Can Trans Men Get Pregnant? What to Know About Family-Building Options
Can trans men get pregnant? It depends on factors that affect all people with a uterus and ovaries, as well as the specifics of an individual’s transition and gender affirming care. Just as every transition is unique, every journey toward parenthood is equally unique. The basic answer is, yes, trans men can get pregnant. Anyone with a uterus and ovaries who is ovulating can get pregnant. However, whether trans men can get pregnant depends heavily on their gender-affirming care and what treatments or procedures they have undergone.
Can Trans Men Get Pregnant on Hormone Therapy?
Hormone therapy is often, though not always, involved in gender-affirming care. Testosterone injections support the development of more masculine physical features such as facial hair, a deeper voice, more muscle mass, and other traits. While testosterone does suppress ovulation and make it more difficult to become pregnant, it is still possible to get pregnant, and it is not in any way a substitute for birth control. A trans man who is taking testosterone can still become pregnant if they have a uterus, ovaries, and are ovulating. Taking testosterone can often stop a trans man from having a period, however he can still become pregnant because ovulation can still happen without a period.
The reason it's harder to become pregnant while taking testosterone is because in addition to suppressing ovulation it can also thicken the uterus lining. This is important to be aware of; however, everyone’s body reacts differently to testosterone and this possibility does not mean that everyone will have issues with conception.
Can Trans Men Get Pregnant After More Gender Affirming Care?
Can trans men get pregnant after gender affirming care? It depends on the type of care. Gender-affirming care looks different for everyone. Some trans men seek no medical treatment, some do hormone therapy, some have top surgery to remove their breasts, and some also have bottom surgery to alter their genitals to affirm their gender. Gender affirming surgeries such as phalloplasty (penile construction) and scrotoplasty (scrotum construction) involve reconstructing the vagina and vulva but they do not directly involve removing the uterus and ovaries. These surgeries eliminate the option for unassisted conception and a vaginal birth, but they do not eliminate the possibility of pregnancy through IVF, and for the trans man to carry the pregnancy to term with a c-section. This can be a complicated process after having gender affirming surgery and it's important to work with an experienced fertility specialist.
Family-Building Options for Trans Men
There are lots of options for preserving fertility during the gender-affirming treatment process. If you want to plan for future family building, it's important to involve a fertility specialist in your process.
Egg-Freezing: Freezing your eggs before beginning gender-affirming hormone treatment can help to preserve the option of having biological children through IVF in the future. This process involves retrieving your eggs during ovulation and cryogenically freezing them until you are ready to start a family. When you come back to use them, the IVF involves fertilizing the egg with a partner’s sperm or donor sperm in a lab and implanting the embryo into your uterus, a partner’s uterus, or a gestational carrier’s uterus to bring the pregnancy to term.
IVF: If a trans man still has a vagina, uterus, ovaries, and is ovulating, it is possible to become pregnant without assisted reproduction technology. For all other circumstances where becoming pregnant without assistance is significantly more difficult or impossible, In Vitro Fertilization (IVF) is often the most effective option for achieving pregnancy, either yourself or with a partner or gestational carrier.
If LGBTQ+ partners are seeking treatment together, sometimes couples choose to carry their partner’s egg instead of their own, so that both are equally involved in the process. This is a great option for those who have frozen their eggs and are no longer able to carry a pregnancy but have a partner who is.
IUI: Intrauterine insemination (IUI) may be an option for those who are still able to carry a pregnancy, but who need the added assistance this procedure offers. It involves inserting a thin catheter into the uterus via the vagina during ovulation to place sperm directly, for a higher chance of fertilizing the egg.
Donor Egg: Can a trans man get pregnant even if there’s no way of using their own eggs or they no longer have eggs? Technically the answer is no; however, building a family does not need to involve your own eggs. There are so many ways to become a parent and just as there are sperm donor banks, there are also egg donor banks. In a scenario where a trans man does not have their own uterus and ovaries, an embryo created with donor eggs and sperm would be carried by a gestational carrier. If a trans man does still have a uterus and ovaries but is not able to get pregnant on their own, they can also use donors to carry a pregnancy themselves.
Can Trans Men Get Pregnant? The Expansiveness of Fertility Care Today
Today, LGBTQ+ patients make up a much larger percentage of the overall percentage of fertility treatment patients. Medical care is evolving toward a much more inclusive environment for care for all people who wish to become parents. While the challenges of trans men are unique, it is fully possible for trans men to build the families they dream of.
Involving a fertility specialist in your gender-affirming care as early as possible is the best way to know all of your options and make the most empowered decisions for yourself. Book a consultation with Spring Fertility today to learn more about how you can benefit from fertility treatment.
At Spring Fertility, we are dedicated to helping all people achieve their dreams of having a family with inclusive, supportive fertility care, and have a dedicated third-party care team to support family-building with the use of donor tissue. Click here to learn more about LGBTQIA+ family-planning at Spring