When you are cis and straight and visibly pregnant, there’s no end to the information people want to share with you. There are the necessary doctor’s updates and CDC advisories and recommended folic acid supplements, but there is also the onslaught of well-meaning advice from people who have been through it. As one newly postpartum friend said to me recently, “If I had actually read everything that people recommended to me when I was pregnant, I would have had a panic attack every day.”
When you’re queer and/or trans and visibly pregnant, however things can look a little different. Even in 2023, many LGBTQ+ families and solo parents find themselves boxed out of the conventional pregnancy, childbirth, and infant-care narrative, unlikely to find medical or practical advice that’s geared specifically toward them and treated with anything from suspicion to hostility.
This is a particularly stark reality given that the number of LGBTQ+ couples raising families of their own has grown in recent years. A 2020 census study found that fifteen percent of the estimated 1.1 million same-sex couples in the U.S. had at least one child under 18 in their household. And there have been more and more depictions of LGBTQ+ families in popular culture of late: Recently released novels by Marisa Crane, Kristen Arnett, and Jacqueline Woodson all depict queer parents. But there still isn’t a wealth of information for LGBTQ+ prospective parents, which leaves many essentially on their own when it comes to figuring out the fertility process. As noted in a 2020 study, LGBTQ+ prospective families often feel obligated to act as “information centers” for physicians, rather than the other way around.
A number of informational books have been published in recent years attempting to fill this gap. Krys Malcolm Belc, a writer whose memoir The Natural Mother of the Child came out in 2021, is a transmasculine, nonbinary father who carried two of his four children. In his memoir, Belc builds essays around documents like his birth certificate or adoption paperwork for the child his wife carried—reminders that while legal and medical information doesn t tell the whole story, it’s also crucial. Belc says he got used to a more “D.I.Y.” approach to information-gathering about issues like lactation support. He cites a few useful books, including the essay collection And Baby Makes More: Known Donors, Queer Parents and Our Unexpected Families, but on the whole, his research has been more informal.“There was this big Facebook group for birthing and nursing transmasculine people that bridged the gap,” he says. (An inadvertent advantage of carrying some of his children: He often felt excluded from the unsolicited advice people would offer his wife, a cis woman, when she was pregnant.)
In April, queer midwives Ray Rachlin and Marea Goodman published Baby Making for Everybody: Fertility and Family Building for LGBTQ+ and Solo Parents, a guide that promises to steer prospective parents through everything from fertility-tracking to navigating the intersection of pregnancy and gender identity. “In my own experience as a midwife and a parent, I saw that there was this lack of knowledge around how queer and trans people create families. The way that people fill this gap is through storytelling: ‘Here’s how I made this decision’ or what have you,” says Rachlin. The book has been marketed as a queer answer to What to Expect, and its breadth and focus on inclusion are impressive; it’s easy to imagine copies of Baby Making for Everybody being passed from friend to friend at barbecues or school drop-offs.
Rachlin and Goodman spotlight a wide array of different family structures: a trio of queer dads in a polyamorous relationship who started their family with donated embryos, a pair of lesbian foster moms who adopted, a a single mom who underwent four rounds of IUI, and a non-gestational trans parent who induced lactation in order to co-nurse her baby along with her partner. “The process can be so overwhelming,” Goodman says. “Especially for trans people, there’s such a lack of accessible information about fertility, and it’s all so gendered and triggering and difficult.” Both authors note that the ideal wouldn’t necessarily replicate the cishet “informational cascade” that can feel overwhelming to many, but carefully provide the facts in a way that isn’t geared toward intimidating or frightening potential new parents. “Ray and I really see access to this information as a reproductive justice issue and believe that everyone deserves the right to grow their families–or not–in the ways they choose,” says Goodman.“I want the next generation of queer people and solo parents to know their options from the get-go,” says Rachlin. “The knowledge that this book is introducing is going to be commonplace in ten or fifteen years–that’s my hope.”
Rachlin notes the impact that isolation can have on mental health for those engaged in this process without resources. “In our larger heterosexual culture around fertility and birth, you don’t talk about pregnancy until you’re out of the first trimester, but for single parents and queer people and trans people, the ‘childbearing year’ begins long before conception. We don’t have a common conversation around that, so people are often really isolated and alone; there’s not a culture of talking about choosing sperm donors or how fragile early pregnancy can feel. ”
Sex educator and writer Ericka Hart, whose long journey toward parenthood finally resulted in the birth of her child East earlier this year, had a certain vision of what their insemination would be like. (Hart, who is nonbinary, referenced the insemination scene in the pilot episode of The L Word, a show that first aired in 2004 yet continues to cast a long representational shadow on the LGBTQ+ community today.) “I had this very Hollywood-rosy idea of how insemination would go, where it’s all beautiful and there’s soft music playing,” admits Hart.
But things went a little differently: “There was a two-year-old in the corner—the doula brought her kid, because she couldn’t find childcare,” they recall. Hart and her partner had planned on an IUI, a-intrauterine insemination, in which sperm is placed directly into the uterus. But the clinic had neglected to inform them that the sperm needed to be “washed”—a process that can improve success rates. “You almost have to become a fertility specialist to do this, because there are so many things people leave out or aren’t necessarily thinking of because they’re not used to working with a queer and/or trans couple.” (Hart s partner is a trans man; heterosexual couples, of course, often have access to an easier supply of sperm.)
As a nonbinary birth worker, Charlie Monlouis has become accustomed to working with queer and trans families within their Brooklyn-based practice, Nourishing Seeds Doula Support. Through that work, they’ve seen firsthand how the societal systems that end up disenfranchising LGBTQ+ individuals hoping to grow their families are often rooted in failures of communication. “We live in a culture that neglects to teach us about our bodies, and particularly our sexual and reproductive health. For example, in sex ed, if we even have access to it, we’re taught how not to get pregnant, but we’re not taught how to get pregnant when that is desired. We’re not taught how to birth or how to care for newborns or how to show up for people postpartum, and trans folks are even more marginalized and alienated from these conversations because of how cis-normative and trans-exclusionary they can be,” says Monlouis.
Obviously, the pregnancy and family-building processes aren’t easy or straightforward for all cishet pregnant people. When you’re a queer or trans person of color trying to start a family, though, things can be exponentially more complex. “Black sperm donors are few and far between, and we wanted a Black donor,” Hart notes. “Out of maybe 400 donors at our sperm bank, there were two Black ones.” (A recent study of four major U.S. cryobanks found that less than 4% of available sperm is from Black donors.) A single vial of sperm ranges in price but can cost up to $2000, putting the process of finding and gathering donor sperm out of reach for many families and (especially) solo parents living on single incomes.
Hart’s experience of assisted conception was sadly not free of “homophobia, transphobia, anti-Black racism or ableism,” they say. “My partner and I were both misgendered multiple times in the fertility-clinic space. We were surprised, because we were like, oh, this is a fertility clinic, they must see queer and trans people all the time.” That said, Hart still was able to find meaning and value in her fertility journey. “Even if the process doesn’t work out in terms of resulting in pregnancy, I do think you will learn about your body, and I found a lot of autonomy in that,” they say. “I didn’t know much about my ovarian reserve, or that one of my fallopian tubes was blocked, or that the Teflon pans we were eating off of probably weren’t great for our bodies, so stuff like that was very powerful for me.”
“Protect yourself and get your people to support you,” Hart advises. “Find a group of people who are also trying to conceive, or talk to your friends with kids about the process, however it may have looked for them.” Monlouis also points to the existence and importance of “horizontal care” among queer and trans prospective parents: “I think there’s a real strength in how we show up for each other and create our own resources.”
