Providing Patient-Centered Perinatal Care for Transgender Men and Gender-Diverse Individuals: A Collaborative Multidisciplinary Team Approach

Obstet Gynecol. 2019 Nov;134(5):959-963. doi: 10.1097/AOG.0000000000003506.

Abstract

Background: Little is documented about the experiences of pregnancy for transgender and gender-diverse individuals. There is scant clinical guidance for providing prepregnancy, prenatal, intrapartum, and postpartum care to transgender and gender-diverse people who desire pregnancy.

Case: Our team provided perinatal care to a 20-year-old transgender man, which prompted collaborative advocacy for health care systems change to create gender-affirming patient experiences in the perinatal health care setting.

Conclusion: Systems-level and interpersonal-level interventions were adopted to create gender-affirming and inclusive care in and around pregnancy. Basic practices to mitigate stigma and promote gender-affirming care include staff trainings and query and use of appropriate name and pronouns in patient interactions and medical documentation. Various factors are important to consider regarding testosterone therapy for transgender individuals desiring pregnancy.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Androgens / metabolism
  • Androgens / pharmacology
  • Culturally Competent Care / organization & administration
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services for Transgender Persons* / ethics
  • Health Services for Transgender Persons* / organization & administration
  • Humans
  • Infant, Newborn
  • Male
  • Patient Care Team* / ethics
  • Patient Care Team* / organization & administration
  • Patient-Centered Care / methods
  • Perinatal Care* / methods
  • Perinatal Care* / organization & administration
  • Perinatal Care* / standards
  • Pregnancy
  • Pregnancy Maintenance* / drug effects
  • Pregnancy Maintenance* / physiology
  • Pregnancy Outcome
  • Professional-Patient Relations / ethics
  • Testosterone* / metabolism
  • Testosterone* / pharmacology
  • Transgender Persons*
  • Young Adult

Substances

  • Androgens
  • Testosterone