Trans and non-binary pregnancy, traumatic birth, and perinatal mental health: a scoping review

Abstract

Background: Many trans and non-binary people wish to be parents. However, few countries record figures for trans and non-binary people becoming pregnant/impregnating their partners. Pregnant non-binary people and trans men may be growing populations, with heightened vulnerabilities to traumatic birth and perinatal mental health difficulties (i.e. pregnancy-one year postpartum).

Aim: To conduct a scoping review on traumatic birth and perinatal mental health in trans and non-binary people to identify research evidence, summarize findings, and identify gaps.

Methods: Electronic databases were searched to identify published English-language evidence. Eligibility was not restricted by type of study, country, or date.

Findings: All studies were from the Global North and most participants were white. The literature focuses on structural and psychological barriers faced by non-binary people and trans men and on the lack of reliable medical information available. There is a lack of empirical research and, to date, no research into trans and non-binary parents’ experiences has focused on traumatic birth or perinatal mental health. However, common themes of dysphoria, visibility, isolation, and the importance of individualized respectful care indicate potential vulnerability factors. Trans women’s and non-binary people’s experiences are particularly under-researched.

Discussion: The themes of dysphoria, visibility, and isolation present a series of challenges to pregnant non-binary people and trans men. These coalesce with external events and internal choices, creating the potential to make the individual feel not man enough, not trans enough, not pregnant enough, and not safe enough during pregnancy, birth, and the postpartum. Further research involving trans people is needed to inform future services.

Keywords:

• Birth
• dysphoria
• mental health
• non-binary
• perinatal
• pregnancy
• trauma
• transgender

Disclosure statement

The authors declare they have no conflict of interest.

Ethics

Ethical review was not required due to this being a review.

Notes

1 Although quality assessment did not form part of eligibility assessment, one paper (Lothstein, L.M., 1988, Female-to-male transsexuals who have delivered and reared their children, Annals of Sex Research, 1, 151–166) was excluded on ethical grounds. In reporting the perinatal experiences of trans men, the author referred to the participants as women, using female pronouns throughout. In addition, the author underlying assumption positioned being transgender as a mental disorder and reported a psychiatric diagnosis for each of the participants. Given the author evident biases, it seemed questionable whether the points represented the participants perspectives.

Additional information

Funding

The first author was supported by an ESRC Fellowship [grant no. ES/T006099/1]. The second author conducted a portion of the research at the University of Leeds, UK.