An overwhelming deluge of legislation targeting the transgender community has continued into its fourth month in 2021, with more than 100 anti-trans bills introduced across 34 states. These include one Arkansas bill, now passed into law, that makes it a felony for doctors in that state to treat trans youth with the latest evidence-based, age-appropriate medical care.
The Arkansas Legislature is the first to seek jail time for doctors who treat transgender youth, but it won’t be the last. Anti-trans activists are pushing these types of laws everywhere, even though their legislative agenda is opposed by a majority of Americans, including those who support the GOP. These activists are unshakable in their conviction that transition is invalid and trans people must not be allowed to pursue it, regardless of the many benefits research has shown it to have. However, the savvy among them will disguise this coercive goal in the more palatable rhetoric of protecting “normal” or “healthy” bodies—particularly female-assigned ones, and particularly with regard to those bodies’ potential to have children. No matter that such “protection” comes at the expense of the actual health and safety of the trans people who inhabit those bodies: Transition must be stopped, and fertility fearmongering is how many anti-trans activists hope to do it.
You can recognize this rhetoric by its strange focus on the “damage” transition can do to specific body parts, such as breasts, uteri, and ovaries. It can be seen in action, for example, in the work of Irreversible Damage author Abigail Shrier (who testified against trans rights before Congress last month) when she worries over “healthy breasts” and casts trans male bodies as “maimed and sterile” in a November op-ed for Quillette. Many conservative anti-trans campaigners use language that echoes or copies Shrier’s, describing surgeries they deplore and anatomy they wish to save in detailed and troublingly lascivious tones focused on the bodies of teens. While it’s not unheard of for activists to bring up damage to trans women’s bodies, with a special focus on trans women’s genitalia, the vast majority of concern trolling about fertility and fitness for child raising is aimed at trans men, whom activists infantilize by referring to them as “daughters” or “young girls.”
The insincerity of fertility fearmongering is clear when you consider, first, that the risks of standard treatments like hormone replacement to trans men’s fertility have likely been overstated, and in any case, that transgender people are well-aware that some treatments may affect fertility. Informed consent protocols require doctors to talk the risks through with trans patients even in the least restrictive model of transition care. As a result of this process, some trans men opt for chest surgery but delay testosterone therapy several years in order to be sure they won’t harm their own ability to carry a child to term. Those who have the means to do so may access methods of preserving their eggs before commencing treatment that may reduce their fertility. Some of us have no interest in raising our own children but satisfy the urge to pass something on to the next generation through foster care or adoption. In other words, we weigh the options and make careful decisions that reflect our individual, adult needs.
We need more research on how different transition treatments shape reproductive health; more information—such as the recent evidence suggesting trans men retain their eggs and are able to become pregnant at similar rates to cis women after stopping testosterone therapy—will enable even more informed choices. However, the fact that some treatments will have an impact on trans people’s fertility does not mean these treatments should be banned, any more than the same procedures are banned for cisgender people who need them. All medical care is based on a careful weighing of risks vs. rewards. Evidence-based care describes the process of formally weighing these and determining the best available course of action to help patients at the current time. Transgender medicine is evidence-based care. That’s why every mainstream medical organization supports transition for patients who suffer from gender dysphoria.
By contrast, fertility fearmongering is the opposite of evidence-based. It stems from sexist ideas about the proper role of women and the purpose of female bodies: to bear children and to raise those children in the home. This reductive view of women as incubators, milk machines, and day care providers is now being visited upon trans men just as it’s been visited on cis women since time immemorial. It makes no difference if a trans man doesn’t want to bear children—conservatives believe he’ll thank them someday, when he’s realized that all he wants in life is to be a mother after all.
Of course, many trans men do choose to undertake pregnancy as men, and there are many steps that could be taken to make the process easier, kinder, and less expensive for them. However, the only people who should have any say about trans men’s fertility are trans men ourselves. The fertility fearmongers may claim they want to protect people, but by making the focus of that protection specific body parts and capacities, rather than a trans person as a whole, they betray their true goal: imposing heteronormativity and conformity, rather than allowing for healthy flourishing across a range of life experiences.