How norms concerning maternity, femininity and cisgender increase stress among lesbians, bisexual women and transgender people with a fear of childbirth

Childbearing at the margins: A systematic metasynthesis of sexual and gender diverse childbearing experiences

“…Sample sizes ranged from 5 to 28 (M = 14.1) participants, with a total sample size of 297. Most participants were from studies comprised of gestational parents (n = 13), 32–44 co‐parents (n = 6), 45–50 or a combination of both gestational and co‐parents (n = 6) 25,51–55 . Samples were predominantly White (≥75%), highly educated (≥59% had at least a college degree) and partnered.…”

“…The majority of co‐parents were cisgender women. Studies included childbearing experiences in the United States (n = 9), 34,36,38,39,46,47,50,52,55 Canada (n = 3), 33,43–45 Australia (n = 1), 37 European countries (n = 5), 25,32,48,49,52–54 or a combination of these countries (n = 3) 35,40,41,51 . Further details of sample and study characteristics are in Tables 1 and 2, respectively.…”

“…Interestingly, some physical changes, such as an enlarged abdomen among transgender men, were perceived as a “fat, male belly” which affirmed their gender as male 36,40 . Enlarged chest tissue, however, was perceived as feminine and resulted in misgendering and dysphoria 36,37,40,54 …”

“…Other physical factors contributing to distress included the impact of testosterone tapering, such as loss of muscle and masculine features and increased feelings of depression 37,38,42 and gestational changes including weight gain, enlarged abdomen, widening hips, and chest tenderness 25,33,37,38,40,41,54 . Some described physical and emotional changes as feminine or incompatible with masculinity, 34,37,38,41,51 whereas others described gestating or chestfeeding as not inherently feminine or belonging to any gender 33,38,40,41 …”

“…Loss of privacy occurred when intimate body parts were exposed during pelvic examinations and childbirth 25,41,54 and when individuals were repeatedly compelled to “come out” to health care staff 32 or strangers when asked about the “father” of the baby 34 . Coming out was frequent, uncomfortable, and exhausting, often requiring explanation and education around their identity or family formation process.…”