Pregnant transmen shouldn’t be pressured to stop taking testosterone despite the risks it poses to babies, researchers have controversially claimed in a Government-funded study.
Current maternity care guidance for transmen — biological women who identify as the opposite gender — recommends they stop hormone treatment in pregnancy.
The NHS warns it could ‘affect the baby’s development’, with some studies linking exposure to the male sex hormone in the womb to genital abnormalities.
Testosterone is listed as a ‘category X’ substance in pregnancy in the US because of the dangers it poses to a foetus.
But a panel of experts, including three from Britain, said the current advice centres too heavily on preventing babies from developing birth defects.
Objections against the use of testosterone in pregnancy are too focused on creating ‘normal’ babies, they argued.
Instead, the team — given a £500,000 grant by a subsidiary of Britain’s UK Research and Innovation to conduct research on trans male experiences — suggested NHS guidelines should be shifted to better support trans men to live out their gender identity.
The three British experts were sociologists hailing from the universities of Sheffield, Westminster and Glasgow.
American bioethicists Jennifer Lahl and Kallie Fell called the findings ‘insane’.
Writing for the website Reality’s Last Stand, they said: ‘Abiding by their paper’s guidance would land us in a vacuum devoid of medical ethics and a seismic shift away from the importance of scientific research and medical evidence in favor of activist directed healthcare.’
Testosterone is considered teratogenic, meaning that it has been linked to birth abnormalities.
Female foetuses are particularly vulnerable to the effects, scientists believe.
High levels of the hormone in the mother’s body have been linked to problems with genital development, a process called masculinisation.
Studies suggest this can lead to incontinence and infertility, and trigger subsequent psychological consequences later in life.
Writing in the journal SSM – Qualitative Research in Health, the researchers, which consisted of experts from the US, Australia and Italy, argued such concerns should take a backseat compared to the harms trans men might experience from not taking their hormones.
‘Both patients and providers tend to pursue precautionary, offspring-focused treatment approaches,’ they wrote.
‘These approaches reinscribe binarized notions of sex, resulting in social control in their attempts to safeguard against non-normative potential future outcomes for offspring.
They based their arguments on a survey of 70 trans people, as well as answers from 22 health care providers who worked with trans people.
Most trans men they quizzed had fears about ceasing testosterone treatment during pregnancy, it was claimed.
Worries included the fear of losing facial hair, change in voice and being mistaken for a woman.
Other feared being misgendered, which could result in ‘increased levels of body dysphoria and depression’.
Some volunteers described their opposition to ceasing testosterone while pregnant, explicitly stating they had wanted to be a ‘pregnant man’.
Healthcare providers offered mixed answers in what guidance they provided.
But most offered a ‘precautionary’ approach, warning trans men about the potential risk testosterone posed to their baby.
The authors were critical of this approach, writing stating such advice ‘may not take into full consideration the degree to which some trans people’s sense of self and wellbeing is linked to continuing testosterone therapy’.
