Trans and non-binary families

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by Huriana Kopeke-Te Aho

Serving trans parents well

Pregnancy health care services need to be inclusive for trans, non-binary and takatāpui parents.

Transgender and non-binary birthing parents face barriers in accessing health services that have been designed for heterosexual women. With a grant to Otago Polytechnic from the Health Research Council of New Zealand (20/1498A), a research team has been working to identify how services might become more inclusive. Led by Dr George Parker (Victoria University of Wellington), the team includes Associate Professor Suzanne Miller, Professor Sally Baddock and Alex Ker from Midwifery at Otago Polytechnic, Dr Jaimie Veale (University of Waikato), and Dr Elizabeth Kerekere (Tīwhanawhana Trust). In the first phase of the project, trans and non-binary people were interviewed about their experiences of pregnancy health care services in New Zealand. 

For phase two the team has now also examined what is happening in practice, conducting an online anonymous survey to assess the current knowledge, beliefs and clinical preparedness of health professionals in the perinatal workforce in Aotearoa New Zealand. There were 476 complete responses for analysis. The researchers' recommendations for providers of pregnancy health care services include:

  • Be aware that the journey into perinatal care may have been challenging for trans people and whānau.
  • Respect and reflect the words people use to describe their gender, pronouns, different parts of their bodies, their babies' sex/gender, and who is part of their whānau.
  • Anticipate whānau diversity in your practice or service.
  • Understand that trans people self-determine and express their gender differently, and there are many ways of being trans.
  • Advocate for trans people and whānau to safely navigate their journeys through perinatal care.

Assuming that gynaecological and reproductive health service users are all cisgender women perpetuates discrimination and disavantage that contribute to poorer health outcomes for others. Aotearoa New Zealand has an opportunity to ensure system and workforce readiness to provide trans-affirming and -inclusive care to improve health equity.