To think that pregnancy care SHOULD be focused on helping women to have healthy babies?

[CatusFlatus]

This article in a medical journal advocates the taking of testosterone by trans-identified females during pregnancy, despite the proven and potential risks to the unborn child.

The claim that ‘gendered’ pregnancy care is too focused on helping women to have healthy babies and that it is acceptable for transmen to continue taking testosterone during pregnancy, despite the proven and potential risks to the foetus because of, for example, concerns the transman has about being mis-gendered or their desire to be regarded as a pregnant man.

They claim that the desire for ‘normal foetal outcomes’ is problematic because it is born of a wish to protect babies “From becoming anything other than ‘normal’” and reflects the “Historical and ongoing social practices for creating ‘ideal’ and normative bodies.”

This is insane.

Are they suggesting that we adopt health advice for transmen that embraces a step away from the normative body ideals of an infant whilst we continue to hen peck women over the harms done by unpasteurized cheese, the odd glass of wine and caffeinated drinks or does everyone get a 'who the fuck cares?' pass?

I imagine the status quo will be maintained for women who don't identify as men.

The looks I got drinking coffee when I religiously stuck to one a day, under the guidance amounts

There's something seriously wrong if you can't see the harm in this.

This! This is exactly what I was going to say.

Madness to suggest that babies don’t actually need to be born healthy if at all possible. But put up against society’s voracious desire to police women who don’t identify as men it’s even more obscene.

Oh fuck off

Like seriously? You think this ok?

My faith in humanity is falling off a cliff. How are you defending this? 🤯

So you are advocating giving rights to the foetus, which will override those of the mother?

You do realise just how far the consequences of that stretch, don't you?

I believe a woman’s body is her own right to do with when pregnant, but much like smoking warnings on cigarette packets the information for all women of all risks of what is put in their system should be made. If a woman decides that taking testosterone and living as a trans man is for their ultimate welfare then so be it, but it should always be clear that taking medication could affect the typical development of a foetus. There’s no point in ‘be kind’ if you’re being sued to hell by a patient who’s child has disabilities that could have been avoided if given the right medical information.

If a woman decides that taking testosterone and living as a trans man is for their ultimate welfare then so be it

What if the woman wanted to take thalidomide? Genuine question.

I agree. I’m uncomfortable with it - given the risks of testosterone during pregnancy - but it should be on a case by case basis.

It's disturbing for sure.

We know drinking excessively causes FASD. How would the argument go if doctors started saying "you're medically cleared to drink 5 vodkas a day because it's your wellbeing that matters, not the foetus"?

They don't - they alert social services and if necessary remove the infant if it's been harmed or is at risk of harm.

IMHO if you don't want a healthy baby above all else then you shouldn't be a parent.

I believe thalidomide is used for some cancers (amongst other illnesses), I suppose doctors weigh up the risks and benefits to both parent and child.

I can see how the "my body, my choice" mantra can lead to this being seen as acceptable behaviour for a pregnant woman, combined with the eugenics perspective it seems like it could potentially be difficult to argue against unfortunately.

Then she does. Just like women decide to still take drugs or drink excessively during pregnancy. I’m not saying I agree with it in the slightest, hell I know people who are living with the consequences of their mothers making these decisions when pregnant, but ultimately I think there is little to be done other than give clear guidelines about what can harm a baby when pregnant. Other than start policing and punishing women about their bodies which is a horrific idea.

The article advocates doctors continuing to prescribe known teratogenic medications to certain patients, not because those patients have life threatening illnesses, but because those patients might not like stopping the medication during pregnancy.

The current standard of medical care is to do everything possible to produce a healthy newborn. This often requires women to adapt or delay their own medical treatments during pregnancy. It is a balancing act because a healthy pregnancy also requires a healthy mother, but women do have to deal with less than ideal treatments for chronic and acute conditions while pregnant. The article claims this standard is unfair to trans-identified individuals who wish to become pregnant.

A woman isn’t just deciding to take thalidomide or testosterone during pregnancy, a doctor is prescribing those medications and the woman is choosing to use them. It is completely different than drinking or using illegal drugs. This is asking a medical professional
to participate in the dangerous and damaging behavior.

I believe thalidomide is used for some cancers (amongst other illnesses), I suppose doctors weigh up the risks and benefits to both parent and child.

Do we have any evidence that doctors are still prescribing thalidomide to pregnant women? In any circs?

If someone wants to "live as a man" for their mental health then surely they wouldn't want to go through pregnancy at all just like a "biological male" couldn't.

Women are routinely not given medication when pregnant so as to not harm the foetus, or given medicine to help it (aspirin, folic acid). Of course you can go out and get drunk, high, smoke and take whatever medication you can get your hands on but we don't operate in a society where no one gives a fuck if the foetus is harmed until the moment it pops out.
If the only thing that matters is the Mom, presumably we should stop giving out folic acid etc, and remove any guidelines or restrictions on fun stuff or medical stuff?

Pharmacists frequently refuse to sell OTC medication to pregnant women in case it causes harm.

The paper says that the risk to a foetus’/baby is that they may have higher chance of being LGB or have ASD. I don’t think that any of that means a baby is unhealthy.

I agree. You can't happily sit there, drowning in testosterone , believing that attempts to protect the baby's health are akin to Nazi eugenics and social control.
Anyone who thinks like this isn't fit to be a.parent.

See, in their review of the scientific evidence they say
”Concerns about fetal exposure to “excess androgens” among offspring born to people with PCOS include, among others, urogenital and intersex conditions (such as an enlarged clitoris or other forms of “ambiguous genitalia”) and later development of “metabolic dysfunction” (including “obesity” and PCOS), non-normative sexual identities, and/or “neuropsychiatric disorders” such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder(ADHD), largely among those categorized female at birth (Byne, 2006; Cesta et al., 2020; Hakim, Padmanabhan, & Vyas, 2017; McDonnell & Hart, 2017; Palomba et al., 2015; Risal et al., 2019). These same studies often do show increased associations between these conditions, experiences, and identities among the offspring of gestational parents with higher-than-average levels of testosterone during the gestational period.

However, making causal claims about associations between “excess androgens” and the aforementioned conditions would be scientifically misguided (Cesta et al., 2020; Susser, 1985). Long latency periods (Susser, 1985) between in-utero exposures to “excess androgens” and offspring’s later development or diagnosis of nearly all of the aforementioned embodiments and identities (with the exception of some intersex characteristics) renders causal assertions suspect. The potential for parental “excess androgens” to be confounded (Susser, 1985) with other possible parental conditions or differences (e.g., insulin resistance, congenital adrenal hyperplasia, genetic variations) may also result in causal misattribution of parental androgen levels for particular offspring outcomes that ignores the originating drivers of parental elevated androgen levels themselves (Cesta et al., 2020). Further, as Richardson (2021) notes, scientific evidence for establishing gestational exposure as a causal mechanism for later development of various human embodiments and heath conditions is often cryptic at best. While we may be able to use current scientific tools to measure and establish various “excesses,” “deficits,” or diversions from metrics established as “normal,” this information does not always translate to perceived differences in actual human embodiments, experiences, or health across the life course.”

Crickets 🦗?

So, in light of the fact there are causal links or proven risks to the physical health of a foetus from excess testosterone, does anyone else think that the outrage is a bit overblown?

When we start defining ‘healthy’ as potentially more likely to be straight and NT….that’s eugenics territory imho.