- •Some transgender men undergo hormonal treatment and/or surgery that preclude pregnancy, but many retain their capacity to become pregnant.
- •The reproductive desires of transgender men appear to be similar to those of cisgender individuals.
- •Many aspects of obstetrical care for transgender men is routine.
- •The provision of gender-affirming services and close monitoring for depression and worsening gender dysphoria are needed.
- •Research is needed to clarify the prevalence of pregnancy among transgender men of advanced paternal age as well as the risks and long-term impacts.
Transgender men are assigned female at birth, but self-identify as male. Although some transgender men undergo gender-affirming hormonal treatment and/or surgery that preclude pregnancy, many (if not most) retain their female reproductive organs and, as a result, their capacity to become pregnant. Although the visibility of the transgender community has increased, the exposure of healthcare providers to transgender individuals, especially transgender men during pregnancy, as well as research that addresses evidence-based practice remain limited. In this review, we discuss obstetrical issues for transgender men who are ≥35 years old, termed the “new” advanced paternal age. We review preconception care and focus on fertility issues, the impact of stopping gender-affirming hormonal treatment, and age-appropriate health maintenance. We review antepartum and postpartum care, including labor and delivery, monitoring for perinatal depression, contraception, and chest feeding. Finally, we conclude with suggestions for areas for further research and study.
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Published online: July 08, 2019
Accepted: July 5, 2019
Received in revised form: June 28, 2019
Received: June 13, 2019
© 2019 Elsevier B.V. All rights reserved.