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Pregnancy After Transitioning Study

July 26, 2013

I’ve written before about the increase in information, resources and stories about trans pregnancy. While we know a lot more now than just a few years ago because trans folks having babies are getting together to share info, there is still a lot to learn about the experience. 

A provider who is queer, doula and midwife friendly asked me to share this call for participates in a survey about transmasculine pregnancy experiences. If you’re interested in participating, see below. 

Pregnancy After Transitioning Study (PATS)

PATS Anonymous Survey – Online Information Sheet

We are doing a pilot study about transgender men’s’ experiences with pregnancy.  This study aims to better understand how to best assist female-to-male transgender individuals who may want to become pregnant as well as how to counsel about pregnancy and possible birth outcomes. The data collected in this initial unfunded pilot study will offer some guidance to transgender men, and their healthcare providers, who are pregnant or interested in becoming pregnant.  The results from this study will support and guide the development of future outcome-oriented clinical research in this area of intense growing interest and importance

This study is an anonymous online survey of people who identify as transgender men (assigned female at birth with a transmasculine/ transmale/ female-to-male gender identity) and have been pregnant and delivered a baby.  If you self-identify with this population, then we would like to invite you to participate in this study.

If you choose to be in the study, you will complete a survey. This survey will help us learn more about transgender men (assigned female at birth with a transmasculine/transmale/female-to-male gender identity) who have been pregnant and completed the pregnancy.  The survey will take about 20 minutes to complete.  The questions will relate to your experience with fertility, conception, pregnancy, and birth.   To be eligible for the study you must be over 18 years old and have completed a pregnancy within the past 10 years.  You can skip questions that you do not want to answer or stop the survey at any time. The survey is anonymous, and no one will be able to link your answers back to you. Please do not include your name or other information that could be used to identify you in the survey responses.

All study results will be made available to the community through the Center of Excellence for Transgender Health at the University of California, San Francisco. The mission of the Center of Excellence for Transgender Health is to increase access to comprehensive, effective, and affirming health care services for trans and gender-variant communities.  More information can be found at http://transhealth.ucsf.edu

Questions? Please contact the study coordinator Lexi Light (415-206-6453LightA@obgyn.ucsf.edu).  If you have questions or concerns about your rights as a research participant, you can call the UCSF Committee on Human Research at 415-476-1814.

Being in this study is optional. If you want to participate, click this link to start the survey: http://bit.ly/PATStudy

Additionally, the researchers at the Center of Excellence for Transgender Health (CoE) at UCSF are doing research that is designed to lead to better programs for transgender people. They want to know if you wish to learn more about their research studies or if you may wish to participate in any of the studies that may be appropriate for you. By clicking this second link & filling in your contact information, you will allow qualified professional people on the staff of the CoE to contact you in the future to ask if you want to participate in any studies.  You will be entering your contact information into a different survey, completely separated from the above anonymous survey.  You have no obligation to actually participate in any study.

By providing your information, if a study on transgender people needs subjects, you may be contacted to ask if you want to participate. You do not have to participate. You may withdraw permission to be contacted at any time by contacting the CoE.  If you do not provide your information, there will be no penalty or loss of benefits to which you are otherwise entitled. 

Participation in research may involve some loss of privacy. However, your contact information will be handled as confidentially as possible. Access will be limited to the data manager and the researcher organizing the study and will require a password. No information will be used for research without additional permission. Your contact information will not be shared with anyone outside the CoE.

There will be no cost or payment to you if you sign this form.   If you have questions now or later, you can talk with the study researcher about any questions, concerns or complaints you have about this study.  Contact the study researcher(s) Dr. Jae Sevelius at 415-597-9183.

If you wish to ask questions about the study or your rights as a research participant to someone other than the researchers or if you wish to voice any problems or concerns you may have about the study, please call the Office of the Committee on Human Research at 415-476-1814  

If you agree to be contacted in the future, please indicate your preferred contact information on the following form https://redcap.ucsfopenresearch.org/surveys/?s=sHwkt3

 

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American College of Nurse Midwives urges quality care for trans and gender variant people

January 17, 2013

Anyone else feel like it really is a tide that is turning these days? The American College of Nurse Midwives issued a statement in support of working towards quality, competent care for trans and gender non-conforming people. Woo-hoo! While it may seem like this is a no-brainer, it’s actually a big step in the right direction for ensuring that trans people can find medical care that doesn’t try to pathologize trans identity, and hopefully someday with providers who understand the needs of trans folks.

From the statement, issued in December of 2012:

It is the position of ACNM that midwives:

  • Exhibit respect for patients with nonconforming gender identities and do not pathologize differences in gender identity or expression;
  • Provide care in a manner that affirms patients’ gender identities and reduces the distress of gender dysphoria or refer to knowledgeable colleagues;
  • Become knowledgeable about the health care needs of transsexual, transgender, and gender nonconforming people, including the benefits and risks of gender affirming treatment options;
  • Match treatment approaches to the specific needs of patients, particularly their goals for gender expression and need for relief from gender dysphoria;
  • Have resources available to support and advocate for patients within their families and communities (schools, workplaces, and other settings).

That all sounds great to me. It’s actually a really fabulous statement, much more comprehensive and far-reaching than the one issued by the American College of Obstetricians and Gynecologists last year. It addresses the need for education about transgender issues in midwifery education, and even the fact that it enumerates the different identities: transgender, transsexual, gender variant, gender non-conforming, is a big step that I haven’t seen many other medical bodies take.

This is my favorite part:

As many as half of gender variant individuals report having to educate their health care providers about their health care needs, but gender variant people do not by default have unique or complicated health issues. Most members of this community require the same primary, mental, and sexual health care that all individuals need. The most important thing all midwives can do to improve the health care outcomes of gender variant individuals is to use their skills to provide care that is welcoming and accessible.

Amen to that. I would say the same thing for doulas.

It’s really incredible to witness the strides being made, while still acknowledging the serious barriers and often really challenging conditions that trans people face in the United States. A longform journalistic article I wrote for Political Research Associates was recently published, and in it I explored a new ad campaign run by the DC government that tries to address discrimination against transgender people by promoting trans respect and awareness. It was a pleasure to interview the many folks involved in working to improve conditions for trans people–it’s clear just how much incredible activism has been happening, primarily led by trans folks themselves. But it was also a reminder of how far we have to go, and how trans and gender variant people face serious discrimination in pretty much every area of life. You can read the article here.

Lastly, another new resource from a group I used to work for, The National Latina Institute for Reproductive Health, about creating health care that is inclusive of trans and gender variant Latin@s.

h/t Claudia Booker for the ACNM link


Transgender Day of Remembrance

November 20, 2012

Today is Transgender Day of Remembrance, where those transgender people who have passed on, whether due to violence, discrimination or suicide are remembered and honored.

Last week was also Transgender Awareness Week, organized by Fenway Health in Massachusetts.

I’ve been working for weeks now on a long article about the transgender community, so I’ve been knee deep in interviews and research about transgender people in the United States.

It’s depressing, to say the least. Experiences of discrimination are frighteningly widespread. Health disparities abound. Violence is a common fact of life.

But there is also much resilience, much hope, much strength in the transgender community. There is much knowledge that the arc of history bends towards justice, and that the transgender struggle lives in all of us who understand how ideas of gender limit all of us.

I wrote about discrimination and transgender health disparities last week at RH Reality Check, which you can read here. The discrimination that transgender people face impacts their health in serious ways, and when race is factored in, the disparities are even greater.

But on this day of solemnity and remembrance, let us also remember perseverance and strength. For every person who has passed on, there are many more who are thriving and surviving.

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New column: Preparing for the trans baby boom

June 20, 2012

My latest column for RH Reality Check was published this week. An excerpt:

This shift in attention toward the issues facing trans and gender non-conforming pregnancy is indicative of a bigger shift overall — more and more trans and gender non-conforming people are giving birth. As Pati Garcia, a Los Angeles doula and midwife-in-training put it during our panel: “We’re on the cusp on a trans baby boom.”

Trans health as an overall field is still in its nascency. Our understanding of hormone therapies, gender reassignment surgeries, and much more is still being developed, so it’s no surprise that the field of pregnancy and parenting for trans people is also new and developing.

Within the needs of trans people in pregnancy and birth is the challenge of addressing what seems like an obvious connection: between pregnancy and femaleness. Trans people are often neglected in the arena of pregnancy and birth because of the strongly-held notion that only female-identified people experience pregnancy and birth. While not all trans people, whether they were assigned female at birth or not, can experience pregnancy (because of infertility or hysterectomy), some can and do, prompting the need for our pregnancy and birth providers to accommodate.

It’s not easy, as it’s a process that is intensely gendered. Everything from maternity clothes to the language of health care providers carries the assumption that the pregnant person identifies as female (and often that the other parent identifies as male). Language is an obvious barrier from the get-go: maternal health, pregnant women, all of the language associated with pregnancy and birth is gendered. From body parts to actors, all is coded in a way that would make a pregnant person who is not identified as a female feel uncomfortable.

Read the whole article here.

It was inspired by my panel at the Philadelphia Trans Health Conference, so big props to Pati Garcia (aka Chula Doula), Ryan Pryor, Abigail Fletcher and Lucia Leandro Gimeno, my co-panelists. It was an amazing conversation about trans and gender non-conforming centered midwifery and doula care. And the room was full! I love how many more people are focusing on these intersections, because there is much work to be done.


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