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The journey in pursuit of parenthood can be such a tumultuous path. In many ways, it is deeply personal. Thoughts of becoming a parent usually unearths memories from one’s own childhood and often questions follow, “Will I be able to be a better parent than… Can I really be as good as… Will I be able to afford… Can I do this alone and be… What will other people say… Do I want to become a parent… Will I be able to become a parent the way that I want?” Personal, as it may be, if you identify as a woman, everyone seems to have unsolicited opinions about if, when, where, or how you should become a Mom. Sometimes, there are so many other people’s opinions floating around in your space, you may feel alone in your efforts to process not only what you want, but also what is within the realm of your reality. But, what is it like when you are from a marginalized racial, gender, age, socioeconomic, or sexual group? Pause here. As you take a second to let that question sink, I’m going to add one more layer. Think about all of these questions living in the body of a person who has intersecting marginalized identities and the impact that it can have on mental health.
The Gender of Parenthood
To start, I’m going to share a little story with you. A couple years ago, I was working on a research project aimed at training a certain specialty of physicians to support new parents during a medically fragile time in their baby’s life. I reviewed four scenarios that would be used to help the trainees through a simulated role play. I noticed that the scenarios were not reflective of the general US population in terms of race, gender, language background, age, or sexuality. I proposed to make modifications to the scenarios to be more representative of these things. My thinking was that if we had the opportunity to train a few physicians nationwide in a way that can reveal and begin changing some of their biases in practice, rather than having their biases or ignorance negatively impact the lives of living people, then we should take that opportunity and make the most of it. The team leads and co-authors were on board. One of the scenarios was about a gay couple with the gestational parent identifying as a transgender man. When recruiting for the actors, one of the team leads reached out to the center that we had to use because it was connected to the university and major hospital where we were conducting the research. When the head of the actor recruitment center read the scenarios they made two comments that made my blood boil.
First, they said that they primarily had access to White cisgender women actors. All I could think was they were saying that thousands of physicians trained at this medical school only had simulated practice sessions with White women, the least vulnerable population for obstetric/gynecological health. And people wonder why Black, Indigenous, and Latine/x maternity mortality rates are so high in the US. Our physicians are using a “White cisgender woman” template and applying it to other racial groups and genders, while using racist and outdated textbook knowledge to treat marginalized birthing people. It made our present reality so very clear. The second thing that the actor recruitment center said was about the transgender scenario. They said, “Why would you want to unnecessarily complicate the trainees’ learning with a transgender gestational parent?” The trainees will already be nervous.” I’ll let you have your thoughts about this statement for now.
Fast forward to Jun 2, 2021 when Kayden Coleman’s birthing story showed up in my news feed. I resisted the urge to passively aggressively send the article to the good old actor recruitment center with a note telling them that it was too bad they chose not to be at the forefront of change and missed out on being hailed in national news as having done something right.
You see, Kayden is one of many transgender men to give birth over the past two decades. He is also a Black man and identifies as a Black Trans Advocate/Educator.
While Kayden doesn’t focus on mental health, he does discuss the trauma experienced by unprepared practitioners. It is important to consider the mental health needs of birthing people across genders. When we review the statistics for perinatal mood and anxiety disorders (PMADs), all of the data is on cisgender people. Yet, transgender people in the perinatal period can experience symptoms of PMADs. Since we know that untreated PMADs can impact gender wellbeing, later parenting outcomes, birthing concerns, and infant and child outcomes, it is vital that PMADs not be a gendered topic. Symptoms of PMADs among transgender people are compounded by the fact that there are still too few practitioners who have any experiences working with them. This gets us to circle back to 2019 when I was told that physician training would be unnecessarily complicated by teaching them to work with transgender birthing people. Transgender parents and prospective parents do not automatically have different needs than cisgender parents; however, they do have layered needs that intersect with their realities and identities. You see, there is no gender of parenthood, yet we tend to have systems in place that tells us that a transgender pregnant person is an unnecessary complication who do not warrant proper medical and mental health treatment.
Working Towards Change
People are working to make changes even though it is not happening fast enough. If you are thinking of becoming a parent, a birthing person, or are already caring for a child, it is important that you educate yourself on some of the mental health signs that you may benefit from additional support. Information about PMADs is free and readily available online. Included in the linked article are also some resources if you are unable to pay for mental health services that are related to PMADs. If you are a Black transgender person, a transgender person, or even a person who identifies somewhere else on the LGBTQIA+ from another racially marginalized group and your concerns about PMADs are dismissed when you bring them to a medical professional, here are a few phrases that may come in handy.
“Please formally document that you are refusing my request to be educated about perinatal mood and anxiety disorders.”
“I have learned that perinatal mood and anxiety disorders, such as postpartum depression, are considered to be the most common complication of childbirth. Please tell me more about my risks and what I can do for support.”
“I am sure that you know that perinatal mood and anxiety disorders are a common complication for people across genders; therefore, I appreciate you informing yourself and your staff on ways to provide me with a supportive environment when I arrive.”
Takeaways
The burden of proper mental health care is not supposed to be placed on those needing support; however, among marginalized communities, that is the current reality.
Perinatal Mood and Anxiety Disorders are common and treatable.
Medical practitioners in birthing fields (e.g., obstetricians, gynecologists, midwives, etc) should screen and discuss PMADs risk factors with you, not just postpartum depression.
PMADs can affect all genders.
There is no gender of parenthood.
Regardless of you gender, you are not alone if thinking about becoming a parent or already being a parents is bringing up feelings for you.
Remember, make time in your day to play a little today.
PlayfulLeigh (playfully),
Dr. Dowtin
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