‘all pregnant people’ training

The Free Training

Trystan Reece runs an LGBTQ training consultancy called Collaborate Consulting and has developed a module aimed at healthcare workers helping ‘all transgender people’ through pregnancy. All Pregnant People is available online and costs €150.

First of all I worked through the free content, comprised of three videos, one in which Trystan introduces herself, a 2 minute ‘humility’ video, and finally Trystan having a proper whinge about being misgendered on maternity wards.

Trystan tell us she’s involved with an LGBTQ organisation called Family Equality which advocates for surrogacy, which she also does herself on a personal level.

‘Family Equality’s mission is to advance legal and lived equality for LGBTQ families, and for those who wish to form them, through building community, changing hearts and minds, and driving policy change.’
_{FROM FAMILY EQUALITY’S WEBSITE}

Trystan claims she has already trained several hundred midwives (‘birth workers’). The training is for anyone involved in the birth process (‘birth photographers, lactation consultants, naturopaths’).

The training gives us the chance to grow ‘as an ally, as an activist, as an advocate and a person’. Trystan assures us that she believes in science and that all the data she quotes is fully citated, though of course ‘community based information is really important as well’ and that ‘data has been used against trans people’ – making the very first message in the training utterly confusing.

The Full Training Materials

Since the course was free at the time of writing I accessed the full training. I watched a segment entitled ‘testosterone and fertility’. Trystan ‘I believe in science’ advises her students that testosterone is a form of birth control. ‘I really really encourage educators to trust trans people to hold the complicated nuance of correct information.’

She goes onto claim ‘every bit of evidence that I could find seems to suggest’ that fertility can simply be reset once testosterone is stopped. Even if a woman has been on testosterone for more than ten years they should be able to conceive just like everyone else and that there are no additional complications.

(This simply isn’t true. Most women who have taken testosterone long term require hysterectomy due to muscle atrophy. Uterine muscles which have atrophied are very high risk for miscarriage and that’s without the added complication of virilization of eggs.)

However, Trystan does concede that testosterone is not good for a developing foetus and advises that it should be stopped right away in an unplanned pregnancy (a possibility on low dose testosterone). It’s telling that she chose the word foetus over the more correct term, embryo.

Now here’s something I never considered. When do you restart testosterone after giving birth? Well if you have had a ‘genital birth’ the wait time is only 6-8 weeks. If you had caesarian it’s 3-4 weeks because ‘testosterone does promote the promotion of red blood cells which can help heal a surgical wound’. Trystan says ‘there’s reason to believe that testosterone may help you heal better from a caesarian wound’ and then tellingly shrugs, rolls her eyes, and says ‘this is just based on what we know about the body’ and giggles. Then she pulls a serious face and qualifies her statement with ‘but there are no specific studies on this’. Of course there aren’t, it’s gobbledegook.

‘Should you start testosterone while nursing your baby?’ is the next question. ‘We don’t know!’ screams Trystan jubilantly and waves her arms. Adult desires are kinda more important than babies since we really don’t know there aren’t enough studies yet but yikes it could be a possibility so if you have any doubts whatsoever then bottle feed. Great clear message there.

There are quizzes too:
When a transgender person with a uterus stops taking testosterone, how long does it take for their menstrual cycle to return (on average)?
A. Six months to one year
B. Three to six months

The ‘correct’ answer is 3-6 months, this is according to this study on trans pregnancy, in which Trystan says it says all participants had their periods return within 6 months. Someone more clever than me can analyse what this paper actually really says, though one thing which occurs to me right off, is that they didn’t speak to any women who were completely infertile as a result of testosterone in the first place, making the results of the study practically void.

Another question:
True or false? Transgender women have successfully induced lactation and have been able to feed their babies exclusively using breast milk.
To which the answer is obviously ‘true’.

The training also covers those women who are transgender or non-binary and who may have not medically transitioned. This group apparently has a worse experience than women who have taken testosterone and may be male-appearing. Trystan says un-transitioned women are especially traumatised as they are forced to come out as transgender over and over and over again.

Other women’s stories

Four other women are interviewed by Trystan about their pregnancy and birth experiences.

A non-binary identified woman who works for a large tech company and chose to get pregnant via egg donation (her wife’s) and sperm donation, making her in actual fact a surrogate mother. She also egg donated so that her wife could give birth to her child at a later time. She claimed that egg retrieval only took a couple of weeks, whereas my understanding that it takes at least a couple of as the follicle stimulating hormones are to be taken in careful succession before the surgical procedure can be undertaken. Her main issue was that because she didn’t have a beard, and still looked very much like a woman, no one knew she needed they/them pronouns.

Another woman, a palliative care nurse, needed a doula all to herself as she didn’t want to be in class with ‘cisgender women’ (remember this isn’t a mental illness). After the birth she experienced hypertension, pituitary gland partial death (it controls sexual reproduction) and a fractured pelvis, and you have to wonder to what extent these complications were bought on, or may worse by, previous testosterone use.

Another testosterone user decided to have a child following a suggestion made by a friend whilst high on acid – ‘it’s in your past’ the friend told her. She concurred. That was the Sunday and then the conception happened a few days later during an orgy with friends on the Thursday night. The pregnancy was not medically observed. Trystan is on the split screen, laughing away.

The fourth woman had been a testosterone user but stopped early into it so she could get pregnant. She tells a very complicated and traumatic story, although she also expresses delight at the beginning of the interview that she will be paid $150 for her story by Trystan. She’s very young. It’s difficult to know quite what’s going on and how much of the story is true.

Institutional support

The training is supported by the Health Care Coalition of Southern Oregon which exists to achieve ‘health equity’ and receives federal and state grants. HCCSO has a specific focus in perinatal care, general maternity care, baby care and substance abuse. It really is an upside down world.