In a recent conversation on navigating the pleasures and challenges of trans parenting, I spoke with Aren Aizura, Ph.D., about his pregnancy—his daughter Kit is now 7—fighting misinformation and misgendering, and finding a support network in trusted friends. Originally from Melbourne, Australia, Aizura is a trans man who lives in Minneapolis and teaches gender and sexuality studies at the University of Minnesota.
Finding “Ordinary” Perinatal Care
Terri Wilder: At a virtual talk earlier this year moderated by trans activist Cecilia Gentili, you talked about your family, your child, giving birth, and parenting. What has your life experience been as a trans guy living in the Midwest and deciding to have a child?
Aren Aizura: I’m not from the Midwest. I’m Australian originally, and I’ve been living in the United States for the past nearly 12 years. I met my partner (or my ex-partner now) when I was a postdoc, and I had just moved to the United States. We tried to figure out where we were going to be for a couple of years because, being an academic, you can’t really choose where you live—you have to follow the jobs.
We knew that we wanted to have kids. For me, I think I had spent my 20s and early 30s thinking that I would never have kids because I didn’t feel that I was emotionally equipped to parent well. Then after having quite a lot of therapy and going through lots of family origins—just working out how to have self-esteem or how to be social as a human being—I was like, “Oh, yeah. I actually want to have kids. I really actually do.” And then there was the question of how we would get them.
Both my ex-partner and I are transmasc, and we both could have gotten pregnant. We were both on testosterone. But we were meeting a lot of people and hearing about people who were on testosterone but who had gone off to get pregnant, and who were having healthy pregnancies. When I started hormone replacement therapy in 2002 (and I’ve been trans for a very, very long time), the doctor that I saw then told me that I would become sterile, that the hormonal changes were irreversible, and that I’d never be able to have kids—or at least I’d never be able to get pregnant or give birth. It’s so funny, because not only is that not true, but it’s also responsible for a lot of accidental pregnancies that trans men get into, because they think that being on T makes them stop ovulating, which is not even necessarily true. Our bodies are really odd, and being on even a lot of testosterone can coexist with ovulating.
So, we decided that it would be me who was going to get pregnant. And that happened to coincide with me getting a permanent job in Minneapolis, which is where my ex-partner’s family lives. It all came together. I finally had a stable job, we had some family support, and we sort of knew where we were going to be in our lives for a little while. Then, I went off testosterone and we started trying to inseminate with donor sperm.
Wilder: When you and your ex-partner decided that you wanted to have a family and the way you wanted to make that happen, what resources were available to you all in the Twin Cities?
Aizura: We were living in Philadelphia at the time when we started talking about getting pregnant. I was going to a trans health care clinic, where I could always see a trans provider. They were like, “There’s tons of trans men who are getting pregnant. You’ll be fine. We’ll totally help you with connecting you to OB/GYNs and doctors who will help deliver the baby.”
Then we moved here with a kind of one-year stint in Phoenix, Arizona, which was where I got pregnant. I was scared about having a baby there because we actually had a lot of trouble finding providers who would help out—not necessarily people who would prescribe the testosterone or help me with trans health, but the intersection of trans health and gynecology or obstetrics. We had been actually working with midwives there because we met these queer midwives who were really awesome and who were very open and willing to work with us.
I know that there’s never enough trans health care providers for the demand or the need. It’s still the case that there are so many people out there who are on waiting lists to see the doctors. There’s, I would say, probably 10 doctors or 10 primary care providers and nurse practitioners in the city—maybe 20 who get referrals within the community. But there are enough that I feel like we got really good care.
Part of that was we did it a different way than a lot of people would, because I was actually very uninterested in being in any kind of hospital setting to give birth. I have lots of medical trauma from having to go through a fairly conservative early-2000s psychiatric process to be diagnosed with gender dysphoria initially and wanting to get top surgery. I was at a gender clinic in Australia that basically was notorious for malpractice and for gatekeeping. Every time I’d go to the doctor, I’d have to be like, “OK. I’m going to be alright.” I’d have strategies.
I was pretty set on giving birth at home. We met with a number of different midwives who seemed to always work in pairs, and found these amazing midwives who work with trans and queer people pretty much exclusively, and who were keen to work with us. They were also really well educated, so they already knew all the things that I was bringing to the table, in terms of being a transmasc person wanting to get pregnant and give birth.
Then, it was pretty routine. I feel like my care was excellent and I got the ordinary care that anyone who is pregnant would get, which was exactly what I needed.
Wilder: When you say that your care was ordinary, but clearly you surrounded yourself with folks that exclusively work with trans people, I’m wondering—what should people be looking for? For trans people that want to have a family and want to get pregnant, what are some things that they should be looking for to make sure that they’re supported and to have the happiest, healthiest experience in having a child?
Aizura: Attitude is really important. Having an attitude of, “Let’s focus on the physiological processes that are happening to your body,” rather than gendering them. I think it’s really important that providers can talk about nursing, for example, without saying, “Are you going to breastfeed?”
We met with these two well-meaning, lovely midwives who were both cis straight women, who asked me, “Are you planning to breastfeed?” I was like, “Well, I don’t have breasts. I haven’t had breasts for a very long time. And, no. But I am maybe planning to chestfeed. I don’t know.” And they were like, “Oh, OK.”
We had told them that we were trans before meeting with them. And I feel like if they had just Googled trans men breastfeeding they would have known that it can be really hard for a transmasc person to have their chest area referred to as breasts, especially if you can just look at me and see that I don’t have breasts. I’d had top surgery years before. So, it felt like a faux pas. I think they were really like, “Oh, wow. We fucked up. We shouldn’t have said that.”
For me, I think it’s important that you can find someone who, even if they don’t know all the lingo, they don’t make assumptions about and start off using intensely gendered language. There’s actually a movement within birth working culture and within birth workers, midwives, and doulas as professionals to start using more gender-neutral language. I think that’s amazing. A lot of people don’t like it because they think it goes against a kind of feminist vision of pregnancy being a powerful thing for women to do. I understand that, but I also think that in order to be inclusive, sometimes you need to adjust your language for a particular people. It’s not hard to do. So, language is one really important part.
And then attitude. I think some of the people that we talked to would be like, “Oh, my God. You’re trans and you’re giving birth.” They would have this kind of excitement and surprise and a slight fetishization happening, where what we were doing was so exotic that they wanted to know all about it and help. But even being understood as something exotic is really hard. Because if you’re being treated as this exotic being who is very special, then you can’t just talk about banal things, or you can’t kind of just be yourself.
I mean, I feel like I’ve been enormously privileged. I went through pregnancy having access to health care. And because I was between jobs, I moved here and signed up for health insurance and got Medicaid health insurance right away (because I was pregnant). I also have cultural competency in navigating health insurance websites. You know, I’ve got a Ph.D. I could have paid for private health insurance between jobs if I needed it. So I feel like my experience was probably really positive because I’m like the ideal consumer. I can choose whichever health provider I want.
But then, we made a hospital transfer plan, because sometimes home births don’t work out and you have to transfer to a hospital. The one thing that my midwives did say was, “Go to the hospital downtown”—which is HCMC—“where most of the people who are on Medicaid or medical assistance go. It’s the most public option. The people who work there have experience working with a really diverse range of people. And they will probably maybe have more respect for your needs and wishes than somewhere else.”
I was surprised by that because I’d done a lot of reading about medical racism, particularly in the context of pregnancy. But I also was like, “Oh, of course.” If you’re seeing a huge range of clientele, then you’re just going to be like, “OK, this person’s pregnant. We don’t really care what their pronouns are. We’ll try to respect that, but, at the end of the day, a healthy baby is the most important thing.” That made me feel comfortable. I thought I was glad to hear that.
On Chestfeeding and Finding Community
Wilder: You wrote an article about chestfeeding and what that experience was like for you and the people around you. What is chestfeeding? And can you talk a bit more about what your experience was?
Aizura: Chestfeeding is an all-gender term to describe feeding a child human milk from a person’s chest. I think it’s really useful for trans and nonbinary people because, often, the term that is used to describe nursing most often is breastfeeding. But as I said, some transmasc people don’t have breasts. Some don’t want to refer to their chest tissue as breasts at all, even if they haven’t had top surgery.
So the term chestfeeding gives us this way of talking about nursing in a way that doesn’t gender and doesn’t induce body dysphoria. For a long time—not so much now—when anyone said the word breasts to describe my chest area, I would just nod. I didn’t feel like that described it. That also was something I deeply disidentified with. So, it’s helpful.
In that article, I talk about the first couple of months of my daughter Kit’s life. I didn’t know this when I got pregnant, but because bodies are kind of wonderful and very strange, being pregnant can make a whole lot of chest tissue grow back. Even after you’ve had top surgery that severs milk ducts from all the kind of connecting glands that produce milk, you can actually regrow them in the course of pregnancy.
That’s something not many people know. I think it’s something that kind of defies the imagination, in a way, where a lot of people think, once you’ve had chest reconstruction surgery or top surgery, then there’s nothing there anymore. You can also induce lactation if you are a cis guy. You can induce lactation if you’re a trans woman. There’s all sorts of ways to induce lactation for everybody.
My experience was that I grew some chest tissue, and I had a little bit of milk, but probably not enough to actually feed Kit fully. So, we relied on donor breast milk, which is a whole ‘nother huge story. We spent a lot of time sourcing milk donors. I had this really intense desire both to feed Kit milk from my own body and for her to just nurse, even if there wasn’t actually milk coming out, because it felt like a really important way to bond with her. And I also knew it wasn’t satisfying for her. It wasn’t enough.
But I’ve also heard of people being able to generate enough milk after top surgery to feed their babies. I’ve heard of people having intense pain because the milk glands regrow in a part that doesn’t actually reconnect to your nipples. So, then it’s kind of stuck there, and that’s really hard.
I guess the main lesson I took from that is that it felt like this private thing, or this thing that needed to be private, because not everybody around me understood what was happening or could see that me nursing a baby did not make me a mother. It’s really weird because I would just assume that if anyone looked at me, they would see I have a beard. I don’t look like a woman in any way. But it seemed really hard for people around me to de-link nursing from being a mother.
I think also some of it was internalized. It was hard for me to take those things apart, as well. So I felt this sense of, well, I can’t show anybody this except for my partner and a few trusted friends, because the feelings that come up are so complicated and I’m so scared of somebody getting the wrong idea that I really want to protect this.
Wilder: That really came through in your article and made me think about the support you get from your queer family, versus your biological family. What are the differences? And where do they come from?
Aizura: Right. It’s interesting. I’ve been doing a lot of reading and research on child rearing and how we come to feel gendered, especially in the heterosexual family, which is the kind of default that everyone assumes is how it’s done. And those relationships, the nuclear family sets up these relationships where, if you’re born with a uterus or you’re assigned female at birth, that means that you become a daughter and you’re supposed to identify with your mother. Your mother also identifies with you. You’re supposed to not identify with your father, although so many people do. Or, there’s just a whole range of family considerations that don’t even get described in that dynamic.
I think what happens sometimes in a biological family is that we internalize the way that things are supposed to be. Part of the reason that parents find it really hard to accept their trans children—and I think sometimes especially mothers try and find it hard to accept trans men, and maybe fathers find it hard to accept trans women—is that there’s this way that parents feel a need to be like them, and for you to reflect the image that they have of you.
Some parents are amazing. My mom especially has done an incredible job of being very supportive of me being trans, the transition, and me being queer before that. And still, she arrived from Australia and was jetlagged and then called me “Mommy” the minute she got there. I was like, “Oh, no. This is not a good start. Please, no. This is not what I want.” But we resolved it and she’s incredible, and she stayed for another six weeks. And now we’re doing it again. And also, we talked about it. I think maybe the real key is to be able to communicate clearly. Some families can do that; some can’t.
But yeah, a queer family was also really important, because I didn’t have to explain anything to them. And whether my queer friends were trans or not, they had all been around trans people for years and just understood things. It wasn’t that I didn’t have to explain anything to anyone, but the level of acceptance or just being like, “OK, whatever you’re going to do. You’re doing you, so we all support you in doing that.” And very material support, too, such as bringing meals and taking the baby for a little while, while someone has a shower, which is really important and is very hard in the first month of when you have a new baby. Or just coming over and bringing chocolate. Those things? I hope that people have that kind of friendship network and support always, because I think as queers—in the absence of biological family support—we have to make those connections ourselves. Sometimes I feel sorry for straight people because they have all this biological family support, but then if that falls through, where’s your support network? You’ve got to have friends. And hopefully friends who are willing to give you care, and also take it and receive it when you’re able.
Parenting “in a Pretty Intentional Way”
Wilder: I’m wondering about parenting and interacting with different systems of care around your child.
Aizura: I think we started off knowing that we would have to parent in a pretty intentional way. Part of it is bigger than transness or queerness, about wanting to kind of speak frankly about the world with children and assume that children have the capacity to understand complex concepts, rather than avoiding certain topics because they’re not supposed to know, because kids need to be protected, or kids should be innocent.
But I think that, for instance, we told Kit about transmascs and—I think not all trans parents do this—we told Kit about the difference between, for instance, if she ever saw us naked, she would see two people with what looks like vulvas, but that we didn’t describe them that way. And that having a penis or a vulva doesn’t necessarily dictate whether you’re a girl or a boy, or whether you use he or she.
She is also surrounded in the community that we’re in by trans and nonbinary people. I live with three roommates, and they all use they pronouns. So, she is very practiced at this point in correcting people’s pronouns. She’ll say, “They don’t use she. They don’t use he. They use they.”
I think because she’s getting older and she’s starting to see that the world is not necessarily like that everywhere, I’m glad that that’s her default. She just started in-person kindergarten, and I think that she’s going to encounter family configurations that are really different from what she understands is the kind of normal. We also know that when she was 2 and 3, she wanted to have short hair. She mostly wanted to wear pants. We had given her this pretty awesome-looking mullet. She was a very chubby baby and she was cute, but not what you would call traditionally feminine. She started in a new classroom at her preschool with some older kids, who suddenly were on her about gender: “Are you a boy or a girl?” And she was like, “I’m a girl.” And then they would say, “Well, girls don’t wear pants. Girls only wear skirts.” That started this real intense anxiety in her. She was like, “I’m only going to wear skirts from now on. I have to wear skirts. Because it’s very important that everybody understands what my gender is. It’s a girl.”
So, we talked to the preschool about that. It was a progressive preschool. Most of the parents are pretty liberal, and yet, all we could do is keep on telling Kit, “You are whatever gender you feel yourself to be, and you don’t have to wear any clothes to prove that. You can wear whatever you want, and we’ll totally support you. If you want to wear skirts forever, great. We’ll get them.”
But I think as she has gotten older, she sees people making statements about gender that are kind of very dictatorial or very binary and she’s like, “What is that about? Why do they do that, Dad?” Recently, we were passing by somewhere and we saw a sticker that said—it was a trans exclusionary radical feminist sticker, or a gender-critical feminist sticker—Woman: Adult human female. It was like on a wall outside the food co-op that we were going into. I ripped it off and I said, “That’s like a really mean sticker. I’m just going to take it off.”
Later, she asked me, “What did that say? And what did it mean?” Because it’s not immediately clear what that is referring to. I said, “Well, when people say adult human female, they mean basically that only people with uteruses and vulvas can be women. We know lots of people who were assigned male at birth and who actually understand themselves to be women but have a penis. And that sticker is saying that they can’t be women.” And Kit was like, “That’s dumb. Why do people think that?”
I mean, I love the fact that she already just is like, “That’s just stupid.” She’s already getting a lot more freeing messages about gender and sexuality than I was at her age. We also talk about policing with her and prison abolition because that’s where our politics are. We talk about the fact that Minneapolis last summer had a huge number of protests because the police killed someone, and that it’s mostly Black people, and Brown people, and Native people who are getting killed. So it’s kind of consistent. We just try to talk about everything with her. If it comes up, we follow it.
Wilder: I think it’s great that that is the approach that you’re taking in parenting.
Kids are great, if you model and teach at a young age. They’re just so great at correcting adult errors—like using the wrong pronouns and calling people by the wrong parental term of endearment.
I think it’s just kind of amazing that people still think of kids as not able to “understand” things. I feel like there’s this perspective of, “Oh, don’t bring it up. They won’t understand,” or, “It will upset them.” But you have all these amazing examples of where kids do get it. They can get it.
Aizura: Exactly. I think it’s so much about adults projecting onto kids what they want kids to know, which is the false picture of heterosexuality and gender normativity. It is wanting to pretend that kids aren’t being fed full sets of ideologies about gender and sexuality right from a very young age, and wanting to pretend that a kind of male and female binary is totally natural and just the way that everything is. So of course it is challenging or threatening to suggest that actually kids can totally absorb really different ideas about gender and sexuality—and race, too—without having any kind of contradiction.
A lot of the time when Kit was like 3 or 4, we would talk to her pretty regularly about how there’s male and female and how to identify as either, there are nonbinary, some people call themselves genderqueer. And even within male or female, there are all sorts of different ways to be. A lot of early childhood educators or people who have read early childhood development scholarship will say, “Well, when kids are 2 or 3, they just need to categorize the binaries. They want everything to be very simple. That’s why children will tell you, ‘Men only wear pants and women only wear dresses.’”
I guess my experience is that it really just depends on what kids pick up from their parents and from the wider world. If they are told, or they only see, that there’s two binary genders and that some people wear skirts and some people wear pants, then that is what they will reflect back. If they’re told, “No, actually it’s way more complicated than that, and we don’t make assumptions about somebody’s gender, in the same way that we don’t make assumptions about your experience as a kid—we ask you what it is that you’re feeling or experiencing”—then they’ll reflect that back.
There’s a lot of anti-trans bills right now that are in red states—actually, not just red states—that Republicans are trying to push through that are specifically targeting trans kids and saying that kids are too young when they’re reaching puberty to understand that they’re trans. And also trying to make sure that schools aren’t allowed to teach about gender and sexual education in a way that includes any mention of trans or queer people.
It’s bizarre. Of course kids understand. Of course kids understand what they are. But a lot of parents and teachers and Republican governors really want to maintain the kind of way of living that would prefer that these kids didn’t exist, or that they were completely unhappy and repressed. I think when you’re an individual doing parenting, it feels to me like that’s a very small thing. It doesn’t necessarily change anything in the wider world. But I think if we link it to all the anti-trans bills, the more people can stand up and say, “Actually, we are doing parenting really differently and our kids are fine. They are healthy. They have good boundaries around consent. We talk about sexuality with them. We talk about how people have sex and reproduce. And that’s actually totally fine,” I hope that it can eventually undo all of those buy-ins around kids are supposed to grow up to be heterosexual, and that’s natural. And they’re supposed to grow up and be the gender that corresponds to their genitals. That’s natural. And anything else is weird, or it’s going to be sad for them. They’re not going to be happy.
That’s also totally not true. Trans people exist and have always existed. In fact, there have been trans kids, and genderqueer kids, nonbinary kids. There are historical documents that stretch back to the early 20th century, where trans kids were able to live, and whose families supported them, too.
There’s also this lie that trans kids are new and that there’s a kind of big social media–enabled contagion around trans kids at the moment. It’s all about shutting down transness.
Wilder: Well, I have hope that your child is going to kind of carry this message across their generation.
Aizura: I know. I feel like that’s a huge burden to put on your kids. I don’t want to make her responsible for changing the world. But I also think that statistically, the number of kids who are in their teens and 20s now who identify as nonbinary or have queer or trans friends is so much larger than it was when I was growing up. It does seem like there’s just more knowledge and more visibility about it in the United States at the moment. That’s a really good thing.