Family reunion

Yesterday, K, E and I attended an event that’s hosted by the reproductive endocrinologist who helped us conceive E. It was held in a park with a bouncy house and free ice cream from an ice cream truck, and was meant to be a sort of family reunion for families who have expanded because of the staff’s loving expertise. K and I wanted to attend because our lives had gotten busy and we had never gotten the chance to take E into the office and thank the staff.

It was a lovely park that we didn’t even know existed, and the weather was perfect for the event. Staff members ooed and ahhed over E and other babies in attendance. The oddest part was an unofficial receiving line of sorts where parents and babies waited to speak to the doctor. It felt a little bit like an unintended “meet your maker” sort of moment, but likely only because there were so many thankful parents (like us) who wanted to say hello to the doc.

The doctor’s practice is located in a very upscale nearby community, so K and I weren’t sure what sort of crowd to expect at this gathering. I was pleased that so many of the families seemed down-to-earth and friendly. We chatted with some of the parents about each other’s babies, milestones, etc. K and I confessed to each other later that we each spent time wondering about each of these family’s experiences with infertility. Thoughts of, “I’ll bet you were a cycle monitored, fertility med sort of family,” and, “IVF with egg donor for sure,” kept swirling through my head.

There was one family that was among the demographic I expected to see at this event: a privileged blond woman with her equally privileged mother and baby. They were, as K put it, a spectacle. The baby’s grandma clearly had a lot of plastic surgery and the entire family was decked out in a wide array of upscale clothing brands. The baby was cruising in a $5 bajillion stroller and had no short of seventeen toys dangling in front of her glitter beret topped head. I imagined that the mother had been married to a very wealthy older gentleman and, upon his death, had a doctor harvest his sperm so that she could conceive her miracle baby and secure a larger part of his estate for her and his postmortem spawn.

I wondered what others assumed our fertility journey was, and mused that they were all likely very far off from the accurate story.

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How to make a baby: sperm donors, IVF, and mad science experiments

I really, really love this recent post on Offbeat Families. It makes me think about how we conceived Falco and how I hope our child one day views this journey we’ve taken in order to grow our family.

So much of this resonates for me, namely:

[S/he] will know how much we wanted [her/him], our precious result of a mad science experiment gone wonderfully right.

Adios, 2012!

I feel like K and I spent half of 2012 in doctors’ offices in our quest to conceive and the other half worrying about the entire process of becoming parents. What if K’s cycle won’t return after so many years of being on testosterone? What if we won’t become pregnant? What if we can’t afford the entire process of trying to become parents? What if we’re pregnant? What if something’s wrong with the baby? What if K barfs for literally 9 months? What if we aren’t prepared to become parents? Is that pain normal? Is that gas or Falco moving? What if we’re having a boy? Am I going to be able to handle the fact that Michigan does not currently allow second parent adoption or view me as legally related to this child? The list is endless and contains both silly and very sobering fears.

2013 will bring about some terrifying and exhilarating changes. Those who know me well are aware that change is not typically my bestie, but I am really looking forward to being a mom and know that I will get through all of the challenges because we are tough cookies who have an amazing support system. I have a handsome and phenomenal partner (truly, you all should be jealous) who loves me and walks through this life with me as the world’s best teammate. K and I have treasured family members, both given and chosen, who are always there for us, even at the drop of a hat like our dear friend M did over the weekend when I suddenly realized that I had no idea how I was going to carry all of the heavy IKEA purchases we’d just made for the nursery. K and I often feel like the luckiest people in this world, and we’re so grateful for that.

Bring it, 2013. We’ve got this.

Fertility Preservation in the Trans Community

At work I have a bunch of different searches set up to email myself different journal articles related to queer bioethics, LGBT research ethics, transgender stuff, etc. Lately I’ve come across a number of different articles on the ethics of fertility preservation in the trans community (particularly with any type of body modification)

I’m probably less interested in the ethical debates and more interested in the implementation.  Things like providers having conversations with their trans patients/clients and establishing clinical guidelines and protocols for these discussions.  It’s nice to see that some places include fertility, like UCSF’s Center of Excellence for Trans Health’s “Primary Care Protocol For Trans Health”.    

Thinking back to the time (about 7 years ago now) when I started taking testosterone no physical or mental health providers ever discussed fertility issues with me. Granted, I may laughed in their face.  I was around 25 or 26 at the time.  I wasn’t ready to think about kids.  I was totally absorbed with surviving day-to-day and jumping through hoops so I could finally begin my transition and feel more comfortable in my body.    

 Things get even more important/interesting/complicated as youth begin to transition at earlier ages.  I know there is quite a bit written about having discussions about fertility in the oncology field, with teenagers who have cancer, but I haven’t found much of anything about teens and transition and fertility.   

Some of the research I currently work on is related to patient education and risk communication related. Specifically we look at improving ways of presenting risks and benefits of different treatments to help patients make better decisions. I often think about the decision to begin hormone therapy for trans folks….but I wonder how effective even the best designed health education materials could really be.  I’m sure everyone has their own unique experiences but personally my drive for self-actualization was so strong that I paid little attention to the risks (or just minimized them). 

In my case I think I would have responded similarly if a provider would have tried to discuss fertility with me back then, yet now I really wish they would have.

On Being Queer

When I was first coming out, it took me a really long time to find an identity label that felt comfortable for me. Elements of various identities felt like they’d work, but nothing fully felt right or described my attraction to people who do not conform to gender norms. Were there women I found attractive? Of course. Did I find certain men hot? Yep. Did my motor run for some who identify as none of the above? Hell yes! Nothing really felt like home until I discovered the label queer.

To me, queer means deliciously atypical. It’s a celebration of my attraction to people who are gender non-conforming.  It’s a pride parade of my own gender nonconformity. For many, many years, “queer” just felt right.

While I’ve hung onto the label queer like a pair of prized jeans that once made my butt look fab but now kind of sagged, the label hadn’t felt totally right for the past several years. I found myself asking, “What’s queer about K mowing the lawn while I do laundry?” and, “What exactly is queer about this life we’re living or this white dress I’m choosing for our wedding?” Part of these feelings, I’m sure, had to do with being perceived as a heterosexual couple living in suburban, middle-class America. This naturally happened more frequently as K began reliably passing as a guy. That’s not the entirety of it, though. There’s something so inherently novel and exciting about queerness, whereas everything in our picket fence lined lives began to feel routine and expected.

Throughout the process of trying to conceive and now progressing through pregnancy, I’ve been shocked to discover that my queerness started fitting again. Women sat alone in the lobby of our reproductive endocrinologist’s office while we became known as the non-conventional couple who actually attended appointments together. We we reached out to and began building intentional community with other gestational transguys and partners. Suddenly, our gender non-conformity seemed more visible and celebrated.

Those who know us well will attest that our gender non-conformity (or love for it) never waned or disappeared, but it is fascinating and empowering to feel like we’re tapping into that level of uniqueness again in order to blaze this trail and build the family we want. It makes me feel grounded, inspired, and poised to take on the massive challenges I’m certain we are about to encounter as a visibly pregnant dude and his loving, supportive, non-pregnant wife.

Total Fangirl Moment

I am totally geeking out. A few weeks ago, I contacted the renowned author of a book that many people use as their how-to guide when trying to conceive. I had heard that she was considering writing a book that focuses on transgender pregnancy and families. When I contacted her using the generic email address listed on her website, I told her about us, mentioned that K is in his first trimester, and thanked her for her inclusive conception book, which we’ve used almost exclusively throughout our journey. I also mentioned that I was very interested in her new project and that K and I would love to be involved in any way we could. I pressed send, doubting anything would ever come of it.

Yesterday, while I was in the middle of a harried, stressful work project, I took a moment to check my personal email. To my surprise, my inbox contained a reply from the author’s actual email address. To my even larger surprise, she was completely receptive to my previous offer for involvement! She wrote:

C,
I am so happy for you guys that you are having a baby! That is fantastic! I am finally getting to writing the transgender pregnancy book so your timing is excellent! I have loads of questions for you guys. I am going  away for two weeks and will return at the end of the month. Let’s be in touch then. I am sorry that it took a while for your email to get to me. This is my personal email so feel free to use this one in the future.
Warmly,
[author]

AHHHHHH!!!!!!!! I only allowed myself to indulge my fangirl impulses for a few moments before hurriedly turning my attention back to my work project.

Even now, I am still stoked by her reply, mostly because it allows K and I an opportunity to do something that was one inspiration of our blog: to help other transgender people and their partners learn more about becoming gestational parents and using what’s available to them to create the families of their dreams. When we first started on our path toward conception, we found very few, albeit warm, open and helpful, transgender guys who’ve given birth to their kids, and even fewer written resources. Knowing that something of that sort could be on the horizon and that we could actually play a role in helping to make it a reality is nothing short of miraculous to us.

Path to pregnancy, a retrospective

The journey to become pregnant for the first time has been a roller coaster for the past 9 months. Since we started our blog just recently, I thought I would share some of the highlights month-by-month to tell the story of how we got to this place.

December 2011
Took my final shot of testosterone on December 23, 2011.  C and I talked constantly about baby making and our plans for 2012!

January 2012
Started charting with Fertility Friend and felt obsessed and empowered by all of my bodily data.  We also began researching sperm donors and narrowed down our choices to our top 2 or 3. Our friends tease us about a Google spreadsheet we created to track pros and cons of each donor option.

February 2012
Still waiting for my cycle to return.  Waiting and waiting, and was getting scared that it would never come back.  On Valentine’s Day, I went to my regular OB/GYN and discussed my plans for getting pregnant.  The doctor and nurse practitioner are excited for C and I and are more than willing to work with us for my pregnancy.  C teased me about showing my bits some love on V Day.

March 2012
March 4 2012–my period returned.  I was overjoyed and grouchy at the same time.

We also had our first consults with reproductive endocrinologists (RE) this month.  We selected one RE based on the fact that they advertised in a LGBT local paper and the other based on good word-of-mouth feedback.  Before scheduling the appointments, C and I drafted long, detailed letters explaining our situation and identities.  They both sent me 30-40 page packets of forms to complete ahead of time, most of which I had to respond with “does not apply.”

The prices were really somewhat shocking, especially that of Dr. W, which were about $750 more per cycle than Dr. MB.
We both felt really excited about going with Dr. MB between his better pricing and REALLY compassionate and nerdy personality. This is somewhat surprising because we both anticipated liking Dr. W more, based on some good experiences we’d previously had with her staff. However, she seemed very judgmental toward C. For example, when I asked directly how queer/trans friendly she was, she responded, “I’m sitting here talking to you, aren’t I?”  Ummmmm….What?!
Looking back, I can honestly say that we couldn’t have made a better choice.  Dr. MB’s staff are so kind and I feel very relaxed and safe at their practice.
April 2012
First month of testing at the RE’s office.  I was introduced to the joy horror of the cycle day 3 vaginal ultrasound.  If I had any issues with being a bleeding man, I was going to have to get over them quickly.  We also had tons of blood work to check hormones, thyroid, FSH, and a bunch of other things.  I had a HSG, which is uncomfortable both physically and emotionally, as it turns out the resident performing the test was in my degree program and remembers me—-as a different gender.  At the end of the testing cycle, we met with the RE who diagnosed me with Hashimoto’s and refers to me another endocrinologist.  Other than my slightly elevated thyroid, all other systems were a go.

May 2012
I was disappointed because I was hoping May would be our first month to try.  Instead, I met with the new endocrinologist, Dr. B.  He’s young and did his residency at the medical school where I do research.  Somehow this makes him more approachable. He prescribed synthroid and wanted to see my TSH levels below 2 before we began trying to get pregnant.

C and I took a trip to Philly to visit our best friends and attend the Trans Health Conference. We attended a half-day intensive workshop on trans-masculine pregnancy and it was amazing! I was still charting this month and also practicing with ovulation predictor kits (OPKs).  While on the drive to Philly, we stopped somewhere on the Ohio turnpike so I could pee on a stick.  I got one of my first smiley faces in a men’s public restroom!

June 2012
My thyroid levels were good and were finally ready to start trying!  This month, we had our first IUI attempt.  We decided to try one natural (un-medicated) cycle.  We did OPKs and went in for back-to-back (24 hours apart) IUIs once we received a positive OPK result.  The first IUI went great, but the second one was physically and emotionally uncomfortable.  We had a nurse we didn’t like as much, she mis-gendered me and spoke about me in the 3rd person.  Plus, she had difficulty inserting the catheter through my cervix and I had a lot of bleeding, camping, and backaches afterward.

We tested after 2 weeks and a got a very faint positive.  After going in for blood work we discovered my HCG (beta) had dropped and I wasn’t pregnant after all.  I was unprepared for how crushed and disappointed I would feel.

July 2012
Because I don’t want to be off T for longer than I have to, and was hoping to be hugely pregnant during the winter months, we decided to move ahead with a medicated cycle for our second attempt.  Doing the medicated and monitored cycle made me feel like we were at the doctor’s office every other day (and we were for two of the weeks).  I did a baseline ultrasound and blood work, took Femara, did 4 or 5 additional ultrasounds (with blood work each time) to check on how my follicles were growing.  We ended up with two mature follicles and did a trigger shot of Ovidrel to initiate ovulation.  Again, we went in for back-to-back IUIs, 24 hours apart.  4 days later, I had another follow-up appointment to confirm ovulation. Two weeks after taking the Ovidrel shot, we got our good news! 🙂

DNA decisions

The month before our first insemination, we attended the Philadelphia Trans Health Conference, mostly so that we could attend an intensive workshop about transmasculine reproduction. There, the presenters described the process of reproduction in the following inclusive way: In order to reproduce, you need an egg, sperm, and a place to gestate the embryo. If you don’t have one or more of these things, you’ll need to decide how to obtain it. Luckily, we had the egg and the place to gestate Falco, but making decisions about sperm was more difficult. We considered many options and their pros and cons in our specific set of circumstances.

A known donor:

  • Pros: The sperm would likely be free and we wouldn’t have to pay for shipping.
  • Cons: We’d need to find someone who was willing/able to do this and engage in some likely, awkward conversations around STI screenings, agreements about paternity and donation logistics. We wouldn’t have options when it came to physical characteristics in our donor and, thus, our child might not look as much like me.

A willing to be known donor from a cryobank (sperm bank):

  • Pros: The sperm bank would do all of the screenings for us and the donor would not have the ability to consider himself the legal father of our child. Our child, at age 18, would have the option to decide whether or not s/he wants to meet the donor.
  • Cons: This sperm tends to be more expensive than anonymous donors at a cryobank. There are fewer donors and thus, fewer options when it came to physical characteristics. Again, the child might not look much like me.

An anonymous donor from cryobank (sperm bank):

  • Pros: The sperm bank would do all of the screenings for us and the donor would not have the ability to consider himself the legal father of our child. There is a wide array of anonymous donors at cryobanks around the world, which would allow us to find a donor that had physical characteristics like me, allowing for a greater likelihood that our child would look like both of us.
  • Cons: Sperm from a bank isn’t cheap and our child wouldn’t have the option of one day meeting the donor.

The major factors for me were based on my identity as an adoptee. I didn’t look much like my parents and I struggled with feeling like I fit into my family. I also think it is critical for children, to the extent they wish, to understand their origin, and desperately wanted our child to have the ability to meet their donor if that was something they wanted. Because finding a sperm donor who looked like me was very challenging, we ultimately had to choose between having a willing-to-be-known or known donor who could produce offspring that would not look like me but would be available to our child for future questions and relationship OR having a donor who was not available for questions or relationships but had the ability to produce offspring that looked like both me and K.

Ultimately, K and I decided to go with an anonymous donor whose baby and childhood photos looked just like mine, which just felt right when we saw them. While I feel really confident that we made the right choice for our family, a part of me feels a sense of grief for Falco that s/he will likely never have the ability to meet someone who helped to create him/her. I hope that one day, s/he will know that we made the best decision we could with the very limited options available.

Safe (trigger alert)

I was married before. My ex, also a transguy, was (and still is, from what I can tell) a terrible, abusive person. He isolated me from friends and family, constantly put me down, and made me believe what he was saying – that I was a worthless whore. He stole my money, literally took my paychecks and spent them however he wanted, took my debit cards, ruined my credit, and refused to hold down consistent jobs, while I meanwhile worked two part-time jobs just to make ends meet. He told me that he would leave me or kill himself if I didn’t try to have his children, that I “owed” him that as his partner. By that point, in the depths of despair and isolation, I believed him.*

We couldn’t afford to use a donor through any of the cryobanks he researched (remember? my ex couldn’t be bothered to hold down a job), so my ex decided that we would use a known donor: his loafish, virgin, socially awkward, pothead friend. We’ll call him Benny. Benny’s hygiene was somewhat suspect and even before my ex coerced me to be inseminated with Benny’s DNA, just being near him made my skin crawl. Each attempt to conceive was horrific. I felt violated and completely dissociated from my body. After several revolting, unsuccessful at-home ICI attempts, my ex finally gave up.

It took about six years of deep depression, isolation and sheer terror at the hands of my ex husband before I finally began to realize that I was the victim of domestic violence and that I deserved better. With the help of a local domestic violence agency’s toll-free hotline, as well as the support of K, who was becoming a dear friend at the time, I made a plan to safely leave my relationship with my ex.

It has been seven years since I left and I wish I could say that the past horror is behind me. It is not. A part of me struggles with it quite literally every day. Luckily, I am more often reminded of the fact that I am now safe, with a partner who respects and encourages me, and have a wide net of loving friends and family.

Looking back, I am certain that I found a way to will Benny’s sperm to leave my body so that I wouldn’t conceive my ex’s child. I’m also certain, while I wasn’t fully aware of it at the time, that my initial and longterm boundary of being child-free throughout the majority of my relationship with K was very much tied to the trauma of being a survivor of domestic violence, especially as it relates to reproductive coercion. Even though I felt safe with K, it took me many, many years to truly believe and feel it. And let’s face it, who wants to (willingly) build a family with someone when they’re not sure they’re safe?

* Everyone deserves to feel safe with their loved ones. If you feel like your partner exhibits any of the traits I describe in the first paragraph or any of the ones listed here, you may be experiencing abuse. Domestic violence takes many forms and can happen to anyone of any age and identity group. For confidential help and hope, please contact the National Domestic Violence Hotline at (800) 799-SAFE (7233).

Finally.

It’s been such a long journey already. At times, it was hard to let myself imagine that we’d finally be at this place and, truth be told, I’m still a little stunned by the reality of it.

It took months for K’s period to make its reappearance, then two cycles involving a wait for ovulation to occur and then agonizing waits to test for pregnancy. Our first attempt at insemination (IUI) involved a long delay between inseminating and K finally getting his period. We were completely overwhelmed by a constant sense of anxiety and took several pregnancy tests during that wait, one of which was a very faint positive. Unfortunately, by the time we went to our reproductive endocrinologist (RE) for blood work to confirm the pregnancy, we must have lost the baby. It’s what many refer to as a “chemical pregnancy.” It was a horrendous feeling of loss and sadness for us both.

Because K was finding it increasingly difficult to be off of testosterone, we decided to work with our RE to take fertility medication and a trigger shot with ovulatory monitoring to enhance our chances at conceiving during our second cycle. Our RE almost exclusively prescribes Femara to his patients on fertility medication because it has many of the benefits of Clomid without the potential side effects such as anxiety and depression. The monitoring involved endless early mornings to have K’s estradiol level checked and ultrasounds to monitor the size of his maturing follicles, most of which wasn’t covered by our insurance plan. We started to heavily stress about money as we watched the savings we’d manage to scrape together for this journey quickly diminish with each monitoring visit. We knew that if the second try didn’t end with the result we’d hoped, we would have to take at least one month off from trying in order to replenish our savings for another attempt.

We went into the second try with so many reservations. We were terrified to get any hopes up. Still, this time, we felt much calmer and a lot less anxious about our two week wait until we were able to test for pregnancy. During the beginning of the second week, when K brought home french onion dip from a routine tip to the pharmacy for refills, and then said he felt too yucky to eat the food he’d purchased on a craving-based whim, I felt a glimmer of hope. On Friday, at 2:30 a.m., K turned to me in bed and announced that he had to pee and wondered if we should test. I, having just ingested my second dose of sleeping medication for the night, followed K into the bathroom and sleepily waited. I wasn’t even paying attention when K announced, “I think I see a second pink line!”

It's a faint second pink line!

It was faint, but much more prominent than the previous month’s result. Still, after our previous month’s heartbreak, we were tentative and frightened. I went back to bed in my zombie-like, already asleep state, while K stayed up ruminating about the result. In the morning, we called the RE’s office and they congratulated us, assured us that a second line, no matter how faint, means that we are pregnant and that we should come in on Monday morning for the first of our bi-weekly HCG beta tests. We began to feel a glimmer of hope, but we were still somewhat skeptical.

That evening, I had picked K up at work and we proceeded to make an hour long trek to visit out-of-town friends for dinner. I brought a digital pregnancy test with me, just in case, so we stopped at a Speedway gas station to see if we could potentially confirm the result. We crammed into a single-stall restroom to test and created quite the line for the women’s room. People, of course, gave us dirty looks when we both poured out of a single restroom, but it was worth it to be able to confirm this joyous news.

We confirmed with a digital test.

On the evening before the 34th anniversary of when my mom learned that she was becoming a mom, I learned that I was about to embark on the journey toward motherhood as well. It was a meaningful and treasured day to receive such momentous news.