Can men become pregnant?

A person who has been born a male and who lives as a man can not become pregnant. Some transgender men, nonetheless, and some nonbinary people can.

Male reproduction is not possible in most cases like cis-men who have sex with men. Nonetheless, new research into uterine transplants may mean male pregnancy may be a possibility in the future.

In this post, before discussing more about transgender and male pregnancy, we’ll explore the difference between sex and sex.

Is it possible?

Pregnant person
Anyone with an uterus and ovaries may become pregnant and bear

Anyone with an uterus and ovaries could get pregnant and bear birth.

People born male and living as men can not become pregnant. Nevertheless, a transgender man or nonbinary individual can.

A person can only be pregnant if he or she has a uterus. The womb is the uterus, where the embryo lives. Male reproductive organs include a penis and testicles but no uterus.

The words “man” and “woman” refer to the gender of a person, which follows the socially constructed features that differentiate the conventional binary sexes— male and female.

Unlike the biological sex of a person which is determined by the reproductive organs and secondary sex characteristics of an individual, genetics alone does not decide the gender of a person.

Gender for a person may include specific social roles, norms, and expectations that distinguish between men and women.

These characteristics are subjective, and differ between societies, classes of society, and cultures. The gender a person identifies with is dependent on the individual.

Gender is considerably more fluid than biological sex.

At birth, people are typically assigned to be males or females. Those who are “cisgender” men and women who identify with the gender that culture identifies with their biological sex.

Cisgender men who have sex with cisgender men are not allowed to become pregnant.

Not all, however, identify with the gender role associated with their assigned sex. For example, a person who has been assigned to be female at birth (AFAB) but identifies as a man may refer to himself as a “transgender” man or a nonconforming person.

Most AFAB people who identify as men or nonconforming individuals of gender maintain their ovaries and uterus, enabling them to get pregnant and give birth.

People with a uterus and ovaries

People with an uterus and ovaries may get pregnant and give birth.

Many people with AFAB may however take testosterone. Testosterone therapy aims to counteract the effects of estrogen while promoting the production of secondary male sex characteristics, including:

  • muscle growth
  • redistribution of body fat
  • increased hair growth on the body and face
  • deeper voice

Research suggests menstruation usually ends about 12 months after starting testosterone therapy and often within 6 months, which can make it harder but not impossible to conceive.

While testosterone therapy does not make people infertile, a person may have a greater chance for placental abruption, preterm labor, anemia and hypertension.

Researchers surveyed 41 transgender men and gender nonconforming AFAB individuals who became pregnant and gave birth in a 2014 report.

Of those people who reported using testosterone before pregnancy, 20 percent became pregnant before returning to their menstrual cycle.

The authors of this study concluded that previous use of testosterone did not result in any substantial differences in outcomes of pregnancy, childbirth or birth.

The authors also observed that a greater percentage of transgender men who reported prior use of testosterone had a cesarean delivery compared to those who had no history of use of testosterone.

These results do not indicate that testosterone therapy makes people unable to deliver vaginally, as 25 per cent of transgender men who had a cesarean delivery decided to do so based on their comfort levels and desires.

The authors of this study concluded that previous use of testosterone did not result in any substantial differences in outcomes of pregnancy, childbirth or birth.

The authors also observed that a greater percentage of transgender men who reported prior use of testosterone had a cesarean delivery compared to those who had no history of use of testosterone.

These results do not indicate that testosterone therapy makes people unable to deliver vaginally, as 25 per cent of transgender men who had a cesarean delivery decided to do so based on their comfort levels and desires.

Research on transgender pregnancy, however, is limited, so it’s unclear how testosterone can affect a person’s fertility or pregnancy.

Researchers have documented the experience of a 20-year-old transgender man who became pregnant 2 months after he discontinued testosterone therapy in a 2019 case study.

After 40 weeks, after an uncomplicated labor, he bore a healthy baby.

He chestfed for 12 weeks before restarting testosterone therapy, the writers wrote.

Chest feeding may not be possible for people who have had a bilateral mastectomy or other chest surgery.

People assigned male at birth (AMAB)

In theory, uterine transplantation may be a possibility for people living with AMAB.

A uterine transplant is a relatively new surgical procedure involving the transplantation into the body of a person of a healthy uterus.

Even for AFAB people with uterine factor infertility, this surgery is still experimental however. There is insufficient research to confirm whether people with AMAB will conceive and carry a baby to full term.

Doctors will need to take their financial, physical, and mental health into account before a person can consider having a uterine transplant.

If an individual wants to become pregnant, they might need to take a variety of hormones. This will often require replacement hormone therapy (HRT), which usually contains estrogen and progestogen. Once the uterus wall becomes more than 7 millimeters thick, they will need to take a progesterone supplement.

They must also wait 6 months to allow for healing after the surgery. It is only at this stage that an embryo may be transplanted by a doctor.

There may be a chance that the body will be rejecting the new uterus after the surgery. To reduce the likelihood of this happening, a person will need to take immunosuppressants.

A person will take the immunosuppressive agents throughout the pregnancy to ensure the transplant is not rejected by the body, which could expose the fetus to dangerous chemicals. An obstetrician with special training in high-risk deliveries will provide support over the pregnancy period.

Gender-affirming surgeries

Transgender men and individuals with AFAB who are not identified as female may choose to undergo a range of medical treatments and surgical procedures during the process.

Examples of gender-affirming transgeneral surgical procedures include:

  • Male chest reduction or “top surgery”: This procedure involves the removal of both breasts and any underlying breast tissue.
  • Hysterectomy: A hysterectomy refers to the removal of the internal female reproductive organs, including the ovaries and uterus.
  • Phalloplasty: During this procedure, a surgeon constructs a neopenis from skin grafts.
  • Metoidioplasty: This treatment uses a combination of surgery and hormone therapy to enlarge the clitoris and make it function as a penis.

If a person has undergone a partial hysterectomy— which involves removing the womb but not the ovaries, cervix, and fallopian tubes — it is possible for the fertilized egg to latch onto the Fallopian tubes or abdomen, leading to an ectopic pregnancy.

This is exceedingly rare though, and there are only 71 cases on record since 1895 according to a 2015 review.

Summary

Sex doesn’t determine who can get pregnant.

People who identify as men can get pregnant and give birth, and they do.

Medical technology advances could even make pregnancy possible for women who don’t have a uterus.

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