Rutgers study reveals increased depression in pregnant trans men

Photo by Kelly Burkhardt

A lack of gender-affirming knowledge among health care providers and difficulties accessing medical care places pregnant trans men at a higher risk of experiencing depression and avoiding care, a new study out of Rutgers University found.  

The review, published in the scientific journal “Maturitas,” examined existing health care research documenting the experiences of trans men who become pregnant at or after age 35. 

The study’s goal was to better inform medical professionals on working with the population, contextualize the long term impacts pregnancy has on trans men’s physical and mental health and explore how it causes gender dysphoria, said lead author Justin Brandt, assistant clinical professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School.

The analysis found that attitudes surrounding reproduction among trans men are similar to those of their cis peers. It also points out a lack of research on trans men who become pregnant and calls for increased efforts to clarify the prevalence of pregnancy among trans men, its risks and long-term impacts and guidelines for medical practitioners. 

About 1.4 million trans people live in the United States, according to a 2016 study by legal think tank Williams Institute. Some trans men choose gender-affirming hormonal treatment or surgery, while others retain the reproductive organs they were born with, retaining the ability to become pregnant.  

Informed, gender-affirming care has been improving over the last several years, Brandt said, though medical professionals usually have to work hard to gain exposure to the knowledge. In Brandt’s own training at hospitals affiliated with Cornell University and the University of Pennsylvania, he said he worked with a small number of trans folks.

“In general, OBGYN providers need to seek out the experience and think about how they can create a gender-affirming clinical environment,” Brandt said, “starting from when patients come through the office, meeting the front desk, coming in, to how they identify themselves with their gender, the pronouns that they select and the names that they choose.”

A desire to improve the environment and gender-affirming care offered at Rutgers’ medical facilities inspired Brandt to spearhead the recent study. From his personal life, Brandt said, raising an 8-year-old nonbinary child opened his eyes to the importance of providing such care to young patients. 

“OGBYN is the first place where some young children and adolescents are going to acknowledge that they have gender dysphoria and question their gender identity,” he said. “OGBYNs need to be prepared to treat everybody in order to provide that care.”

A widespread lack of trans-informed knowledge in the health care world drives many to pursue birth alternatives like midwives, birthing centers or staying home, Brandt said. While Rutgers’ medical facilities have yet to work with a pregnant trans male patient, he added, the institution is “gearing up so that we’re prepared.”

Rutgers Robert Wood Johnson Medical School is home to the Gender Center of New Jersey, led by Drs. Ian Marshall, associate professor of pediatrics, and Gloria Bachmann, professor and interim chair of Obstetrics, Gynecology and Reproductive Sciences. The facility seeks to provide medical services to trans patients seeking various levels of gender-affirming care across all ages. Bachmann and Marshall co-authored the new study. 

Brandt said he hopes the study impacts the medical community by drawing attention to the need for devoted research of pregnant trans men. He also pointed to the need for a survey that better assesses and monitors depression among the demographic. 

“I just wanted to make sure all people have a place to get good obstetrical care where I work,” he told PGN. “This is my little contribution.”