Biology:Transmasculine reproduction

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One of the several Transgender Pride Flags that are commonly used

Transmasculine reproduction is when an individual with a masculine gender identity, who was born with biologically female reproductive organs, conceives and births a child. Transmasculine individuals were assigned female at birth, but identify more on the male side of the gender spectrum than on the female side. These individuals may identify with some stereotypically masculine behaviors and gender performances, but may not necessarily identify with all aspects of masculinity or refer to themselves as “a man”.[1] They are also born with mammary glands and milk ducts,[2] so in most cases it is also possible for them to breastfeed or “chest feed” their children even if they had surgery on their chest. Transmasculine reproduction is a matter of sexual and reproductive health,[3] but transmasculine individuals commonly deal with lack of cooperation from health care professionals when attempting to seek medical attention for stereotypically “woman’s health issues”.[2]

Breastfeeding

Transmasculine individuals have several terms they use to describe the act of feeding their children with their bodies natural lactation. Some commonly used terms include chestfeeding,[4] breastfeeding, nursing, feeding, and mammal feeding.[5] Chestfeeding is a term that can be used by both cisgender and transgender parents to describe feeding their baby, since it is gender inclusive. The term breastfeeding can cause feelings of gender dysphoria among transmasculine people. Gender dysphoria[6] is the emotional and psychological distress a person experiences when their gender identity does not aligned with their biological sex, and it can cause extreme anxiety, stress, and depression for those who experience it. Referring to transmasculine people's chest as breasts can some trigger this dysphoria,[7] which is why gender neutral terms are often preferred.[4] Gender dysphoria can also come to transmasculine individuals through the action of holding their baby to their chest to nurse,[2] since it is a traditionally female action. 

Although everyone is born with mammary tissues, the presence of grown breasts on a transmasculine person can lead to feelings of discomfort in how their body aligns with their gender identity. Some transmasculine people choose to have bilateral mastectomies or “top surgery” due to this discomfort. After a transmasculine individual has undergone a bilateral mastectomy their chest size has been reduced, they may still have some mammary tissue remaining, and the ability to lactate a small amount of human milk.[7] It is not always easy, but with the help of a lactation consultant, it may be possible to lactate, although it is usually not sufficient enough in quantity to feed an infant after surgery. Chestfeeding is a personal choice made by some, but not all transmasculine parents and it is just one aspect of transmasculine reproduction.[7]

Sexual and reproductive health care

Even though transmasculine individuals do not identify as women, they still need to screened for the same sexual and reproductive health concerns covered in women's health as long as they retain the same organs. Transmasculine individuals are at risk for heath problems like cervical, ovarian, and uterine cancers,[3] unless they have these organs removed as a part of their transition. Health care providers are not always aware of the necessity for transmasculine people to be screened. There have been many instances of providers discriminating against trans individuals either by refusing service and treatment or being verbally abusive.[3] Doctors and health care providers should be aware of the needs of patients so they can properly treat them while respecting their gender identity so as to not create further gender dysphoria.[8] More generally, clinical management of transmasculine patients can be complicated by a lack of knowledge or unfamiliarity of physicians and failure to accommodate these patients within healthcare systems, which leads to poorer health outcomes.  

References

  1. Engdahl, Ulrica (2014-05-01). "Wrong Body" (in en). TSQ: Transgender Studies Quarterly 1 (1–2): 267–269. doi:10.1215/23289252-2400226. ISSN 2328-9252. http://tsq.dukejournals.org/content/1/1-2/267. 
  2. 2.0 2.1 2.2 "What It's Like to Chestfeed". 2016-08-23. https://www.theatlantic.com/health/archive/2016/08/chestfeeding/497015/. 
  3. 3.0 3.1 3.2 "Trans Men's Health is a "Women's Health" Issue: Expanding the Boundaries of Sexual & Reproductive Health Care". March 2013. https://www.nwhn.org/trans-mens-health-is-a-womens-health-issue-expanding-the-boundaries-of-sexual-reproductive-health-care/. 
  4. 4.0 4.1 MacDonald, Trevor; Noel-Weiss, Joy; West, Diana; Walks, Michelle; Biener, Marylynne; Kibbe, Alanna; Myler, Elizabeth (2016). "Transmasculine individuals' experiences with lactation, chestfeeding, and gender identity: a qualitative study". BMC Pregnancy and Childbirth 16: 106. doi:10.1186/s12884-016-0907-y. PMID 27183978. 
  5. "What Is Chestfeeding & How Does It Relate To Breastfeeding?". https://www.romper.com/p/what-is-chestfeeding-how-does-it-relate-to-breastfeeding-32294. 
  6. "Gender Dysphoria". Diagnostic and Statistical Manual of Mental Disorders. DSM Library. American Psychiatric Association. 2013-05-22. doi:10.1176/appi.books.9780890425596.dsm14. ISBN 978-0890425558. 
  7. 7.0 7.1 7.2 "Transgender Parents Chest/Breastfeeding". http://kellymom.com/bf/got-milk/transgender-parents-chestbreastfeeding/. 
  8. Snelgrove, John W.; Jasudavisius, Amanda M.; Rowe, Bradley W.; Head, Evan M.; Bauer, Greta R. (2012-01-01). ""Completely out-at-sea" with "two-gender medicine": A qualitative analysis of physician-side barriers to providing healthcare for transgender patients". BMC Health Services Research 12: 110. doi:10.1186/1472-6963-12-110. ISSN 1472-6963. PMID 22559234.