Trans and pregnant

Show notes

Trystan Reese is the Director of Family Formation at Family Equality, the nation's leading nonprofit dedicated to supporting LGBTQ+ families and those who wish to form them.  

Trystan’s blog chronicles his family-forming journey and other aspects of his and Biff’s life together.

If you're a Carrot member and interested in learning more about transgender fertility considerations, check out our Read & Learn library in your Carrot account.

Transcript
Marie (00:03): For a long time, Trystan had been led to believe that he could never have biological children. He is transgender and doctors had told him when he transitioned that he would not be able to get pregnant. But they could not have been more wrong. Fast forward a few years, today he and his partner Biff have three children. Two they adopted and one biological son. Their whole family is just so beautiful, so loving and is the fulfillment of the kind of dream that Trystan many years ago, didn't even dare to dream. So from thinking that family forming and pregnancy would never be a possibility for him, to building his family and giving birth to a lovely, healthy son. That was a journey. Today, Trystan is going to walk us through it. He is a generous, passionate, kind man and an amazing storyteller. There were times when I got chills just transcribing his interview. So this is one you're going to want to hear.

Marie (01:20): This is Baby Steps, a podcast from Carrot Fertility, about the many diverse paths that people take in the pursuit of parenthood. I'm your host, Marie McCoy-Thompson.

Trystan (01:33): I'm Trystan Reese. I am the Director of family formation at Family Equality, which is the nation's leading nonprofit dedicated to supporting LGBTQ plus families, and those who wish to form them. I'm Canadian by birth, although I've lived all over the country. I used to be a political organizer. And so it was my job to travel the country and work on specifically on LGBTQ plus campaigns.

Marie (01:56): So Trystan does amazing work. He's community oriented and passionate about creating meaningful change. And when he was in his mid twenties, he met someone whose passions matched his own.

Trystan (02:09): I went to a friend's brunch at their house and there was the man who would eventually become my partner, Biff. And I was completely smitten with him, basically immediately.

Marie (02:20): Do you remember what you were first drawn to when you met him?

Trystan (02:24): It's going to sound so shallow. He was just so beautiful and he's just captivating. And he was talking about how he had just moved to LA from Bakersfield. And he was really excited to move to LA because he assumed that there would be lots and lots of ways for him to connect with other LGBTQ people. And then he was really shocked and disappointed that in fact, there was pretty much just the bars. And so not to be deterred because this is just so who he is. He was like, "Oh well then I'll just build it." And so he created a social group for queer, bi, trans, questioning gay men called Guys Like Us. So from him being stunning to him being this, just like visionary who wanted to and was creating the world that he wanted to see. It was just like immediately I was like, "Oh, this is the guy. This is the whole package."

Marie (03:20): It sounds like you were both pretty active organizers. And I can see why you would have hit it off early on.

Trystan (03:27): Yeah. We're both trying to create change in the ways that we felt called to do so.

Marie (03:32): So you met and you start dating? Did you talk about wanting kids early on? Or when did you start having those conversations?

Trystan (03:41): I mean, I don't honestly remember the first time we talked about wanting to have kids. What I know is, at the time because marriage for a couples like us was illegal. A lot of our peers who are LGBT, were really rushing into formalizing their relationships. For us that seemed like an overreaction. That seemed like a reaction to the fact that they couldn't get married. And we didn't want to do that. We wanted to take things really slowly. The most we had ever said was, we kind of casually talked about what kind of a timeline, we thought of ourselves as being on for kids. And I was on, I remember saying like, "I think I could see being on a five year timeline." And he was like, "I am more on a 10 year timeline." And that's I think as formal as we'd ever talked about really until we got the phone call that his sister's kids needed a place to stay.

Marie (04:35): Getting that phone call was the beginning of an adoption story that is actually the subject of an entirely different podcast, which I will link in the show notes if you want to check it out. We won't go into the full story here today, but I asked Trystan if he could give a recap of how he and Biff adopted their first two children.

Trystan (04:55): My partner Biff, his family has a lot of struggles. There's issues of poverty and of course we know that with poverty comes, in many cases drug use, drug addiction, domestic violence. I mean a lot of things happen when you can't afford the social safety net that you need. And his family was not immune to that. And his sister was not immune to that. She fell pregnant with her first child when she was 15 and then had her second when she was 18. And yeah, we had known that things were difficult in her house, but it was extremely painful for us to see children in that kind of a situation where they just... it was shocking to me that anybody would allow children to be neglected or hurt or even abused. I just could not fathom it. And so we knew that things might be coming to a head in that situation. And we had reached out to her social worker to just say, "Hey, just let us know if we can help." And then finally we got the call from her saying, "Yes it's time. Things in that house, there had been enough phone calls to the police, enough claims of domestic violence. We are going to come and we're going to remove the kids from that home."

Trystan (06:12): We got a phone call on Friday that the social worker was coming to the house on Monday, to take the kids away and put them in foster care and probably separate them. And the social worker shared that she didn't think that his sister would be able to do what she needed to do to ever get those kids back. So it was possible that we would be losing them to the system forever. So we had three days to make a decision. And we didn't take three days, we took not even an hour. My partner got that phone call, he called me and I said, "Great, let's go get them." And that's how we became parents overnight, to a one year old and a three year old.

Marie (06:50): I'm so glad that the ending of that story is that these kids are with you, and that you've gone through the adoption process. But it does sound like a pretty traumatic way to start a family.

Trystan (07:03): Yeah. I wish that everyone could become a parent on their own terms, and in a situation that brings everyone joy where it's just joy and not bittersweet. But our situation happened to be bittersweet in a lot of ways. It was really hard.

Marie (07:19): How is everyone doing now?

Trystan (07:21): It's been so long now. We still celebrate Chappelow family day. Their last name is Chappelow and so we celebrate every year on the anniversary of them coming to live with us. We celebrate our formation as a family, and we give the kids and... just a special to extra time to really think through their story and ask us whatever new questions they might have. They can ask us questions anytime of course, but there's something important about celebrating their adoption, about celebrating our formation as a family. And we celebrated our eighth Chappelow family day this year. And they're doing great. There are residual issues that both of them have and may all always have. Those first few years that they didn't get what they needed and that they were exposed to violence. Those are really, really formative years. So, yeah.

Marie (08:09): Trystan and Beth have been able to give their kids the support they need. And as they nurtured their first two kids, Trystan started thinking about having a third, a biological child. But the path to do that wasn't immediately clear to him.

Trystan (08:25): I'm a transgender man. So I was assigned female at birth and I lived the first 18 to 20 years of my life appearing to the world as a woman and having the body that most people would associate with other women. And really around age 18 to 20, I had always had this feeling that I was different and that there was something wrong with me. Now, of course, as a happy well adjusted transgender adult, I want to tell young version of me like, "You're not broken. There's nothing wrong with you. You're just trans." It's just a variation on the norm. It's not something that's bad or wrong. My gender identity is different than my sex traits. My assigned sex at birth. I started taking testosterone under a doctor's supervision. And brought my body more in alignment with my gender. And that brought me an enormous amount of peace and it allowed me to continue to stay alive and live my life as a transgender man.

Trystan (09:25): And in all of that I was told that when I transitioned, even hormonally, just by taking testosterone, that I was closing the door on ever becoming a parent biologically. That's what I was told. And definitely culturally, I believed when I started transitioning that I was also closing the door on ever finding love. On ever having any kind of a family biologically or not, on every ever having any kind of a community. I just didn't know any trans people who were happy. I didn't know any trans people who had love, who were married, who had kids. I didn't know any of that. And I still chose to transition because for me the choice was between life and death. It wasn't a choice between being trans or not being trans. I chose to save my own life and transition even though I thought it was giving up any measure of happiness that I might have. And I'm just really, really lucky, the path that my life took meant that I was able to find someone to have a relationship with, to have a partner, a life partnership with.

Trystan (10:26): And it turns out that what the medical community had told me in those very early days of the trans movement were just not true. And now hundreds, maybe thousands of transgender men around the world have successfully gone off of their hormones, regained the ovulatory cycle, and been able to get pregnant and give birth to happy beautiful children by the hundreds and maybe thousands.

Marie (10:48): I was just really surprised that you said that a doctor told you that transitioning meant closing the door on having a biological child. Was that just what the medical community believed at the time and research has improved? Or what happened there that that was the information that you were given?

Trystan (11:08): Yeah. I mean at the time there was no data and I don't know why physicians, and this happens today, I hear regularly on Instagram and when I go to conferences and do keynote speeches at universities, I hear often that medical providers are still telling people that if they go on testosterone, that it will render them sterile, which is not true. There's never been any data to suggest that that's true. It is true that testosterone is a dose dependent ovulation suppressant, which is super fancy language for, "If you take it the way you're supposed to, it will stop your ovulatory cycle." But that's temporary and reversible. And all the data that we have since 2014. So they're five years now, of really solid academic, scientific and medical studies showing that it's temporary and reversible. And then anecdotally we've known that too for about at least 20 years. Transgender men have been having babies after having been on hormones.

Trystan (12:06): So we've known it in the community for a long time and now the medical community is starting to catch up. I'm just not sure how to get the word out. And globally, transgender people should be counseled on their fertility before starting transition. Going on testosterone, if you have already gone through puberty, it is not going to stop you from being able to get pregnant. Or just harvest your eggs and have your partner carry your genetic child. There's so many other ways that people can become parents if they're transgender. But yeah, getting the word out and making sure that doctors are really practicing evidence based care. It's a struggle that I am still working on tackling.

Marie (12:45): Yeah, absolutely. I mean it seems like you're doing a pretty excellent job with all the speaking that you're doing and the activism with trying to get the word out. I mean, it kind of sounds like it's a little bit comparable to taking birth control and then stopping it in the sense that as you're saying, it's temporary and reversible.

Trystan (13:05): That's right. When it comes to reproductive function, testosterone, again, if it's taken the way that it should be, nothing is perfect, but it is essentially hormonal birth control. It stops your cycle, but it's not going to have a negative impact on your uterus or on your egg health.

Marie (13:29): When you did decide that you were curious about pursuing or maybe already knew for certain that you wanted to have a biological child, did you know what your options were at that point?

Trystan (13:42): So when I first got the idea that I might want to have a biological child with Biff, I just started researching. I'm a huge nerd and so I like really wanted to see all those studies. I wanted to talk to more people. I had already at that point known personally, probably a dozen transgender men around the country, who had already been through this process. And then I started talking to them and saying like, "Okay, what's the protocol that you went through? When do you stop your testosterone? When is it safe to start conceiving? When can you resume your hormones after you give birth? What do doctors say?" And I went in and I saw a physician who did an ultrasound to look at my follicles. Is this something that it looks like I can even do? So I did my own research by reading academic studies, by speaking to people who had been through the process and then by speaking with professionals in the world of trans-fertility, to get a sense of what's out there globally and then what's happening in my own body. Was this even an option for me?

Marie (14:40): Yeah, absolutely. Can you talk about just the emotional experience of deciding that you did want to see what was out there, in terms of resources for having a biological child?

Trystan (14:55): I mean for me, watching my friends go through this process. I definitely remember thinking, "Oh my God, that is so great for them." But I would never want to do that. I did not want to be... I just couldn't imagine going through that with my body, going through it socially. It was just not something I ever considered doing myself, until I met Biff. The love that we have between the two of us, even after we adopted Haley and Riley, it felt like there was still more that we could create, that we could be, that we could bring into the world. And so it's no more complicated than that. I met someone, I fell in love and I wanted to build a family with him. And we built a family and that was so difficult that when I wanted to grow our family, we just couldn't go through another adoption process. And so for me, I was just really hopeful that this was something that we could do when that, that all those doors I thought were shut when I came out as trans, ever finding someone that would love me, ever building a family, ever having the community, ever having the child, a biological child, all those other doors, it turned out were not closed at all.

Trystan (16:07): They were unlocked and I just needed to open them and I was really excited to walk up to this final door, this biological child door, and to see if it would open, when I wiggled the handle.

Marie (16:29): When you first decided to conceive a child, you had to stop taking your hormones first. What was that like, both physically and I'm imagining emotionally?

Trystan (16:43): Yeah. Going off of testosterone for me wasn't difficult physically. Most of the changes of testosterone are permanent. So my beard didn't fall out, my voice didn't change. Maybe my body shape changed a teensy bit, but very little. What really, has a bigger impact is on mood. And just access to emotions and my patience level went way down. My tolerance for chaos and annoying things went way down, things like that. The biggest thing really was just dealing with mood shifts. That was harder and regaining the cycle, which for me was fine. I don't struggle with that. I'm a man who has an ovulatory cycle, who cares? But other transgender people talk about that being a pretty difficult experience for them.

Marie (17:35): Hmm. Yeah. I'm sure every experience is as unique as every individual.

Trystan (17:41): Yeah. The first six months of transition are extraordinarily difficult because you are literally going through puberty and menopause at the same time. It is like there's a lot going on. And so I was kind of going through that, but in the reverse. So yeah, yeah. It was difficult. But I'm an adult and I tried really hard to be able to notice when things were happening and not take it out on my family. But no one's perfect. And so that period of time was pretty difficult for me. And I think it was difficult for poor Biff and our kids as well.

Marie (18:13): How long did it take for you to get pregnant?

Trystan (18:17): On average, for transgender men who have successfully gotten pregnant and given birth, it takes about three to six months for a cycle to return, if they have been not having a cycle because of a hormone use prior to that. And over 90% of transgender men who've given birth were able to conceive within a year of trying. So it's very much in alignment with average statistics or average rates of conception. And I was, no different from when we started trying to when I got pregnant it was about six months, maybe five months I guess, somewhere around there. So pretty average.

Marie (18:57): When Trystan got the positive pregnancy test, it was early in the morning. He wasn't expecting it to be positive because he'd been tracking his cycles and it didn't seem like it would be possible for him to have gotten pregnant yet. But there it was, that positive sign on the test. And he and Biff were so happy to see it.

Trystan (19:18): Just super excited. I'm also super really, I'm really superstitious so I didn't want to get too excited because I knew that one in four, no one pregnancies ends in miscarriage. So I just wanted to be peaceful about the process and not so excited about what was going to happen at the end. Just sort of live in the moment.

Marie (19:37): Trystan is someone who does his research and is as pragmatic as he can be. But getting that positive pregnancy result is still such an exciting thing. And one of the things it brought up for him and Biff was the question of who they should tell.

Trystan (19:54): Initially we did not want to tell anybody about the pregnancy story at all. We wanted to keep it very private. Maybe our closest friends and family, but that's it. But we were just in a place as a country, where there was so many transgender women of color, on the front lines doing this educational work, telling their stories. And it felt really irresponsible to have the opportunity to tell a new kind of trans story about a family, and falling in love and adoption and possibility. And so I thought, as a transgender man living in Portland, Oregon, it's really my responsibility to tell that story if and when I can. And we had no idea it was going to blow up the way that it did. I just had no idea how many hot button issues my story was going to tap into.

Trystan (20:42): I didn't know how triggered the right wing was going to be by this idea of a little tiny family in Oregon growing by one. But it hit on some nerves and it became a huge opportunity to talk about trans people in a new way. That isn't about horrible things that happened to us, but instead is about all the possibilities that are available, when we are out there living our best lives. So yeah, there were highs and lows there too. And I think often people ask me like, "Do you regret it? Or would you do it again?" And the answer is I just don't know. I cannot tell you for sure. Yes. If I could go back in time, I would choose to tell my story publicly, again. I might not. I might not.

Marie (21:31): That's a tough question for Trystan to answer. The question of whether he had shared his story publicly, if he could go back and do things differently. But I can see from the communities Trystan has built, through his contributions to the national conversation on these issues, that so many people have gotten a lot of good from hearing his story. But even without it becoming a headline, preparing to have a baby is enough work on its own. What was the experience of your pregnancy like? Obviously there's all kinds of experiences that people have with pregnancy. For some people there's so much morning sickness and it's really hard. Some people have it pretty easy. Where did you fall in that spectrum?

Trystan (22:15): Somewhere in the middle. I mean when I first had my first appointment with the certified nurse midwife at Kaiser. I told her, It's my goal to be your most boring patient." And she thought that was funny because I was a man of course. But I was serious. I wanted everything to go very smoothly, not cause any problems, do exactly what they wanted me to do. And it was very textbook, really straightforward. My first trimester I was pretty nauseous. Second trimester I was feeling my self. I got the boost of energy. I was just starting to fill out a little bit, weight wise. And I've always been a little bit thin and so my face being a little rounder, I was like, "I look fantastic." So that was fine. And then towards the end of the third trimester, things got extraordinarily difficult. People say that your body won't grow a baby that's too big for it. That is not true at all. Do not listen to those people. They are lying. Because nature is messy and does not care about you.

Trystan (23:14): And the way that genetics work, you can want a 100% grow a baby that's too big for your body, which is what happened to me. And I had rib separation and so that's just add that to the list of 10,000 things they never tell you can happen during pregnancy. Which is my ribs were splintering from my sternum, in the front and then separating from my spine in the back. So it was an excruciating pain for the last whatever a couple of weeks of the pregnancy. So yeah. 

Marie (23:41): Oh my God. They really are, I mean the list of things they don't tell you is truly shocking.

Trystan (23:48): Yep. And people are like, "Oh, you know that you might poop during the delivery." And you're like, "Yeah." That is not even in the top 100 most distressing things that can happen. Right? Your literal uterus can fall out while you are giving birth.

Marie (24:01): Oh my God.

Trystan (24:01): That is way more drastic than a little bit of poop, which once you've dealt with an actual newborn, you didn't care about poop anymore. You know what I mean? The things that people worry about are just not even on the Richter scale.

Marie (24:14): Right. Because the poop thing is what I feel people talk about all the time. That's the one that always comes up.

Trystan (24:19): Yeah. No, no, no. Your literal bladder can fall out during childbirth.

Marie (24:24): Jesus.

Trystan (24:24): Your ribs can splinter and separate because your baby's too big for your body. And that's what happened to me.

Marie (24:30): Oh my God. How was your birth experience? I mean, I don't know that there's many instances of labor that are pain free by any means, but how did it go for you?

Trystan (24:43): Yeah. I mean it wasn't pain-free per se. I got an epidural as early as I possibly could, which was the 100% best decision I could have ever made. I was induced and so I got to go through my entire pre labor, early labor, active labor and delivery process surrounded by medical professionals who have done this literally thousands of times. And I really loved that. It was very empowering for me to be able to do that. It wasn't perfect. The epidural helped, breathing helped. But overall it was a really empowering, transformative process that was miserable at times and the highest high I've ever experienced at other times. Yeah. It was all the things.

Marie (25:33): Childbirth really is all the things for Trystan and Biff. It gave them a beautiful healthy baby.

Trystan (25:42): He's truly the light of our lives.

Marie (25:44): That is so sweet. So after your son's birth, what was your postpartum experience like?

Trystan (25:52): I'm really, really lucky. There's no data out there on postpartum experiences of transgender men who've given birth. That's on my top three list of priorities when I'm doing advocacy work as like, "We need more data on postpartum." But for me, I had postpartum elation. I loved him so much. The fourth trimester thing was so real. Being his parent was the first thing I've ever been great at, without trying. It was such a beautiful time. It was such a beautiful time for me to get to be with him. Yeah, it was really, really lovely. I need a little bit of help with the healing process just from labor. And so I postpone going back on testosterone. But I think three months just because I wanted everything to heal up. And your body really gets flooded with estrogen during the labor and delivery and postpartum process. Both to promote milk production but also because estrogen is really, really critical for healing wet tissues, postpartum.

Trystan (26:54): And so I wanted to allow all those hormones do their thing and hit my body with any testosterone until it really healed. And so when I felt like I was on the upswing from the healing process, I got to go back on my hormones and I've been back on them ever since. And that's been great.

Marie (27:09): And when you went back on the hormones, was that sort of another adjustment period?

Trystan (27:13): I think that part was fairly easy for me. I mean there's a lot of other things going on. You're already postpartum, there's already big mood stuff happening, big body stuff happening. So I'm sure that it was hard. I just don't remember it because there was so many other things going on at that time.

Marie (27:28): Yeah. Trystan was a little busy for awhile. Healing his body and caring for a newborn. And he and Biff were parenting their two older kids too. Now that their baby is two and a half, Trystan has had some time to reflect on everything his fertility experience has taught him.

Trystan (27:47): I think there are some things that I learned along the way that I've found are particularly useful for any marginalized person going through a fertility process. I think number one, just remember that you don't have to do any of this on your own. If your partner's not also from that marginalized community, deputize your partner or partners if you have multiple or if you don't have a partner, a friend, your parents, someone that you meet literally online. I've put out calls on LGBT health groups on Facebook to say, "I need someone to come to an appointment with me. Or I need someone to call my insurance and ask this question for me." There are people out there who want to do great allyship work and want to show up for you. Never feel like you should go through any of these processes by yourself. So I think that's really critical. That's number one.

Trystan (28:39): I think the other thing that I'd tell other LGBT people or really anyone who's experiencing infertility, is to hold tightly to your vision of having a future family. But hold lightly to how you get there. Sometimes people think like, "Oh well we have to have a biological child and if that doesn't work out, we're screwed." No. I've had a biological child and I have adopted kids and I will tell you there is nothing magical about a child sharing your genetics. You will not love that child any more than you love a child that comes to you through some other means. Whoever you end up parenting, whoever ends up being your child, that's the person who is supposed to be your child. So I think, yes you want to be a parent. Hold tight to that, but how it happens, just try to be open to what the universe has in store for you.

Marie (29:27): That beautifully told advice is probably the best place to end. But before I play us out, one more thing from Trystan.

Trystan (29:35): If people want to see more baby pictures, they can always follow us on social media. Where Biff and I on, Instagram and Facebook and Twitter and blah, blah, blah, all the things. Yeah.

Marie (29:48): They have a whole community on there and all kinds of resources that they link to as well. So really a great thing to check out. Baby Steps is a podcast from Carrot, the leading global fertility benefits provider for employers. To show you how Carrot helps its members, I am here with Adam who is the head of Carrots Care Navigation. Hi Adam.

Adam (30:13): Hello.

Marie (30:14): I'm going to read a question that you have received from a Carrot member and you are going to walk through how you would help that person. Sound good?

Adam (30:22): Sounds great.

Marie (30:23): So here's the question from a Carrot member. "I was wondering if Carrot covers the reimbursement for having a fertility check. I was diagnosed with hypothyroidism a few months ago and fertility could be an issue for some people with this condition."

Adam (30:38): Good question. Yes. The Carrot benefit does cover fertility consultations. So long as they take place at an eligible provider. Every member has access to a personalized Carrot account, from which they can see all of the eligible providers within their local area. Of course, if they need additional help, they can reach out to our Care NAF team, and we're happy to help them find the best clinic that will work for them.

Marie (31:02): To learn more about Carrot, visit carrotfertility.com. This has been an All Turtles production. Baby Steps is produced and edited by me, Marie McCoy-Thompson. And also edited and mixed by the one, the only Jim Metzendorf. Our original music is by Chris Ploeg and Chili Corder who have not yet formed a band called Chili and the Ploeg, but it's got to be any day now. Our artwork is by Allie Packard, who recently gave me a compliment on Slack and it just sprained my whole day. Thanks Allie. And thanks to you, dear listener, for listening.