Providing birth support to trans and gender non-conforming folks

So I had a great weekend at the Philly Trans Health Conference. It was my first time attending the conference and I went to speak on a panel about trans parenting organized by an amazing genderqueer activist and new parent.

My favorite part of the whole weekend was when during my panel, I asked at the beginning of my comments for folks to raise their hands if they’d heard of doulas before. In a room of about forty people, almost EVERYONE raised their hands!! And this was not a doula/birth centered conference at all. I think that says a lot about how far doulas have come in recent years.

I met one other doula at the conference, Beagle, who practices in Asheville. And I met an awesome midwife, Abigail, who works in Gainesville. Abigail and I are plotting a workshop for next year’s conference focusing specifically on pregnancy and birth, and I would love to get a meet up of trans and gender non-conforming birth workers together.

I’ve gotten a few emails over the years from trans and gender non-conforming doulas or aspiring doulas. As providers, there are many questions to be answered about how we do our work as doulas and as trans/gender non-conforming folks. It can be tricky, when being a doula is in many ways not about us, to figure out how to make space for yourself and your identity with in a highly gendered and gender normative birth environment.

I’ve worried for a while that my gender presentation as a genderqueer person might make some birthing folks uncomfortable. I’m still not sure how I would deal with that, it’s yet to come up in my work.

But another big set of issues is providing support to trans and gender non-conforming parents. I think as doulas we can do so much to make sure that folks have the best experience possible. You don’t have to be queer, trans or gender non-conforming to provide care as a doula that is sensitive to these communities. Here are some ideas/things to think about when working with trans and gender non-conforming (TGNC) doula clients:

  • Asking about preferred gender pronouns is always a good start. Heck, even with folks that you don’t know identify as TGNC! It’s the assumptions that get us into trouble. Just because someone is pregnant doesn’t mean they identify as she/woman/mother etc.
  • As a doula, you could help the pregnant person strategize about how best to communicate preferences like language and pronouns to their doctor or midwife. If they were comfortable with it, you could even do some of the advocating/explaining/reminding. It can get tiring as a TGNC person to constantly be reminding and educating folks.
  • Pronouns aren’t the only important thing–the language we use to refer to our bodies is important too. TGNC folks often use language as a way to talk about their bodies in a fashion that reflects their identity. This might be hard for medical providers to understand or get used to, but as their doula if you respect this language it could make a big difference.
  • Unfortunately there isn’t much research out there about TGNC folks and pregnancy/birth. We don’t know much about the effects of hormone treatments like testosterone on pregnancy and fertility, or the impacts of chest binding on breastfeeding. Research as much as you can and see what communities exist for TGNC folks to share experiences and knowledge.

That’s all for now! One resource that was mentioned as somewhat helpful was The New Essential Guide to Lesbian Conception, Pregnancy and Birth. I haven’t checked it out but I recommend looking it up.

If you have experiences/tips to share about working with TGNC folks, please add in comments! I hope to write more about this issue in the future.


One thought on “Providing birth support to trans and gender non-conforming folks

  1. k. emvee June 10, 2010 / 8:57 pm

    Despite the name of the book, Stephanie Brill who write The New Essential Guide to Lesbian Conception, Pregnancy and Birth is a very trans-friendly provider. In fact, she left the midwifery practice she founded to focus solely on working with transgender youth at Gender Spectrum.

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