Pregnancy, Miscarriage, and Gender

IT WORKED!

We were pregnant! If you missed the story of how we got here, check out Getting Pregnant is Hard to do Without Sperm.

The first thing we felt was excitement. The second was anxiety. Not because suddenly such a big thing was happening, but because we had spent so long stopping ourselves from being excited in order to avoid the pain of disappointment that any excitement we felt triggered anxiety. This reaction slowly wore off and we allowed ourselves to be happy and excited but the more excited we got the more we wanted to share the news. Suddenly, we had a secret again.

I knew I was pregnant before we got the results. I know that’s a cliche but it’s true. My breasts were so sore that I couldn’t touch them, days in advance of when I normally have PMS symptoms. I was fatigued to the point of being in a daze. These symptoms continued and were joined by mild to moderate intermittent nausea. All the typical symptoms but nothing extreme. If you know me at all, you know I can’t keep anything to myself. Especially if it involves distress. I much prefer to complain – I mean, commiserate – about it with others. Luckily, a couple people at work were in their second trimester and gave me a small community for support with this new adventure.

GENDER WHILE PREGNANT

If you’ve read other posts on this blog, you may already know that I am gender fluid, shifting between moderately female and mildly male with the majority of time spent in the neutral space between. But, as I talk about in Menstruation and Gender, I consistently shift towards the female side during my period. The same thing happened when I was pregnant. Except that I wasn’t just pregnant for a few days, like when I’m on my period. So I shifted to female and stayed female for two and a half months.

After about three weeks of being consistently female I started to feel like the male part of myself, Ray, was imagined, a dream, a ghost. I was missing half of myself, unable to experience my full range of gender that I had only just recently struggled to understand and accept. This was a symptom of being pregnant that I couldn’t so easily explain to or commiserate about with others.

EARLY ULTRASOUNDS

Because we were followed by the fertility clinic, we were scheduled for early trans-vaginal ultrasounds. The first one was when I was 7 weeks pregnant. The image on the screen showed a slightly small gestational sack in my uterus but no yolk sack or fetal pole. This was mildly concerning but not conclusive since it was still early and the gestational sack was small. We went back the next week for another one. It showed the same result which was significantly more conclusive of a blighted ovum. With some googling, I learned that this happens when the egg that was fertilized happened to grow without any genetic material inside it. An ’empty egg’.

So, I had to come to terms with the fact that at some point in the next few weeks, when my body figured out something was wrong, I was going to have a miscarriage. I was waiting, and dreading, but not yet able to grief or process because if I did, I would be grieving until it happened, which could be days or weeks or a month. But I had to go to work as usual, travel to visit my family, and stand with my friend in her wedding. So instead, I became emotionally constipated, numb, and burnt out.

While visiting family, I had some spotting and cramping but then it stopped again. When we returned home, we had a final ultrasound that showed the same result and gave an official diagnosis of a non-viable pregnancy. This triggered a referral to the early pregnancy loss clinic. They called me four hours later and reviewed my options. I could let the miscarriage happen naturally (which my body didn’t seem to want to do), take a medication that would induce severe enough cramping to force my body to miscarry (sounds terrifying), or have a procedure (Dilation and Curettage or D&C) where they put me to sleep, dilate my cervix, go in, and scoop everything out. If the first two options didn’t expel everything I may end up needing the D&C anyway. Since I had known this was coming for what felt like an eternity already, I work in a hospital so medical stuff doesn’t bother me, and I had had a polyp removal six months prior via the same procedure, I opted for the D&C. It was scheduled for three days later.

RECOVERING FROM MISCARRIAGE

Both the physical recovery and the emotional recovery took longer than I expected, despite warnings from everyone I talked to who had also had a miscarriage (it is surprisingly common given how little it’s talked about). Physically, I had a few days of mild cramping and fatigue. When these initial symptoms faded out I felt like I was better and returned to work only to find that more than half an hour of being on my feet (I have a fairly active job) caused waves of moderate to severe fatigue, shakiness, dizziness, and hot and cold flashes. My body was in hormonal shock.

The most frustrating part physically was that knowing why it was happening and trying to connect with my body to calm it down did absolutely nothing to help. It felt like my body’s operating system had crashed and was taking forever to reboot. So I started doing really slow, gentle, breathing pace exercises. Anything from dynamic stretching to Qi Gong. Almost instantly, my mind-body connection began to repair itself. It was such a dramatic improvement at a time that I needed it most that I have kept up with these exercises ever since.

Emotionally, I expected to be a wreck as soon as the procedure was done and maybe the day after. But because I had not allowed myself to feel the grief for three weeks I was in an emotional holding pattern. I thought that maybe I had been processing my emotions this whole time and I didn’t need to have a strong, overt reaction. But the exhaustion after the second day back at work meant that I didn’t even have enough energy to hold my emotions back and once I got home I broke down and had a couple hours of intense crying and grieving with my lovely husband for support.

Overall it took just over a month for me to feel like I was back to my normal self.

GENDER WITH MISCARRIAGE

Going through the procedure itself and being in a ‘Women’s Hospital’ didn’t feel dysphoric since I was still feeling very female at the time. A week or so after miscarriage, my gender started shifting slowly back to the middle, then to the male side. And there it stayed for almost three weeks. This felt both good and bad. Good, because I was finally able to experience the other half of myself that had been missing for the last two and a half months. Bad, because all of a sudden I had dysphoria again. And I was out of practice with how to deal with it. While still being very emotionally raw.

Initially, it was very distracting and a constant irritation that sucked up a lot of mental and emotional energy. But I slowly remembered the strategies I had been using before and became acclimatized to the discomfort of dysphoria and it faded to a background buzz.

TALKING ABOUT MISCARRIAGE

Over the last few years both myself and my husband have been through some pretty major experiences that all have different levels of taboo and layperson knowledge/understanding. When I talk about our fertility struggles, very few people have negative reactions to discussing that and it doesn’t feel threatening for me to open up about it and though most people don’t know the variety of options, they have a general understanding that there are medical options and often know someone who has used them. When I talk about gender identity or transitioning, I don’t always know what reaction the other person will have and often have to deal with a negative or ignorant response. Most people have little to no understanding of nonbinary gender identities or the transitioning process to the point that they can’t even relate to whatever it is I’m telling them about unless I explicitly state what emotions are tied to this experience.

When talking about miscarriage, everyone instantly understands that that would be a difficult thing to go through, understands what emotional response is appropriate, and provides support. And yet, it’s still something that isn’t often discussed openly. I’m guessing this is partly because historically, it was viewed as the fault of the woman that it happened and was shameful. But nowadays, I think we’re mostly past that (based on the reactions I get when I talk about it) so I’m guessing it’s not discussed simply because it’s an emotionally difficult thing to talk about and considered a very private experience. I’d like to change the culture of silence around miscarriage and normalize talking about it and then eventually, normalize the idea that people of any gender identity could have a miscarriage.

THE JOURNEY CONTINUES!

At this point, we are still trying to get pregnant. There are a few more options we are willing to try and since the last one worked, I feel like it is likely to work again. But we have also discussed what our limit is in terms of how long we want to try for and how much money we are willing to put towards it. We are not tied to the idea of the child being genetically related to us (seeing as how it won’t be genetically related to Jake anyway) and open to considering adoption if we reach our personal fertility limit.

Subscribe to the blog or keep checking back to get future updates and find out what happens next!


Have you had pregnancy struggled or miscarriage? For those of you who are trans/non-binary, how did pregnancy and/or miscarriage affect your gender? Please leave a comment below. I’d love to hear your experiences.

Getting Pregnant is Hard To Do Without Sperm

When Jake and I first met we were unsure if we wanted kids. Once our lives stabilized it seemed a lot more feasible. Around the same time we spent some time with a couple small babies and had our parental instincts kick into high gear. Since both of us had a uterus and ovaries we had a choice of who would carry. Jake was more worried about being able to bond with the kid and I was more worried about the physical process of pregnancy so initially he was going to carry (this was pre-transition for him). This decision came with the caveats that if for some reason he couldn’t conceive or if gender ever became a question and he was no longer comfortable with it, I would carry.

Since neither of us produce sperm, our options were sperm banks, fertility clinics, or known donor. We were both less comfortable with the known donor path and there was a two year wait for our local fertility clinic. So the best option for us was to start with a home insemination program run by a sperm bank. We started saving money as each attempt through this program would cost between $1,500 and $2,000. When Jake’s gender questioning led him down the path of transitioning and he started to come out, we figured that was enough emotional stress on its own so we put the baby making on hold.

A year and a bit later, things had calmed down and we were ready to start trying. We started with home insemination from the sperm bank in Toronto. We signed up for the program, had a consult, and got blood tests done. We went through the online catalog and each month on day 1 of my cycle we would send in our top three choices to the sperm bank. On day 11 a 2.5 foot tall box would arrive which contained a large cryo container and a tiny vile of frozen sperm. It also contained specific instructions on how to thaw it and inject it. I tested for ovulation (LH surge) each morning and when it was positive we carried out the instructions. Then the dreaded two week wait (that anyone who has struggled to get pregnant will understand) began.

After four cycles and no success we decided to save the rest of the money we had put aside for future options. We quietly asked a few friends and family members if they would be interested in being a donor for us and ended up trying twice with two different donors (four more cycles). This involved a lot more social engagement and logistical planning but ultimately followed the same pattern of make plans, test for ovulation, do the thing, wait two weeks. Again, no success. We decided it was medical intervention time.

We went to our family doc to request a referral to the fertility clinic. Since we had only technically completed 8 tries (equivalent to 8 months of TTC – trying to conceive), he was reluctant since the typically referral criteria require 12 months of TTC. So instead, I got a referral to a women’s clinic where they ordered more specific blood work and other tests to make sre there was nothing structurally wrong. When this all came back normal, that doctor finally referred us to the fertility clinic.

The two fertility clinics in our city (one public and one private) had recently amalgamated which cut the wait time from 2 years to 6 months. When we finally got our appointment there was more blood work and tests. They started me on a low dose of Synthroid to get my thyroid levels from low normal to high normal. On the scan of my uterus they found a fairly large polyp that they decided should be removed prior to any insemination attempts so I was on a waitlist for that for another four months (which turned out to be 7 months). I had very little warning when my surgery date came up so, suddenly, I was having surgery (which went totally smoothly) and then we were told we could try on the next cycle.

Except with all the waiting I had slacked off and hadn’t gotten the mandatory counselling session booked, a requirement before ordering sperm. Within a week we had that done (a stupid, expensive hurdle that I could rant for a paragraph about but I will spare you), we ordered sperm (a fairly straightforward process since we had done it before), Jake got his final blood work done, I had my surgery follow up, and we were ready to try!

We decided that we would start with IUI (intra-uterine insemination) with a natural cycle (ovulation is not enhanced or induced with drugs) since I don’t have PCOS or endometriosis or other conditions that interfere with the menstruation and ovulation cycle. Again, I peed on sticks to detect ovulation, we phoned the clinic early in the morning when I got a positive result, and went in a few hours later. We received a mini report of the quality of the sperm and how well it had woken up from cryo. The insemination was completed by a nurse and off we went.

The two week wait was even worse than last time. Unfortunately our first attempt didn’t work. The month after we were out of town during my ovulation dates so we gave ourselves the month off to regain our emotional stability and tried again the month after. Somehow, this time felt different. A week after insemination my breasts became very sore and I had a few sharp pains in my uterus area. Since we were doing a blood test for pregnancy (HCG) two weeks after insemination we didn’t bother peeing on a stick. This time, the result came back positive. We were pregnant!!!

Read the next part of our journey in Pregnancy, Miscarriage, and Gender (coming soon).


If you relate to any part of the story above or have any questions, leave a comment below and I will respond!

Menstruation and Gender

Having a menstrual cycle is treated as a very female experience. It is seen as the transition from being a girl to being a woman. It is treated as a symbol of fertility and future motherhood. So it is understandable that people who menstruate but who do not identify as women would struggle a lot with this time of the month.

Menstruation is a huge trigger for dysphoria in a lot of people. For people that menstruate who don’t identify as women, they are going through PMS mood swings and the physical pain of cramps and the inescapable bleeding all while combating feelings that this invalidates their gender identity, that their body is doing things that feel wrong, and that no one would understand how this feels if they ever had the courage to talk about it.

Then there are the women who have never menstruated and never will. They hear other women complaining about their symptoms, having to take birth control pills, or see it represented in media (on the rare occasion). Not having a period and not being able to relate to the experience of having a menstrual cycle can feel invalidating of their identity as a woman.

There are many reasons why a woman may not have a menstrual cycle. And it’s not only women that can menstruate. We need to start separating the things our bodies do and the way our bodies look from gender. Menstruation is something that some bodies do. It does not belong solely to women and it is not necessary in order to be a woman.

Menstruation is something that some bodies do. It does not belong solely to women and it is not necessary in order to be a woman.

I am an AFAB, non-binary, genderfluid person. When it comes to my period, I am one of the lucky ones. Almost every menstrual cycle, my gender shifts in the female direction with the beginning of my period and has a corresponding shift in the male direction as my period ends. This means I have very little dysphoria when it comes to my period. Sure, I still have the fatigue and cramps and grossness but I feel more female than male at the time so it feels in line with my gender. Usually these shifts in my gender are gradual over the course of a couple days but when they happen in the span of a few hours it makes me feel very cranky, out of sorts, and often dysphoric. Maybe this pattern is hormonal, maybe its societal. All I know is that it’s consistent and very helpful.

I figured out this pattern by tracking my gender for a couple months which I describe here. Knowing this pattern has helped me significantly when managing dysphoria. I know to watch for the shift in my gender around the time when my period is supposed to start and then again as it’s ending which allows me to adapt my presentation and dysphoria management strategies more easily.

Not everyone with a fluid gender will have predictable fluctuations in their gender like I do and not everyone will have fluctuations based on a menstrual cycle. My gender fluctuates in less predictable ways during the middle of my cycle.

Regardless of whether someone’s gender fluctuates or not, they do not need to be a woman to menstruate and they do no need to menstruate to be a woman.


What influences your experience of your gender? Do you experience dysphoria related to having or not having a menstrual cycle? Leave a comment below with your experiences!

Different Ways to Explore Your Gender

The period of time between wondering if you might not be cis and figuring out what your gender actually is can be confusing, frustrating, scary, and isolating. There are many different ways to explore your gender. Don’t be afraid to try more than one. You might use all of these strategies at different times or only a couple of them. I hope this helps you find the most authentic and comfortable version of yourself.

Practical Experimentation

  • Try out a different presentation with clothing
  • Cut or grow your hair or try a wig
  • Use makeup or an app to try out facial hair (Snapchat, shaving apps)
  • Try a binder, packer, bra padding, or tucking
  • See what strategies decrease your gender dysphoria
  • See what strategies increase your gender euphoria
  • E.g.: the first time I wore a binder and saw myself in the mirror with a flat chest I knew that was how I was supposed to look.

Vicarious Experiences

  • Talk to other people with similar questions and identities
  • Listen to podcasts about gender (see my Resources page for a list)
  • Explore other people’s experiences on social media to see what resonates with you
  • Look at lists of labels and how different people define them to see if any of those definitions sound like your experience of your gender (if more than one feels right, that’s fine too! Labels aren’t boxes, they’re descriptors)

Process of Elimination

  • Determine what you for sure are NOT
  • Pay attention to what words, interactions, articles of clothing, or experiences make you feel less like yourself and head in the opposite direction
  • E.g.: I know I am not a girl but I’m not sure if I am a boy or agender.

Objective Guidance

  • Follow a guide for exploring your gender such as ‘You and Your Gender Identity: A Guide to Discovery’ by Dara Hoffman-Fox or ‘How to Understand Your Gender: A Practical Guide for Exploring Who You Are’ by Alex Iantaffi and Meg-John Barker
  • Track your sense of your gender on a scale that makes sense to you (5 female to 0 to 5 male, 0 can represent neutral or no gender)
  • List things that you have tried and how strongly they felt right or wrong to you to see if there is a pattern (maybe things that feel good all relate to a specific direction on the spectrum or maybe they are from all different points in the spectrum and you should be looking at gender-expansive identities)
  • Talk to a therapist who specializes in gender identity (highly recommended regardless of which other strategies you try if you are able to access one)

Try it Out

  • Sometimes it is very difficult to see how something will feel until you hear yourself referred to in that way
  • Find a group of two or more close friends or family that you trust and test out different pronouns, a different name, or different identity labels (if it is only one other person they likely won’t be using your name or pronouns since we only do that when we refer to someone in third person)
  • Pick an event that happened to you on a specific day and write it out like you are a character in a story using the name and pronouns that you want to test out
  • Join an online chat group that is gender positive and use the name and pronouns you want to test out
  • Try it out in private, then with close friends or family, out anonymously in public, at a larger queer group or random event, and eventually in everyday life
  • E.g.: I had been using they/them pronouns as a default because I knew that she/her and he/him felt equally wrong but when my friend started using xe/xir for me so I could try it out I had finally found something that felt right.

What strategies have you used? What strategies did you find the most helpful? Where certain strategies more useful at different points in your gender exploration? Leave a comment below with your experiences!

Note: the examples I used in this post are not my own experiences but are experiences I have heard other people describe.