Abstract
A transman presents for prenatal care with a planned, desired pregnancy and no underlying medical issues. Clinicians caring for him are initially unable to initiate a pregnancy episode in the electronic medical record (EMR) secondary to his legal designation as male, and must change the gender marker in the EMR to female in order to document the pregnancy. This situation illuminates the systemic challenges faced by transmen seeking health care, especially in the area of obstetrics. This article will review language used to define the trans* community, highlight trans* healthcare disparities, review the context in which transmen receive perinatal care, discuss what is known about their experiences, and make recommendations for improvement in healthcare systems to eliminate barriers to safe, effective, and culturally-competent care.
Highlights
A transman presents for prenatal care with a planned, desired pregnancy and no underlying medical issues
Trans* is an all-inclusive term that captures any individual with an internal gender identity that differs from the sex they were assigned at birth
These individuals can identify as the “opposite” gender, as agender, as multiple genders, or as fluctuating genders. Many of these identities have recently evolved in conjunction with a greater societal understanding that gender identities fall along a spectrum, as opposed to a strict binary.[1]. Cisgender individuals are those whose internal gender identity is congruent with the sex they were assigned at birth
Summary
While trans* masculine patients face social and structural barriers to culturally appropriate care, obstetric providers have the opportunity and responsibility to improve individual and institutional readiness to meet the needs of trans* families in the perinatal period. Our efforts must be interdisciplinary, involving all staff who have face-to-face encounters with families, and those who can effect change of the EMR infrastructure necessary to provide safe, respectful care
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