Nurturing Birth doula and writer Emma Ashworth interviews Yuval Topper, trans man from Yorkshire and birth father of three to find out more about his experiences, and how doulas can better support trans men during pregnancy and birth.
Emma: Tell me about yourself, where you’re from.
Yuval: I am married to Matan, I’m from Israel but I live in the UK and I’m a trans man with three children who I gave birth to.
I had my oldest son (Lyrie) and my daughter (Aria) in Israel – my son in hospital and my daughter at home, although I had planned a home birth for them both. It’s not easy to have a home birth in Israel, and most midwives will not come once you reach 42 weeks, so at just over 41 weeks I was getting quite nervous. I decided to take castor oil which did seem to trigger labour – but also may have been why my Lyrie passed thick meconium when my waters broke, so we transferred to hospital.
Emma: How did Lyrie’s birth go?
Yuval: I really hadn’t wanted to go to hospital. I had gone to a different hospital at about 26 weeks with reduced movements. The experience in the hospital wasn’t too bad, and my baby was looking healthy, but then shortly afterwards a national newspaper contacted me, wanting to write about my ‘story’. Matan and I decided that we really didn’t want to talk to them – and they ran the story anyway – the first trans man to be pregnant in Israel. It was not positive coverage. The hospital denied that it came from them of course, but it really made me wary of contact with unknown medical staff.
Lyrie’s birth was quite traumatic. As is common in Israel I was made to have interventions that I didn’t want, such as an episiotomy and ventouse. I was also mis-gendered a lot. In Hebrew everything has a gender. In English I might be mis-gendered when someone talks about me, ie using she/her rather than he/him, but in the Hebrew language this can happen when someone speaks to you directly, and this happened a lot during his birth.
I really wanted to be completely naked while I was in labour, but the staff kept covering me which felt really irritating and against my body’s instincts. I did wonder whether they felt uncomfortable seeing my non-conforming body which is why they kept trying to cover me.
After Lyrie was born and I was moved to the postnatal ward, I had a frustrating conversation with a midwife or nurse who kept telling me how unusual the situation was, and she’d never come across it before, but she was fine with it. She was clearly out of her comfort zone and continuing to repeat that she was “fine with it” showed that she maybe wasn’t! Next day another staff member came round to see me and asked whether I was going to “stay a woman” now!
Emma: That sounds really exhausting
Yuval: Yes, I was feeling that I had to justify my existence rather than focus on my baby. But it didn’t end there. Although they gave Lyrie a registration number in the hospital, I had lots of problems when it came to register his birth. They would not allow registration from a man, and that forced me to re-register myself as a woman, register Lyrie and then register as a man again. The process is complex and for a while it was unclear whether they would re-register me as a man, which would have left me with unmatched identification such as my passport and driving licence.
Emma: What happened with Aria’s birth?
I again planned a home birth with Aria, and this time had a very positive birth at home. However when it came to registering her I had even more problems! The Registrar refused point blank to register her and actually told me that Lyrie’s was a “one time offer”! We did manage to register her in the end but it took so much time and effort, and for no benefit to anyone at all. It was transphobia, pure and simple.
Emma: So then you moved to the UK?
Yuval: Yes, and I became pregnant with our third child, Liam. At around 12 weeks of pregnancy I was phoned by the hospital and asked to come in for a scan – they had found a problem on my blood tests. My husband was away and my friend was unable to come with me – I was really nervous about attending an unknown hospital in a new country. Did they even know I am trans? How would they treat me?
In the end I went with a midwife that I had met once before, who I knew was trans friendly, and that she would support me to advocate for whatever I needed – but as it turned out I could not have been better cared for.
When I went to the appointment I received the devastating news that Liam had died at around 10 weeks of pregnancy. Despite the shock of the news I felt extremely well cared for by the obstetrician at the hospital. She made sure to ask me my pronouns, not assuming that I would prefer he/him (which I do) as some trans people prefer they/them or something else. I was otherwise treated just like anyone else – no one tried to ask me whether I was now going to stay as a woman! They were kind and supportive and recognised that I had just lost my baby, and my gender changed nothing about that.
Emma: When you were pregnant with your fourth baby, how did this influence your care decisions?
Yuval: When I was pregnant with Teagan – or Tig as we call him – a medical condition meant that I needed to have frequent scans and tests. My body had become Kell+ sensitised. This is a very rare condition which is very similar to being RhD Positive, but there is no equivalent with Kell+ to the anti-D treatment. I am Kell- and my husband is Kell+, so each baby has a 50/50 chance of being one or the other. As with RhD, this doesn’t matter for the first baby, but if any baby has a different blood type to the birth parent, and if this blood mixes, this can cause problems for subsequent babies. It seems likely that Aria’s blood, which is Kell+, mixed with mine during her birth. This means that my body became sensitised to it and my immune system is then able to attack the blood cells of any Kell+ baby.
We discovered through the NIPT test that Tig was almost certainly Kell-, which was a huge relief, but we could not know for sure. This did lead to a very stressful pregnancy, and I decided that I needed the support of a midwife that I knew, so we hired Hannah, the independent midwife who had been with me when I learned that I was miscarrying Liam. Having Hannah was a huge help, although I was also receiving excellent support from the NHS as well. In the end I birthed Tig at home together with Hannah and my friend Mari, and these photographs are the ones that Matan and I decided to share, and which have gone viral!
Even though the care in the UK was far more trans-friendly than I experienced in Israel there were still serious issues. For instance, the lab rejected my blood tests a number of times as my medical record has me recorded as male, and the lab tests were for pregnancy related conditions. This caused delays and could have impacted on mine or Tig’s health. I was also frustrated that, like in Israel, I had to have my name recorded on Tig’s birth certificate as “mother” – but here I also had to add in my occupation. So Tig’s birth certificate says “Mother… occupation – Full time dad”!
Emma: I love that! I do hope that the NHS will be able to update its systems to better support trans and non-binary people with all aspects of health care. It’s great that that you got the support from the staff. I’m wondering what, as doulas, we could do to better support trans or non binary clients?
Yuval: I think my biggest request would be to not make assumptions! For instance, many people assume that trans people don’t like their bodies. This is really not the case for many people! Many of us are very happy with our bodies. Different people do have different feelings about their body parts though – especially the genitals and the chest. Some people really struggle with the names of genitals and prefer to use different names. Others are happy to use the regular names. Where appropriate and relevant, just ask. However, consider whether you need to know – don’t just ask just because you’re curious. Also listen carefully for the words that the person you are supporting uses, and use the same words. For instance, if they mention chestfeeding, use the word “chestfeeding” rather than “breastfeeding”.
Please don’t assume what our pronouns will be, but ask what we prefer to use.
It can be really helpful to have the discussion about what kind of advocacy would be useful to us when we are in labour, or in hospital if we’re planning a caesarean. Please check whether, for instance, we’d want you to correct people using the wrong pronouns or words to describe the body that we have already said we would prefer to not use.
Ask if there are any other aspects of care that the doula should know and ensure that the medical staff know, if relevant. For instance, some trans men may be even more likely than women to object to having their breast/chest exposed or touched – especially those trans men who have not had top surgery (breast removal surgery).
Otherwise, trans people have the same needs in pregnancy and birth as anyone else, so once the differences have been discussed, please just support us as you would everyone else. Like birthing women, we want to have births which are right for us and personalised support where we are each asked what we need as an individual.
Yuval lives with his husband Matan and three children in Yorkshire, UK. To follow him on Facebook, click here: https://www.facebook.com/yuvaltopperez
If you are looking for doula support, please visit the Nurturing Birth Doula Directory.
Nurturing Birth would like to thank Tara Leach for permitting us to use her birth photography images in this article.
‘Your Child’s First Adventure’. ‘Tara Leach is a Manchester-based birth photographer. She is interested in documenting all births and all adventures. To get in touch either see her on Facebook or email firstname.lastname@example.org