By Ana V. Soto-Sánchez, M.S.

The transition to parenthood is often a gendered experience, with pregnancy typically seen as a milestone in womanhood or femininity. For genderqueer people—those whose gender exists outside the male-female binary—this may not be the case. Anyone with a uterus, regardless of gender identity, generally has the biological capacity to conceive, though various health conditions or challenges may impact this ability. This includes cisgender women, nonbinary or genderqueer individuals, trans men or transmasculine individuals, and some intersex people.

For genderqueer parents, navigating parental and gender identities during pregnancy can be challenging. For example, some genderqueer parents feel like they must choose between getting support for their pregnancy or getting support for affirming their gender identity. Navigating the parental and newborn care system as a genderqueer parent can also be overwhelming, impacting overall emotional well-being. If this sounds familiar, know that you’re not alone!

Navigating Shifts in Identity

Parenthood is already a time of shifts in identity. If you find yourself questioning how your parental role might impact your gender identity (or vice versa), consider the negative messages about gender and parenthood you’ve received from others. When you believe these messages, this is called internalized oppression.

Identifying internalized oppression can be challenging, as it often shows up as automatic thoughts that we accept as facts without questioning. Ask yourself: What messages have you received from others about what parenthood should look like according to different gender roles?

Identify the identities that make up who you are, and what you value about them. For example, as a feminist, I value authenticity, equality, and passion; as a Latinx individual, I value heritage, family connection, and commitment to service. Look for other genderqueer parents who inspire you. What attributes about them do you admire?

Consider how you want to present yourself to the world in a way that feels meaningful to you and honors your sense of safety. Keep in mind that what feels safe for you and your child can change depending on your surroundings.  

Psychology researchers Ashley Austin and Shelley Craig also recommend developing a Coping Action Plan for dealing with gender-related stressors, which can be helpful when adjusting to your parental identity. For example:

• What is your goal? (e.g., I want to create a supportive community of queer parents before my baby is born.)
• Why is this important to you? (e.g., I want my child to be surrounded by people who respect and affirm our family.)
• When do you want to achieve this? Who can help you achieve this? (e.g., I want to connect with at least one queer family by the start of my third trimester. Parent groups can help.)
• What resources do you need? (e.g., Online LGBTQ+ parenting forums and community events.)
• How will you know if you achieved it? (e.g., When I have at least two people I can turn to for emotional support and advice during and after pregnancy.)
• What barriers might interfere with your goal? (e.g., Feeling isolated, dealing with discrimination, or struggling to find local groups.)
• What strategies can you use to address these barriers? (e.g., Attending virtual meetups and asking friends to introduce me to others.)
• What are your first steps? (e.g., Searching for LGBTQ+ parenting groups online and messaging a few to ask about joining.)
• On a scale from 1 to 10, how confident are you about achieving this goal?

Pregnancy and parenthood are individual experiences, but they don’t have to be isolating. Determine who is part of your support network and what role they play. Make a list of people and the type of support they can provide. Maybe your siblings can provide instrumental support, like doing laundry or cooking meals, while a friend can provide emotional support. Check in regularly with your healthcare provider to support your overall well-being.

Navigating Prenatal Care

Encounters in the parental and newborn care system can be overwhelming, especially if you are experiencing stigma and managing changes in hormone-based or other gender-affirming care. To advocate for yourself and ensure care that is sensitive to all your needs, consider the following strategies:

• Use provider directories to search for providers who openly express allyship to genderqueer families.
• Have a support person accompany you to your appointments.
• Connect with a care coordinator.
• Bring a list of questions and concerns to your appointments.
• Connect to support groups with other genderqueer parents.
• Create a birth plan highlighting what is important to you. Identify what is necessary and where you can be flexible.
• Introduce yourself to the care team by including pronouns, gender identity, and/or sexual orientation.
• Ask your healthcare provider what to expect in terms of physical changes, especially if you’ve had top surgery or are engaging in hormone treatment.
• Know the resources available within your healthcare system to support advocacy.

Trans Fertility Co.‘s fertility educator Trystan Reese also suggests:

• Step 1: Highlight what is going well in your care and express gratitude. (e.g., I really appreciate how supportive you’ve been during my appointments, and how you always make time to discuss my concerns about feeding and infant care.)
• Step 2: Identify a single situation you would like to change that is not going as you had hoped. Try to describe the situation as objectively as possible. (e.g., “I’ve noticed that much of the information provided on feeding mostly focuses on breastfeeding in a way that doesn’t acknowledge chestfeeding.”)
• Step 3: Explain why this is important for you. Be assertive, calm, and confident. (e.g., “I want to ensure that the information I’m receiving reflects my experience. This helps me feel respected, included in the decision-making process, and reduces my stress during appointments.”)
• Step 4: Communicate your needs using “I statements.” (e.g., “I would appreciate having access to feeding resources that are more inclusive of chestfeeding, to ensure I can make informed choices and feel supported.”)
• Step 5: Ask for your provider’s feedback to make sure they understand. Be open to other solutions. (e.g., “Would it be possible to recommend or provide resources that include chestfeeding as an option? Or perhaps there’s a way to integrate this feedback into the clinic’s materials moving forward?”)
• Step 6: Express appreciation again!

In the book Baby Making for Everybody: Family Building and Fertility for LGBTQ+ and Solo Parents, midwives Ray Rachlin and Marea Goodman share valuable information for queer, nontraditional family building and parenthood. They offer a comprehensive guide to hormone treatment during the postpartum period, lactation practices for people who’ve had a top surgery, fertility considerations for trans individuals, and parenting in polyamorous families. You can also visit their website to learn more about support groups and other resources for genderqueer parents. 

Best Practices for Healthcare Providers

If you are a healthcare provider, it is important to prioritize the parent’s autonomy and practice informed shared decision-making. Pregnancy is a vulnerable time, and the patient-provider relationship can be one of the most valuable and trusting relationships. To optimize the parent’s experience and perception of care:

• Demonstrate a safe environment by being open about your allyship.
• Use inclusive language. Ask your patient how they are referred to and pay attention to the vocabulary they use for themselves, their bodies, and their experience. (For example: do they use terms like “lactation” or “chestfeeding” instead of “breastfeeding”? Do they refer to themselves as “gestational parent”? How do they name their genitalia?)
• Acknowledge that some genderqueer parents may have mistrust toward the healthcare system due to historical medical trauma. Respect their autonomy and invite loved ones or support people (including doulas) into their visits.
• Be willing to talk about expectations, fears, and concerns about the pregnancy and their gender identity.
• Consider their past experiences with IVF or assisted reproduction therapy. What has their reproductive journey been like? Does it include any losses?
• If they are undergoing hormone treatment, counsel them on when, how, and why to pause it. Discuss the potential interactions between testosterone and the baby’s development, expected changes, and available support.
• Be clear that there is no one-size-fits-all approach to hormone treatment during the postpartum period. Tailor expectations in care based on the parent’s needs and priorities.
• Assess any fear of childbirth and how internalized stigma may impact their experience.

If you would like further information, the Sexual and Gender Minorities Special Interest Group of the International Marcé Society for Perinatal Mental Health provides a list of introductory resources and training for gender-affirming prenatal care. Their report includes inclusive language recommendations for perinatal mental health care and research with queer people. You can also check out Trans Fertility Co.‘s “All Pregnant People: Trans Birth for Birth Workers” training for providers.

Start by familiarizing yourself with the World Professional Association for Transgender Health Standards of Care (Version 8), particularly the chapter on reproductive health. Another great resource is A Guide to Providing LGBTQ+ Inclusive Reproductive Health Care, which offers evidence-based information and practical tools for providing safe and compassionate care for LGBTQ+ individuals.

Conclusion

One thing is clear: we must create more resources for parents and providers alike to better support genderqueer parenthood. Creating inclusive resources and care is not just about providing information. It’s about fostering a sense of belonging and respect for all families. By developing materials and support systems that recognize and celebrate genderqueer parenthood, we can ensure that every parent feels seen, valued, and empowered in their journey.

References:

Austin, A., & Craig, S. L. (2019). Transgender affirmative cognitive-behavioral therapy. In J. E. Pachankis & S. A. Safren (Eds.), Handbook of evidence-based mental health practice with sexual and gender minorities (pp. 74–96). Oxford University Press. https://doi.org/10.1093/med-psych/9780190669300.003.0004

Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F. L., Monstrey, S. J., Motmans, J., Nahata, L., … Arcelus, J. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health, 23(sup1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644

Fisher, S., Hippman, C., Lapping-Carr, L., Pereira da Silva, B., & Vozar, T. (n.d.). Inclusive language recommendations for perinatal mental health clinical care and research with sexual and gender minority people. International Marce Society for Perinatal Mental Health, SGM Special Interest Group. https://pmg.joynadmin.org/documents/1002/667b09d31269a221c5591e63.pdf

Greenfield, M., Luxion, K., Molloy, E., & Hinton, A. (Eds.). (2025). A guide to providing LGBTQ+ inclusive reproductive health care. Routledge. https://doi.org/10.4324/9781003305446

Rachlin, R., & Goodman, M. (2023). Baby making for everybody: Family building and fertility for LGBTQ+ and solo parents. Hachette Book Group.

Reese, T. (2020). Self-advocacy or allyship intervention [Online training module]. Trans Fertility Co. https://transfertility.co/training/transbirth

Note: Some examples in this post were developed with the assistance of an AI tool. All final content and opinions are my own.

About the Author

Ana V. Soto-Sánchez, M.S.

Ana Soto is a Ph.D. candidate in Clinical Psychology at Ponce Health Sciences University in Puerto Rico. Her work bridges clinical practice and research in the sexual and reproductive health field to support individuals through the unique challenges of pregnancy and parenthood. Ana’s dissertation explores the impact of obstetric violence on birth outcomes, a subject she is passionate about. She has also contributed to promoting cervical and breast cancer prevention among genderqueer individuals. Ana is dedicated to improving care for underrepresented perinatal populations and advocating for equitable reproductive healthcare.

Perinatal Mental Health: Signs, Symptoms, and Treatment

LGBTQIA+ Resources 

Support for Queer and Trans Parents