Queering birth

Let’s be clear. It’s 2018.

Our world is shrinking. Technology has advanced migration, media has altered our consumption of fact, and your neighbours may not live their life like you live yours.  Nuclear, binary, heteronormative families are far from no longer the only option. 

I myself am pansexual and non-monogamous. Which is just a fancy way of saying my attraction is less based on your gender or sex expression, if you're a cool person, I'm probably going to be into it.  

Birth in our culture is primarily considered a female act. Mothering and breastfeeding are considered exclusively female practices.  But this is no longer the case. Chestfeeding technology has come a long way in breaking down the barriers for people who can't or are having difficulties lactating to contribute to feeding babies. People of all genders and sex expressions have the right to birth in a space where they feel safe, supported and respected in their expression.

It’s 2018. The time for "I didn't know", is over.

Glossary of Terms:

Sex - The classification of male or female that an individual is assigned at birth based on the expression of their chromosomes and usually based on the outwards appearance of their sex organ. A person's sex, however, is actually a combination of bodily characteristics including: chromosomes, hormones, internal and external reproductive organs, and secondary sex characteristics.

Gender Identity - External manifestations of one's gender constructed through gender performances of clothing, hair, makeup, behaviour, body-characteristics and societal pressures. Society identifies these cues as masculine and feminine, although what is considered masculine or feminine changes over time and varies by culture. Typically, transgender people seek to align their gender expression with their gender identity, rather than the sex they were assigned at birth.

Sexual Orientation - Describes a person's sexual, romantic, physical and emotional attraction to another gender identity. Gender identity, gender, and sex are all different and a transgender woman may be straight when dating a man, lesbian when dating a woman, or both when dating everyone. 

Transgender - An umbrella term for people whose gender identity and/or gender expression differs from what is typically associated with the sex they were assigned at birth. People under the transgender umbrella may describe themselves using one or more of a wide variety of terms - including transgender. Always use the descriptive term that they desire. 

Transexual - An older term that originated in the medical and psychological communities. Still preferred by some people who have permanently changed - or seek to change - their bodies through medical interventions, including but not limited to hormones and/or surgeries. Unlike transgender, transsexual is not an umbrella term. Many transgender people do not identify as transsexual and prefer the word transgender.

Trans - Used as shorthand to mean transgender or transsexual - or sometimes to be inclusive of a wide variety of identities under the transgender umbrella. Because its meaning is not precise or widely understood, be careful when using it with audiences who may not understand what it means. 

Crossdresser - While anyone may wear clothes associated with a different sex, the term cross-dresser is typically used to refer to men who occasionally wear clothes, makeup, and accessories culturally associated with women. Those men typically identify as heterosexual. This activity is a form of gender expression and not done for entertainment purposes.

Transition - A complex procedure during which a person changes their sex and expresses their gender as the sex that best suits them. This process includes an extensive mental, sociological, and physical shift in the person's life. Avoid the term “sex change”.

Sex Reassignment Surgery - Also called Gender Confirmation Surgery (GCS). Refers to doctor-supervised surgical interventions, and is only one small part of transition (see transition above). Avoid the phrase "sex change operation." Do not refer to someone as being "pre-op" or "post-op." Not all transgender people choose to, or can afford to, undergo medical surgeries. One does not need to undergo sex reassignment surgery to have transitioned.

Gender Dysphoria - In 2013, the American Psychiatric Association released the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) which replaced the outdated entry "Gender Identity Disorder" with Gender Dysphoria, and changed the criteria for diagnosis. The necessity of a psychiatric diagnosis remains controversial, as both psychiatric and medical authorities recommend individualized medical treatment through hormones and/or surgeries to treat gender dysphoria.

Cisgender - A term used to describe everyone else who fits the gender binary or associated with the gender they were assigned at birth. 

Gender Non Conforming - A term used to describe some people whose gender expression is different from conventional expectations of masculinity and femininity. Please note that not all gender non-conforming people identify as transgender; nor are all transgender people gender non-conforming. Many people have gender expressions that are not entirely conventional – that fact alone does not make them transgender. 

Non-binary/Genderqueer - Terms used by some people who experience their gender identity and/or gender expression as falling outside the categories of man and woman. They may define their gender as falling somewhere in between man and woman, or they may define it as wholly different from these terms. The term is not a synonym for transgender or transsexual and should only be used if someone self-identifies as non-binary and/or genderqueer.

That’s a lot of terms! Whew. 

Language is extremely important as it influences our thought patterns and how we interact with and perceive the world. Having correct terms and language to discuss these topics is the first step towards safe, inclusive, birth for all. 

More definitions: https://www.glaad.org/reference/transgender 

What’s in a name? Or a pronoun?

Always use the name that a person introduces themselves as. Names hold a lot of weight and it is important to respect the way a person wishes to be addressed. 

Pronouns, they don’t have to be a nightmare! If you’re unsure which pronoun to use, use they/them or simply ask. Most people won’t be offended if you are genuinely asking for information. Use the pronoun that they request. If it is not appropriate to ask, use the pronoun that is consistent with the person's outward expression of gender identity, or use the singular they/them. 

Things to be considerate of:

“Transgenders” “A transgender” - avoid using transgender as a noun, it is an adjective. Instead used “transgender people” or “a transgender person”.

“Transgendered” - “-ed” is problematic at the end of transgender. An "-ed" suffix adds unnecessary length to the word and can cause tense confusion and grammatical errors. It also brings transgender into alignment with lesbian, gay, bisexual, and queer. You would not say that Elton John is "gayed".

“Transgenderism” - This is not a term commonly used by transgender people. This is a term used by anti-transgender activists to dehumanize transgender people and reduce who they are to "a condition."

“Passing” and “stealth” - While some transgender people may use these terms among themselves, it is not appropriate to repeat them in mainstream media unless it's in a direct quote. The terms refer to a transgender person's ability to go through daily life without others making an assumption that they are transgender. However, the terms themselves are problematic because "passing" implies "passing as something you're not," while "stealth" connotes deceit. 

“Tranny” “Shemale” “it” “Shim” “He-She” - All these terms are extremely outdated, harmful and are usually derogatory to transgender people. Never use these terms. 

What should I know about Trans Medical Care?

Accessing Medical Care - Can be extremely difficult as a transgender person. Not all doctors and nurses are sensitive to transgender health issues. Transgender people may feel uncomfortable in their bodies or being examined. It is important to be accomodating of the possible dysphoria transgender people feel in hospital rooms. Furthermore, medical staff may use the sex assigned at gender to determine how to treat a person. 

History of Intersex - There is a long history of ethical issues and medical injustice surrounding intersex, transgender, and gender assignment. Read up on the medical history of intersex if you’re looking for some tear jerking stories. 

Additional Resources:

Planned Parenthood  - https://www.plannedparenthood.org/learn/sexual-orientation-gender/trans-and-gender-nonconforming-identities

Two Doulas Talk - 


Facebook page, podcasts, great info!

Trans Chestfeeding Documents - 


A google docs of many links to resources on breastfeeding.

Birthing Beyond the Binary - 


Offers classes and workshops related to birth and transgender identities. 

Birth for Every Body - 


Midwifery based movement of inclusivity.

Understanding Gender - 


A gentle discussion of gender identity.

Trans 101 - 


Get a deeper understanding of trans identities.

For Providers 

Providing Culturally Sensitive Care for LGBTQ2+ People - 


Midwifery training online workshop on cultural sensitivity for birth workers. 

Caring For Genderqueer with Cultural Humility - 


A 90 - Minute webinar on cultural humility and transgender. 

Providing Culturally Sensitive Care to Transgender People -


An independent CME course. 

Counseling LGBTQ2+ Couples - 


Webinar on chestfeeding in LGBTQ2+ communities. 


Obedin-Maliver, J., Makadon, H. J. (2016) Transgender men and pregnancy. Obstet Med, 9(1):4-8.

MacDonald et al. (2016) Transmasculine individuals' experiences with lactation, chestfeeding and gender identity: a qualitative study. BMC Pregnancy and Childbirth, Online.

Ellis, S. A., Wojnar, D. M., & Pettinato, M. (2014). Conception, pregnancy and birth experiences of male and gender variant gestational parents: It's how we could have a family. Journal of Midwifery & Women's Health, 60(1), 62-69.

Light, A. D., Obedin-Maliver, J., Sevelius, J. M., & Kerns, J. L. (2014). Transgender men who experienced pregnancy after female-to-male gender transitioning. Obstetrics & Gynecology, 124(6), 1120-1127.

Pyne, J. (2012). Transforming Family: Trans Parents and Their Struggles, Strategies and Strengths. Toronto.