Transgender man gives birth and wants to be recorded as baby's father

[OrchidInTheSun]

FFS

I just heard this on the news. This fucked up person says it's a breach of their human rights not to be recorded as the baby's father.

I'm kind of running out of words to express my feelings about this

@poisonoussmurf Millions and millions of parents make selfish decisions about some things. Their decision should definitely not lead to the very cruel and life destroying action of removing their baby.

And can I just point out that this person is a woman. The people we are concerned for primarily here. The fact she does not wish to be has no bearing on me. I detest seeing them disparaged in such a harsh way.

I would really like this thread to stand because there is some really informative stuff on here.
Nobody else on here has called for a child to be removed from its parent based on this case and what has been discussed on here PoisonousSmurf

@GeorgeFayne

I feel like I'm being victimised here.

I didn't say all female infants with CAH have what appears to be a penis and scrotum only that some can. In understand that cliteromegaly or an ambiguous appearance would be more common.

It is certainly possible so please don't accuse me of lying.

Explaining that an apparently male child with undescended testes is actually XX with CAH to parents was one of my cases in an MRCPCH prep course.

Would you care to read this paper exploring the issues surrounding "approach to assigning gender in 46, XX congenital adrenal hyperplasia with male external genitalia" which is based in a case series before you accuse me of lying.

academic.oup.com/jcem/article/95/10/4501/2835100

I didn't say all female infants with CAH have what appears to be a penis and scrotum only that some can.

That is correct. You didn't. You claimed that someone can be born with a uterus and male genitalia.

Your quote: Imagine the following: I am XX with a womb. But I also male genitals that I was born with, a male physique, a birth certificate where I am given as a boy, a wife with whom I have penetrative sex.

@Terfsup

Again, which they can. As I said before, not an impossible scenario.

Classic CAH with virilisation at birth (therefore androgynous or male appearing genitalia) can with steroid treatment produce ova and sustain a pregnancy. Obviously most people in this position would identify as female, and would have had corrective surgery to make their genitalia appear female. However, in theory if they did not, if they chose to keep a phallus with a typically male penile appearance (obviously they could not conceive naturally without a vagina), and were taking adequate suppressive steroid treatment, then they could sustain a pregnancy in their own uterus, despite having a "penis'.

I don't actually know how taking the steroid treatment would affect erectile function.

Really, I should not have brought up intersex (I regret it), this isnt the right thread to discuss it. However, I profoundly resent being called a liar when I am not.

Here is a case study of a woman with CAH who sustained a pregnancy in her own uterus. She had corrective surgery to alter her genitalia to have a more female appearance (clitoral resection and vaginoplasty) www.ncbi.nlm.nih.gov/pmc/articles/PMC4742476/

Okay?! So please stop calling me a liar.

Just to be clear (and so that I am not accused of being dishonest!) the woman in this case was identified as female at birth. She did not have completely male genitalia. However, I can see no reason, given that CAH is a spectrum with a variety of internal and external presentations, that it is possible for a person to have male appearing external genitalia, and a functional uterus in this condition. This ofc would not be common! It's a stupid point that I should never have brought up. But I wasn't lying.

@Shrimpi

No. A person with XX chromosomes cannot be born with male genitalia with which they can have penetrative sex with a woman. Please provide me with an example from the literature to support this "scenario" (your word, not mine).

Since this Also, a fully functional uterus AND fully functional Male genitalia have never been seen to coexist - again please do let me know if I’m wrong. Non fully formed male genitalia and non functional aspects of the female reproductive system have been found in individuals. has been asked twice, now is your chance to set the record straight.#

Thank you.

@shrimpi

Okay?! So please stop calling me a liar.

Please point to my post(s) where I did so.

She did not have completely male genitalia.

But this contradicts the "scenario" you posited and that I quoted, in full, above.

However, I can see no reason, given that CAH is a spectrum with a variety of internal and external presentations, that it is possible for a person to have male appearing external genitalia, and a functional uterus in this condition.

Again, you are using the term "appearing". There can be a huge difference between what someone or something appears to be and what they are. A person with a hearing impairment can appear to be someone with perfect hearing. A person with a prosthetic leg, while wearing trousers and and shoes, can appear to be a person with two legs.

I can see no reason, given that CAH is a spectrum with a variety of internal and external presentations, that it is possible for a person to have male appearing external genitalia, and a functional uterus in this condition.

CAH is not my speciality, so I will be open to any specific case studies, but as far as I’m aware, it doesn’t ever result in a phenotype with fully functional genitalia of both sexes.
Indeed this is one reason why the waitcand see approach is now (or was before all this trans madness) advocated. What can appear to be fairly normal male or indeed female genitalia in a child can be present but then when puberty hits, the person may find their real sex starts to become more physically apparent - there are many cases of this going back a very long way.

The trauma caused to a child who is ‘assigned’ a sex, is raised as that sex and then finds they are actually a different sex is immense. That’s why watch and wait is the best option. Once you’ve surgically removed something, it’s not going back. This also is a powerful argument against gender stereotyping - intersex people need to be treated as ok as they are, not shoehorned into a girl box or a boy box with attendant surgery.

Indeed if we were all just ok as we were and not shove down into these little boxes, then there would be nothing to be transgender about. and the world would be a better place.

The trauma caused to a child who is ‘assigned’ a sex, is raised as that sex and then finds they are actually a different sex is immense. That’s why watch and wait is the best option. Once you’ve surgically removed something, it’s not going back.

Absolutely. There was a case some years ago of a little boy whose penis was destroyed in an accident. The parents were advised to raise the little boy as a girl, with devastating results for the child in question.

More information here: www.bbc.co.uk/news/health-11814300.

@Terfsup

Females with fully externally male genitalia and CAH still have uteruses and ovaries. It is the external genitalia that are virilised.

Females with CAH and a uterus can sustain a pregnancy if taking the correct steroid treatment (fertility problems are common ofc but not insurmountable).

The steroid treatment would not alter the appearance of already formed external genitalia.

So where does it follow that what I said was impossible? I haven't found a specific case from the literature (by which I mean Google search because I am literally on my phone) of someone choosing to retain male appearing genitalia whilst wanting to sustain a pregnancy but there is no reason why they could not (with IVF). Here is another study dealing in reproductive outcomes in in women with "classic CAH" (that means virilisation at birth resulting in partly or fully male external genitalia). So women born with partly or full male genitalia can be fertile with CAH. See this article www.ncbi.nlm.nih.gov/pmc/articles/PMC3784860/
.. Which deals with fertility in "classic CAH".

It's simply the case that the vast majority identify as female and would therefore not retain male genitalia. Anyone XX CAH identifying as male would probably be highly unlikely to want to carry a pregnancy as that would interfere with their gender identity particularly as they would have to suppress their androgen production in order to do so. Their ability to produce viable ova and a uterine lining amenable to pregnancy might be impacted if they had produced excess androgens for a long time (by not taking the treatment, as I imagine you would not if you wanted to remain male)? I'm not sure.

But in theory, there is nothing to stop a woman from being medically treated for CAH, but not surgically treated, thus retaining male appearing genitalia. Her uterus would still work. And she could still become pregnant.

I concede it was a theoretical point for an arguments' sake. I was trying to make a comparison between a confusing or unclear situation re male sex and pregnancy in a biological intersex scenario (about which I assumed people would be sympathetic) in order to increase empathy for the same situation caused by a psychological or psychiatric disorder (transgender). In the same way that people often create allegories between physical and mental illness because mental illness is stigmatised. I shouldn't have made it as it has become a huge distraction from the actual point of this thread. And I was too confrontational and I'm sorry.

But regardless of my failings in our exchange, it isn't impossible! The part I genuinely don't know enough to say either way is what the impact upon male sexual function in my hypothetical would be. There is literally no literature or evidence on that that I can form a supposition on! If I were to recreate the hypothetical scenario, I would leave that bit out ;)

Okay, that is literally all I have to say on this. I just want to be understood and for my motives to be clear that I haven't got some kind of agenda, and I wasn't being dishonest. If you think I'm a TRA or a crazy person to just an idiot then that's okay but let's just finish it because I think we both would benefit from getting on with something else!

I really regret becoming confrontational because this topic is actually really interesting and I would like to be able to just discuss it without being defensive or trying to prove a particular point. Albeit in the wrong thread, but what the hey.

Babelfish people with XX CAH do not have testes. They have ovaries and a uterus. So they dont have double gonads. And they will never produce a sperm. In that way they cannot ever have full male reproductive function.

But the clitoris and the penis are essentially the same organ (the phallus) and how penis-like it is depends on the developmental response to androgen. The same is true for the labia / scrotum.

Its not unusual to refer to a phallus which has a male anatomy glans, shaft, urethra etc as a "penis" or as "male external genitalia" even in XX CAH. Nor to refer to scrotum (an empty one) as a scrotum. Most people with XX CAH won't be that fully virilised but some are. Technically, it is a virilised or enlarged clitoris (but so are all penises!)

I really regret becoming confrontational because this discussion is actually really interesting and would be so much more enjoyable without a point to prove or defend. Even if it is the wrong thread!

Now my reproductive endocrinology may be fuzzy in places but bear with. Babelfish - people with XX CAH have uteruses and ovaries, the do not have testes. I believe this is because the presence of testes are determined by mullerian inhibiting factor found on the y chromosome and not by testosterone. Only after the gonads have been determined do the testes in males or ovaries in females either begin to produce or not produce testosterone accordingly.

So I believe that all women with XX CAH have ovaries and a uterus. None have testes (unless by freak coincidence they have a separate intersex condition). They will never produce sperm or be fertile males.

However, the structure appearance of the external genital tract and genitalia (that is vagina, urethra, vulva/scrotum and clitoris/penis (aka the phallus) are determined by subsequent testosterone production. In CAH the adrenal glands produce lots of testosterone even in the absence of testes.

Now, "male appearing" vs simply "male" is almost an arbitrary point. It is common in literature for XX CAH genitalia to be referred to as "male external genitalia", "phenotypically male", and "penis and scrotum". It could also be acceptable to refer to them as "androgenised" or "virilised" vulva/clitoris/genitalia. But all penises are a virilised clitoris, or equally, all clitorises (clitori?) are a non-virilised penis, depending on how you look at it. They are equivalent organs. If you have a structure consisting of foreskin, glans, shaft, erectile tissue that contains your urethra you have a penis or "virilised" female genitalia simply depending on the terminology someone prefers to use.

So absolutely not, people with XX CAH are not haemaphrodites in that they only possess female gonads and they can't produce sperm. But they may possess phenotypically male genitalia (the difference being their scrotum would not contain any testes), and as to whether this would be functional - it isn't ever going to ejaculate but otherwise could function entirely as a penis would (erection, sensation etc).

As you said Babelfish, if I found my own child in this position (male external genitalia, XX CAH) I think I would probably not opt for irreversible/destructive surgery until it became necessary and was the child's own wish. However, the question re medical treatment for androgen suppression becomes important around puberty as it could affect the female reproductive capability of the individual (eg their ability to produce viable ova and fall pregnant). Hopefully, at this time their gender identity would be established making decisions a bit easier.

It is my understanding that the vast majority with XX CAH have a female gender identity.

@Shrimpi - you keep using the word "appearing", which makes your argument invalid.

Therefore, what you are proposing IS impossible.

@Shrimpi - can you please tell me where I called you a liar? This is the second time I have asked.

You do seem to evade questions that you are unable to answer, which further damages the credibility of your claims.

A fourth request to answer BowlofBabelFish's post above, please.

Now, "male appearing" vs simply "male" is almost an arbitrary point.

No, it is not. It is a crucial difference. It is the difference between the reality of something and the semblance of something.

@TerfsUp

I don't want to have a confrontational argument with you, but trying to take a step back and make things more friendly doesn't seem to be working. From my end it feels at the moment as though you are trying to prove every single thing that I say "wrong" so that I will be vanquished. Thats a very unrewarding position to be in, regardless of who is "right" or "wrong". I'm sure that you don't enjoy arguing bitterly either? Who does?

I'm sorry that I was confrontational and rude to you initially. I think I've said all that I need to to make my view clear and to explain it as best as I can. Repeating myself isn't going to help and I don't have any more new "arguments" to make. Either people will read what I've written and understand where I've been trying to come from, or they won't. I have to accept that and stop this discussion now.

Thank you for your time.

I do get your point - I think mine was that individuals generally don’t have what a layperson would consider to be fully functioning male genitalia PLUS fully functioning female reproductive parts. By fully functioning I mean possession of working ovaries, uterus, and a connection to the external body via a vagina.

What most people with ambiguous genitalia have is not what a layperson would consider ‘correct’ (and I use that term without offence to anyone intersex.)

The reason this is a hot topic on here is because we have endless TRAs pontificating about a rather warped version of science where everything is on a spectrum and there are a million different sexes. In this frankly warped world view intersex people are often held up as ‘proof’ of this when in fact they’re nothing of the sort.
Even what’s classed as ‘true’ hermaphroditism isn’t what people seem to think it is (the popular perception is all the female parts and all the male, fully functional in one person.) it’s more usual to have. 46,XX karyotype, with either some degree of crossover from the Y tagging along or the mosaicism discussed earlier. It usually presents as ambiguous genitalia and people were historically raised as boys but then began female secondary sexual development at puberty in line with the true sex.

This isn’t an accusation levelled at you, shrimpi, but rather one at the TRAs who tend to come here - intersex people are being used by the TRA lobby. I can imagine they’re pretty pissed off with it. Their existence is not some kind of freak show, or some kind of ‘aha! But what about!’ Proof of TRA ideology. They suffer from a rare and often distressing condition and it’s dosturbing to me that they are being hijacked in this way. Again, that’s not a criticism of you, I’m trying to explain why bringing up intersex conditions tends to get people on here riled.

I wonder how a girl child would be brought up in this situation.

Thank you babelfish. I think the problem is that I tried to raise something that I shouldn't have and was ultimately completely unhelpful to the purpose of the thread, I recognise that. But I'm a "newcomer" to trans debate threads. As I told you I avoided them because of the bunfight aspect. So I was not aware of any arguments that are "usually" made by any group.

I feel like I tripped some kind of wire I didn't know existed that led to several people immediately assuming I held some kind of extreme ("TRA") platform I do not; and the immediate reference to and slamming down of things I didn't refer to, didn't think of even. Lots of points seem to have been vigorously refuted that I wasn't aware might have come across from my statements (and that I was never trying to make).

I can see in the context of this debate (and its history) why that happened. I didn't understand that context being a "newcomer".

It has taken a long time to clarify my own views and I really appreciate that you have given me the chance to do that and have been so well mannered about it.

Trans seems like one of these topics where there is a heavy context and polarisation into 2 opposing views and the labelling happens fast.

To avoid the same thing happening again, I feel before making any "pro trans" statement I would have to consciously and pre-emptively refute unfair or false TRA arguments just so that I am not misinterpreted as trying to make them myself. But that is really exhausting and off-putting. I think in honesty my learning point from this discussion is "resist any temptation to ever engage in a trans debate on mumsnet".