A transgender man who gave birth has criticised information given to trans people at the beginning of their transition as being equivalent to “de facto sterilisation” because it misinforms people of their parenting options later in life.
Freddy McConnell, who has an 18-month-old son and made a documentary about his experience of pregnancy and parenthood, called Seahorse: The Dad Who Gave Birth, is among the few trans men in the UK to have given birth.
Speaking to Sky News, McConnell – who started testosterone therapy known as ‘T’ in 2013 – said he was told at the time the drugs would make him infertile.
“I remember signing a consent form to start testosterone and thinking ‘well this is it, I just won’t have biological kids’ and I’ll figure out what to do in the future,” he says. But this was not the case as McConnell went on to conceive and carry a baby in 2018 with donor sperm.
“I should never have been put in a position where I thought I was signing away my fertility,” he told Sky News.
In some countries, including Japan, trans people are required to be sterilised before they start transitioning. This was also the case in Sweden until 2012.
This is not the case in the UK. However McConnell suggests that because of the misinformation given to trans people when they start transition, many are doing it under the belief they’re signing away their chance at biological parenthood.
“By paying such little attention to trans people’s wishes to start families and have full lives, and not just the lives that they dictate through this narrow sense of what it is to transition, it is in fact de facto sterilisation,” he said.
McConnell started transitioning six years ago, and since then more information and support has become available to prospective trans parents.
The Tavistock and Portman NHS Foundation Trust, which runs the Gender Identity Development Service [GIDS], told HuffPost UK: “The implications for fertility of hormone blockers, followed by cross-sex hormones, are explained and discussed recurrently with the young people who wish to access medical interventions with GIDS. They are encouraged to seek further information on fertility preservation from their relevant local service if this is something they think they may wish to have recourse to later.”
Some parents of trans children say they are still confused by this advice and agree with McConnell that the information available should be clearer.
Sarah*, a mother of a trans boy, whose name has been changed to protect her and her son’s identity, told HuffPost UK: “As supportive parents to a now 8-year-old boy who was assigned female at birth, we had our first call with our NHS gender clinician when he was six.
“Having read in numerous publications that, in future, the options when taking testosterone were either to have a hysterectomy or have an increased chance of cancer, I asked the clinician to explain what the future might look like for our son’s [fertility] in terms of medical intervention.
“I was told that, while there is little research on the subject, my understanding about the [lack of] choices my boy would have was right. Naturally, it left us as parents with a crushing weight bearing down on us that we were going to need to make life-affecting decisions in the not too distant future.”
Sarah says the “enormity of this decision” impacted the whole family and her own mental health. “So to watch these myths being busted by Freddy rocked our world. Doctors and specialists really need to be more clear about the effect medical choices really have on people because it’s so confusing,” she said.
For most people who want to begin transitioning, the first point of contact in the healthcare system will be a GP – but are doctors equipped with accurate advice?
In a policy document shared with HuffPost UK, the Royal College of General Practitioners advises: “General practice plays a vital role in ensuring these patients receive the care they need. GPs are expected to approach the holistic care of gender-questioning and transgender patients as they do with every patient – openly, respectfully, sensitively and without bias.”
“GPs face difficulties in accessing gender identity specialists in a timely way which often has severe implications for the mental and physical health of their patients.”
The RCGP goes on to acknowledge that most GPs are not experienced in treating and managing patients with gender dysphoria and trans health issues. Gender dysphoria and gender identity issues are not part of the GP curriculum or training and GPs are currently required to refer patients experiencing gender dysphoria to a specialist in this area for assessment and advice on treatment.
“GPs face difficulties in accessing gender identity specialists in a timely way which often has severe implications for the mental and physical health of their patients. As such, GPs are under increasing pressure to provide services which are usually provided in specialist clinics, as they lie outside the remit of a GPs generalist expertise, with limited access to specialist support,” it said.
The RCGP said the solution is to “urgently” increase the capacity of gender identity specialists and clinics across the UK, as well as expand the understanding of gender variance issues across the entire health system. It adds that there also needs to be more “definitive knowledge” about the outcomes for patients of interventions or ‘wait and see’ policies.
A spokesperson for the transgender children’s charity Mermaids UK says: “We must make every effort to ensure that information being given to transgender people is accurate. Freddy is quite right that many trans people are confused about the impact certain medical pathways will have on their fertility.
“There is also a lot of wilful misinformation on this sensitive and important subject on the internet and in the popular press. The children, teenagers and families we support should be able to look at the options ahead of them without being misled by inaccurate information from people they ought to be able to trust.”