In 2020, when Danny Wakefield gave birth to their first kid, a number of problems that transgender parents confront in the healthcare system came to light.

Wakefield, 36, who identifies as transgender and also uses they/them pronouns, says of her pregnancy: “I had a pretty rough pregnancy.” Wakefield claims that during their visits to the emergency room, they encountered “snickers” from the nurses as well as “doubt, incredulity, and a lack of competence” from doctors unprepared to address their requirements.

Because they didn’t think I was pregnant, it took an hour and a half in one case for them to treat Wakefield, she claims.

“The doctors and nurses would talk quietly among themselves, asking each other questions about me, instead of asking me directly — the patient who’s sitting right in front of them.”

Stories like Wakefield’s are not uncommon, says Dr. Juno Obedin-Maliver, assistant professor in the Department of Obstetrics and Gynecology at Stanford University School of Medicine. That’s mainly because the medical establishment — and society at large — has little knowledge about pregnancy in the trans male population.

“We grow up in a world with books, from preschool on up, that until very recently have not imagined or really represented the diversity of communities as they are,” Obedin-Maliver tells Yahoo Life. “None of our systems have been designed to delineate the difference between somebody’s gender and somebody’s pregnancy capacity.”

That’s slowly changing, Obedin-Maliver points out, due to a growing demand from transgender patients — and because more and more are sharing their stories, as with a recently trending New York Times Op-Doc about a trans man giving birth in a small town in Mexico.

Obedin-Maliver says, until society acknowledges the basic truth that “anyone born with a uterus, ovaries and tubes” has the capacity to become pregnant, there will always be a lack of accurate research and data, leaving trans parents at a disadvantage.

Trans Men Can — And Do — Give Birth

In accordance with Obedin-Maliver, transgender guys can become pregnant in the same manner that anyone with reproductive organs can. Transgender men are people who were born with female anatomy but live as and identify as men. That covers both sexual penetration with a sperm-bearing partner and the use of assisted reproductive technology (ART), such as intrauterine insemination (IUI) or in vitro fertilization (IVF).

Trans masculine pregnancies are not well understood because of the dearth of study on them and because they are not widely publicized. The idea that trans guys on testosterone are unable to become pregnant is one of the biggest, according to Obedin-Maliver.

Although more research is needed to determine how testosterone affects ovulation in general, taking the hormone does not make it impossible to conceive.

She clarifies that there is a distinction between ovulating and having a period, or not. In the body, those are actually separate yet connected processes. Therefore, it’s possible that a person using testosterone may not be menstruating anymore but is still ovulating or producing eggs. She continues, “That’s true for everybody [with female reproductive organs], and sometimes makes it hard for people to know whether they are pregnant since they’re having sex with sperm involved and we don’t know how much testosterone slows ovulation down.”

The people who need to hear it the most frequently don’t understand it.

Kayden Coleman, a gay transgender man — meaning his gender is trans male and his sexual orientation, something separate and different90, is gay — is father to two daughters, 9 and 2, and has been on testosterone for 14 years. He went off during both pregnancies at the advice of his doctor but was still taking doses of the hormone when he discovered he was pregnant — both times unplanned.

Coleman tells Yahoo Life that “there are many doctors who are providing testosterone to transgender males and selling them this idea that they’ll somehow be infertile or not be able to get pregnant.” You can become pregnant as long as you have sex with someone who produces sperm.

Wakefield experienced something like. They were informed they “would not be able to conceive or carry a kid since it would serve as a natural birth control” when they initially started taking testosterone ten years ago. Wakefield ultimately became pregnant against her will.

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Sonny Witt, a trans father in Australia who gave birth in 2022, planned his pregnancy through IVF. At the advice of his doctors, he went off testosterone during the egg-retrieval process (as well as during the pregnancy itself).

He started up again “about three months” after giving birth.

In some cases, trans men may choose to pause their hormone treatments in an effort to get pregnant, but this step is sometimes unnecessary — and those considering it should consult with their doctor beforehand. And again, not all transgender men use testosterone, just as not all keep their uteruses.

As for Witt, 30, he says he had no idea pregnancy was an option until he started seeing other trans dads sharing their journeys online. That’s when he decided to make his dream of fatherhood a reality by reaching out to a “rainbow clinic,” specializing in LGBTQ family planning.

“I had no idea that this was available to a trans person,” he tells Yahoo Life, “which is why I have publicly shared my own journey. I want more people to be aware that this is a possibility.”

Shon McCloud, a Virginia-based U.S. Army vet who identifies as trans, is currently pregnant with his first child, conceived naturally with his male partner. His doctors considered the pregnancy “high risk” because he was on testosterone during conception, which is partly why he has paused taking the hormone until after giving birth.