Everything a Prospective FTM Parent Would Like to Know

Frequently asked questions on parenting and FTM

http://oocities.com/fasterthanlife_2000/ftm.html

While there are excellent FAQ (Frequent asked questions and their answers) for hormone application for the change of secondary sex characteristics towards both a more masculine appearance or a more feminine one they rarely touch the question how this is to be brought in alignment with the desire to found a family. Of course it is theoretically possible to adopt or have children via surrogate partners, both options are not legal in all countries or states and usually even extremely difficult to achieve for the average heterosexual couple. Most people eventually give up on adoption because it’s a very difficult and often expensive process. Having own children is the easiest way to found a family. The option of choice is sperm storage for FTM transgendered people (especially who are lesbian) and pregnancy for FTM (especially those who are in a gay relationship or single). This page deals with the medical implications of this tasks.

Question 1 Does Testosterone administration inhibit ovulation and thus prevents pregnancy reliably?

A: yes it does, if a dosage of approximately 250 mg Testosterone (cyprionate a.g. depot-testosterone) is administered every 12-21 days. With dodecanate 4 weeks can be sufficient. For first time users the period must have been gone for at least 2 months to be safe.

A higher doses does not prevent pregnancies better, in contrast it can lead to the conversion of testosterone (T*) into oestrogens. In this case ovulation can reoccur. Some notice spot bleeding. If you want to be secure have a test at your endo, which would be a good idea now and then anyway. Another option would trying out one of these hormone-test, pregnancy prevention kits, which are sold as contraceptive guides. I don't know if T* interferes with their use, ask a endo first if that will work.

Fertility reoccurs depending on the age (after 35-40 fertility might not reoccur but this is not scientifically proved). Due to a rebound effect (body thinks no hormones are present and will produce much more than the average level) the fertility can be increased, medicine has routinely administered T* both to men or women for this purpose. Fertility can come back before a period happens. The effect will be most pronounced after short T* administration 6 months to 14 months.

Question 3: if I take T* will this prevent sexually transmitted diseases?

No. You still must use a condom, or you might contract AIDS or nasty and very dangerous diseases like Syphilis, Gonorrhea, or the nasty tripper. Although you can be vaccinated against Hepatitis B there are other Hepatitis variant where no vaccine is available. Did you know that more people are dying every year in Europe and the US from Hepatitis than AIDS ?

Testosterone decreases fertility while being on medication. After stopping testosterone he will experience a rebound effect, e.g. increased fertility. The amount of this effect will vary depending on hormone intake, duration and individual. I would recommend a fertility test. A do-it-yourself screen can be done using this urine-hormone-check devices sold for contraception, but a more reliable test can be performed by endocrinologists or gynecologist if there is a doubt if the fertility is regained/sufficient. To increase fertility various medications is possible as well.

Question5: He currently lives and passes as male in all respects. He's had top surgery, has a great deal of facial/body hair and a very masculine physique. He would not desire to remain to off testosterone for long. The goal the couple has is to have their own child with the minimum of legality concern and they feel that one of their options is for the F2M to conceive, bear the child, and return to the testosterone therapy as soon as practically possible, as he in no way wishes to return to a feminized state at all/for long.

In my opinion he will be able to pass as male during the whole pregnancy term, people will assume he is overweight most likely. A tip would be - as he had top surgery - to pack (if he can stand the heat) on top, to level things out a bit. If he wouldn't have had top surgery breast growth would have done that.

Depending on the kind of top surgery he had, breast growth might occur, I doubt he will be able to nurse however as the milk channels will have been cut. To prevent complications I would recommend to take a drug which stops the milk production immediately after giving birth, he will have to demand this in case it will be forgotten. for pregnancy related questions I recommend the book of Kinziger.

I think what he is doing is a courageous but rewarding decision, my compliments.

I would expect that in future, as more FTM transition relatively young that cases like him will increase. Therefore I would caution against sterilization in young FTM, as they might regret it later.

Regarding general health, a new antibody-pap test will soon be approved for US market which might be more reliable for the FTM population as it traces the virus directly.

Question 6: The F2M has been on testosterone hormones for about 4/5 years, and currently has the implanted pellets form. He mainly wants to know if he would need to go off testosterone to conceive. He reports having a monthly cycle up until approximately 3 months ago. What happens when he does it?

It should be self-evident, but he will have to have the implants removed. It sounds strange that he had a monthly cycle, but that can be even a good sign for his purpose to have a child. Probably the T* dosage is too low to prevent ovulation.

There will be no medical complications for him going off T*, he will not loose his facial hair, but body hair will decrease a bit.

I would be interested to know something else, I would like to know what will happen to his genitalia....I guess first his penis (clitoris) might shrink a bit after discontinuing testosterone, but I wonder if he will experience a second growth spurt after pregnancy and returning to testosterone.

Question7: When can he return to T* treatment?

It is safe to return to testosterone after the uterus has contracted again and is completely healed (6 to 12 weeks) after giving birth.

Question8: Has it been done before?

Yes. Numerous FTM have given birth before transitioning and several after. I know of one case where a FTM who started T* at 19 became pregnant at 29 after almost 10 years of use of T*. So it can be done.

Question 9: Does it affect the identity? Could it cause confusion?

Generally all FTM reported a strengthening of their conviction to be male. The hormones involved in pregnancy seem therefore not to disturb a male gender identity. I think they enforce the identity which is already present in the case of FTM this one is male. A bit confusing is that textbooks always refer to the person who is pregnant as she, mother or women and not in a gender neutral way. The reason of this is simply a statistical one, if more FTM would become pregnant and more FTM would exist in total this might change. As the FTM population is small there is not much hope there, alas.

Question 10: Can FTM breastfeed? How will affect body image?

If they do not take hormones, they can. A direct switch after birth to T* might negatively affect the uterus and belly musculature, so I wouldn’t recommend it. Breast feeding reduces belly and helps the uterus to contract. Also it’s an easy, cost-efficient way to raise a child in the first month. The switch to T* can be done directly afterwards.

Question 11: What happens to breast size?

Question 12: What happens to the breasts during pregnancy if I still have them?

They grow. This however conceals the growth of the belly, which will make you appear more than a fat guy than a pregnant women if you wear loose clothing. So there is a bright side of the whole matter.

Question 13: Can FTMs pass as male until birth? Yes. But it depends how well you passed before. During the second/third month pheromone segregation can reduce passing drastically. Afterwards this stops. In the late stages passing reduces, this was the only time in my life flirting lesbians seemed to pop up everywhere. Other people tried to figure out if I was male or female and I got some snide remarks, nothing outright physically aggressive however. I took it as a compliment, obviously I turned from male into ambiguous, I never realized that I passed so well to strangers I didn’t talk to.

Question 14: will people notice the pregnancy?

Some will, some won’t, many of my colleagues didn’t notice and I worked up to 5 days before.

Question 15: How do you explain this to people that the kid has two daddies?

Well, contrary to people's thinking I have so far never had to provide a birth certificate - except the day I opened a bank account for her, not for kindergarten registration, international travel, visas. People assume I am the dad. Yes, people ask: where is mummy - constantly, but as a small talk question. In the age of divorced families it's not too evasive if one replies there isn't any, and it'd be a complicated/long story.

It's nothing to be ashamed of to be FTM and usually people are very accepting. If they start having a problem it might be they don't have a problem with you, rather than with their own perception of identity and gender.

As a single dad people are usually very accepting and offer to baby sit etc, when they hear that there is no "mummy"

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