However, it is not currently possible for cisgender men, or anyone without a uterus and ovaries, to get pregnant. On the other hand, research on reproduction possibilities for everyone is ongoing.
This article explains how pregnancy relates to sex and gender and how some men can get pregnant. It also discusses information about gender nonconforming pregnancies and research into male pregnancies.
Terminology
Below are definitions of some terms used when discussing sex and gender.
Gender: This term encompasses expressions, identities, and societal roles.
Cisgender: This refers to people whose gender corresponds to the sex they were assigned at birth. For example, someone assigned a female at birth whose gender is a woman is cisgender.
Transgender: This refers to people whose gender does not correspond to the sex they were assigned at birth. For example, someone assigned female at birth whose gender is a man is transgender. Some people include other gender identities, such as nonbinary or gender nonconforming genders, as transgender.
Gender nonconforming (GNC): This term describes gender identity or expression that does not match social norms or expectations of gender and how it relates to sex. Someone who is transgender may be considered GNC, as their gender does not correspond to traditional expectations of sex and gender.
Assigned female at birth (AFAB): AFAB refers to people assigned female by others at birth. This can include both cisgender women and GNC people.
Assigned male at birth (AMAB): AMAB refers to people assigned male by others at birth. This can include both cisgender men and GNC people.
At birth, clinicians assign people a biological sex. This label is used to represent various physiological characteristics, including:
- the reproductive organs and genitalia
- hormone levels
- genetic structure, such as having male (XY) or female (XY) sex chromosomes
Sometimes, people assigned a particular sex have a different gender. For example, a person whose sex was assigned female at birth may identify as a man.
Other people can be intersex: A person has sexual or reproductive features that do not fit the medical requirements of female and male as expected.
As a result, some men may have the features necessary to become pregnant or carry a pregnancy, such as ovaries and a uterus.
It may be possible for people with an adequate level of fertility and an intact uterus and ovaries to conceive a pregnancy. This can include transgender men and GNC people born with these reproductive features.
Some GNC people may undergo therapies to affirm their gender. While some gender-affirming therapies may affect reproductive organs and hormones, pregnancy can still be possible in some cases.
A 2021 overview suggests that transgender men with an intact uterus experience similarly high rates of unplanned pregnancy than cisgender women.
However, other gender-affirming treatments for transgender and GNC people may impact a person’s ability to conceive.
Below are some explanations of how different treatments may affect fertility and conception.
How hormone therapies may impact fertility
Hormone therapy with testosterone may decrease fertility for some people because it can stop menstruation and ovulation.
However, it’s still possible to become pregnant while taking testosterone, even if you experience changes in your menstrual cycle. This is because while testosterone can affect fertility, it’s not a form of contraception.
However, it is not recommended to become pregnant while taking testosterone because it can affect the development of fetuses. Instead, a person may need to pause hormone replacement therapy during conception, pregnancy, and nursing.
Therapy to suppress puberty in adolescents with gonadotropin-releasing hormone agonist analogs (GnRHa) may also decrease fertility, according to a 2019 review. However, some of the effects of GnRHa therapy may be reversible.
How surgical therapies may impact fertility
A few reports show that people who have had genital or reproductive organ surgeries have been able to become pregnant.
A 2014 report describes one case in which a person with a phalloplasty or metoidioplasty carried a pregnancy. Phalloplasty and metoidioplasty are both surgeries that can construct a penis.
To carry the pregnancy, the person used procedures such as:
- artificial insemination
- in vitro fertilization (IVF)
- gamete intrafallopian transfer
However, in many cases, gender-affirming surgeries may make pregnancy impossible. Surgeries that may prevent pregnancy include the removal of the uterus or ovaries.
It is possible to become pregnant and give birth after surgeries to the chest.
GNC people assigned female at birth may experience similar symptoms and complications to cisgender women.
However, in general, there is a lack of high quality research into childbearing in GNC and other people who may have undergone gender-affirming care.
As a result, it is unknown whether GNC pregnancies have the same or higher rates of pregnancy complications as in other groups, such as cisgender women.
Read more about pregnancy complications and high risk pregnancies.
As with other topics, research on the process and effects of giving birth for GNC people is limited.
For some transgender people assigned female at birth, vaginal birth is possible. Others may elect cesarean delivery. Researchers suggest this may be due to feelings of dysphoria and distress around vaginal birth.
Like other people who become pregnant and give birth, GNC people may experience perinatal depression. “Perinatal” refers to the time soon before or after birth.
A 2020 review suggests that rates of perinatal depression may be higher for transgender men. However, the exact frequency and extent of this depression are unknown.
Following birth, some people may want to nurse the infant themselves. Some people assigned female at birth may be able to chestfeed, even if they’ve had gender-affirming surgery to the chest.
However, for many others, this may not be possible. This is because some gender-affirming surgeries, such as mastectomies or free nipple grafts, may affect the glands, nerves, and ducts responsible for milk production.
Also, a baby may find it more difficult to latch onto the nipple if the chest has less soft tissue. Binding to reduce the appearance of soft tissue in the chest may also increase the risk of a mastitis infection while chestfeeding.
Contact your doctor or midwife for advice regarding chestfeeding and the postpartum period.
Learn more about mastitis, including its causes and treatment.
Many clinicians and drug manufacturers consider it unsafe to chestfeed infants while taking testosterone. Also, topical testosterone products applied to the skin can harm infants and children if they come into direct or indirect contact.
Always consult your doctor before chestfeeding if you have received any gender-affirming care, including hormone therapy. Use medication following your doctor’s or the product label’s instructions, including when not to use it.
Others may start to produce milk even if they do not want to chestfeed. Your doctor can provide advice on stopping milk production or other support.
Some people may experience gender dysphoria during conception, pregnancy, birth, or postpartum. Many features of pregnancy and birth link to stereotypes of gender and sex and cause gendered or uneasy feelings.
There is also a lack of gender-sensitive resources on pregnancy. Not all clinicians consider gender sensitivity during care or accommodate the needs of gender nonconforming people. Also, some GNC people may face stigma.
The nonprofit organization Family Equality offers guidance and support on family building and reproduction for transgender and GNC people.
Counseling or therapy may also help your experience.
Read more about gender dysphoria, including available support resources.
There is no known evidence of pregnancy in people assigned male at birth. Pregnancy has also not been observed in people who did not have a uterus and ovaries due to other reasons, such as having surgery to remove them.
However, research into reproductive science continues. Some people say reproductive science may one day allow pregnancy in those who did not previously have a uterus or ovaries.
Uterus transplants for pregnancy
Some people assigned female at birth have been able to give birth following uterus transplantation, according to a 2021 review. The research, which looked at 12 cases of live births, found that the live birth rate of infants per successful transplant was 79%.
Due to the success of some uterus transplants for cisgender women, some people have suggested that this procedure may be possible for people assigned male at birth or others without complete female reproductive organs.
For this procedure to be successful in people assigned male at birth, other treatments may be necessary to address additional risks and complications, such as:
- cesarean delivery for a person who does not have a birth canal
- hormone therapy to regulate hormone levels
- immunosuppression
However, a 2021 review suggests that while additional treatments may be required, these considerations may be manageable.
Cisgender men, or anyone born without a uterus and ovaries, cannot become pregnant. However, transgender men and other gender nonconforming people may become pregnant if they have a uterus and ovaries.
Gender-affirming care, such as hormone therapy or surgery, may affect the possibility and safety of pregnancy. However, it is still possible to have a healthy pregnancy and birth with the support of your medical team.
Research is ongoing on uterus transplant procedures, which may increase the options for others who cannot become pregnant.
Contact a doctor if you have questions about pregnancy or any treatment you receive.
