Unintended and teen pregnancy experiences of trans masculine people living in the United States

Abstract

Background

Trans masculine people are more likely than cisgender peers to have a teen or unintended pregnancy, though little is known about the origins of these disparities.

Aims

This study aimed to describe teen and unintended pregnancy experiences among trans masculine people in order to elucidate risk factors and pregnancy-related needs.

Methods

As a part of the United States-based SexuaL Orientation, Gender Identity, and Pregnancy Experiences (SLOPE) study, in-depth, semi-structured interviews were conducted between March 2017 and August 2018 with 10 trans masculine people, ages 20–59 years, who experienced a teen or unintended pregnancy. Audio-recorded interviews were professionally transcribed, then analyzed using immersion/crystallization and thematic analysis approaches. The themes were contextualized using sociodemographic survey data.

Results

The four themes that were developed from participants’ narratives highlighted: 1) how trans masculine people navigated having a pregnant body (e.g., heightened gender dysphoria due to being pregnant); 2) the importance of the cultural environment in shaping experiences as a trans masculine pregnant person (e.g., pregnancy and gender-related job discrimination); 3) the development of the pregnancy over time (e.g., decision-making processes); and 4) how pregnancy (and gender identity) affected relationships with other people (e.g., adverse family of origin experiences).

Discussion

This study identified a number of risk factors for teen and unintended pregnancies among trans masculine people including physical and sexual abuse as well as ineffective use of contraception. This research also identifies unique needs of this population, including: relieving gender dysphoria, combating discrimination, and ensuring people feel visible and welcome, particularly in reproductive healthcare spaces. Public health practitioners, healthcare providers, and support networks (e.g., chosen family) can be key sources of support. Attention to risk factors, unique needs, and sources of support will improve reproductive healthcare and pregnancy experiences for trans masculine people.

Keywords:

• Contraception
• pregnancy
• pregnancy in adolescence
• qualitative research
• transgender
• unplanned

Disclosure statement

No potential conflict of interest was reported by the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Funding

National Institutes of Health (F32HD084000, F32HD100081, R00HD082340), American Cancer Society (MRSG CPHPS 130006), Maternal and Child Health Bureau (6T71MC00009), Society of Family Planning (SHPRF9-18), Aerosmith Endowment Fund for Prevention and Treatment of AIDS and HIV Infections at Boston Children’s Hospital, and the Boston Foundation.