A new systematic review is shedding light on a topic with surprisingly little research behind it: pregnancy among transmasculine people — trans men, nonbinary people, and other gender-expansive individuals who were assigned female at birth.

The review, published in Acta Obstetricia et Gynecologica Scandinavica, found evidence that a small but noteworthy minority of transmasculine people have pregnancies (6% to 9%) and children (4% to 9%), including after transitioning.

Testosterone, Contraception and Pregnancy Loss

Investigators identified 44 relevant studies for their analysis. Testosterone use before pregnancy appeared to be associated with fewer conceptions compared with never having taken it, but the researchers caution it was not reliable enough to serve as a form of contraception on its own. Pregnancy loss also seemed to be higher among those exposed to testosterone before or during pregnancy, though the authors note that much more evidence is needed before a full picture emerges. The review also found very little existing data on rates of postnatal depression among transmasculine people who become pregnant.

“This comprehensive work has shown important gaps in knowledge on transmasculine pregnancies. It demonstrates the need for more trans-specific research that could be done by academics and research bodies working together with transmasculine people with lived experience,” said corresponding author Catherine Meads, MD, PhD, of Anglia Ruskin University in the UK. “Transmasculine people can have contraceptive, abortion, pregnancy, maternity and gynecological needs, and must be treated with respect by health services.”

Journal: Acta Obstetricia et Gynecologica Scandinavica
Article Title: Transmasculine pregnancy—Occurrence, associations, and outcomes: A quantitative systematic review
DOI: 10.1111/aogs.70276