomies are performed on cisgender women). The surgery is often performed alongside a procedure called a bilateral salpingo-oophorectomy, which removes the ovaries and fallopian tubes. For many trans men and transmasculine people these procedures are an important element of their affirming journey.

Yet some people, like Freddy, choose not to undergo this surgery. The reasons are personal and complex, but wanting to become pregnant can be one of them. Whether a person has this surgery or not makes no difference to the validity of their gender identity.

In order to provide informed consent to medical transition, you need to fully understand the long-term consequences – and that includes fertility. Some trans people know from the very start that they don’t ever want biological children – and that’s absolutely fine – but others are uncertain.

Puberty blockers are considered a ‘fully reversible’ treatment. This means that coming off blockers should result in your ability to have children returning completely, with time. However, gender-affirming hormones – like Freddy’s testosterone – are considered ‘partially reversible’. This means that some of the changes caused by these hormones, like a deeper voice, are permanent. Transmasculine people should consider a loss of fertility as one of the consequences of testosterone therapy before starting any treatment.

However, it’s a myth that testosterone will inevitably cause infertility. As Freddy’s story quite clearly shows, trans men can become dads even after long-term testosterone use. It is important to note that testosterone use may reduce the likelihood of pregnancy, and you may need to stop testosterone during the period in which you are trying to conceive. If fertility has been substantially reduced, fertility treatments (like IVF) may need to be considered.

 

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However, while it can adversely impact fertility, testosterone is not intended for use as a contraceptive, and it will not stop a person getting pregnant. Transmasculine people who do not want to become pregnant should still use contraception if they have sex with a person with a penis. Transmasculine people who take the Pill should ask for the progesterone-only version as other versions may have unwanted feminising effects.

Freddy’s story shows us that pregnancy and birth can be happy and safe events in trans men’s lives. However, it won’t be right for all transmasculine people. If you don’t ever want to be pregnant but still want to have children, there are lots of other options.

Many trans people consider fertility preservation. This is when you freeze genetic material (sperm or eggs) before starting medical transition, so that it can be used if you want children later in life. For transmasculine people, this means you can freeze your eggs and then later have them fertilised and implanted in your own womb or a donor womb (usually a partner or a surrogate). Fertility preservation techniques vary and can be expensive, and the laws on surrogacy are complicated. You can find further information on the Human Fertilisation and Embryology Authority website, or by speaking to a gender specialist.

You can also start a family in lots of other ways. Adoption, chosen family, fostering, and co-parenting are all valid and fulfilling ways to raise children, regardless of your fertility. Remember that fertility isn’t guaranteed for anyone, regardless of gender identity, and that whether you can have biological children or not doesn’t make you more or less suited to parenthood.

 

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You can learn more about the latest developments in fertility and gender-affirming care on our blog, or send any questions via our secure contact form.