Sally Hines has a hand in this. Why should pregnant transmen have to stop testosterone?
https://www.sciencedirect.com/science/article/pii/S2667321523000811
Medical uncertainty and reproduction of the “normal”: Decision-making around testosterone therapy in transgender1 pregnancy
Some extracts:
But what happens when medical science doesn’t yet have all the answers about how patient behaviors may relate to health outcomes for both the pregnant person and the fetus—particularly when they may create potentially-divergent health outcomes for the pregnant person and fetus? How do patients and providers understand and weigh relative health risks and benefits as they formulate, dispense, or work to interpret and follow medical advice at this complicated intersection? How might assessment of health risks, and concomitant medical advice for behavioral change, reflect historical and ongoing social practices for creating “ideal” and normative bodies and people?
We find that the medical science around the potential effects of gestational parent testosterone therapy on fetal development in-utero or infant secondary exposure during the postpartum period (e.g., via chestfeeding/breastfeeding) remains nascent at best (Oberhelman-Eaton et al., 2021). Previous research repeatedly demonstrates how ambiguity and uncertainty is associated with authority-(re)establishing practices that may either intentionally or inadvertently involve stigma, discrimination, and poor care (Doan & Grace, 2022; Freeman, 2015; Poteat et al., 2013; shuster, 2019, 2021) and gendered precautionary practices that work toward avoiding potential risk through protecting embryos, fetuses, children, and families above all else (MacKendrick, 2018; Waggoner, 2017).
These precautionary and expertise/authority-(re)establishing approaches had the result of shoring up social constructions around binary conceptualizations of sex and sex hormones and was driven, in their explanations, by a focus on attempting to (re)produce normative bodies and people.
The logics guiding current medical advice around precautionary testosterone cessation in pregnancy involve potentially troubling assessments of the sorts of risks testosterone exposure in the prenatal and postpartum environments may pose for later child and adult development: namely, potentially heightened likelihoods of autism, obesity, intersex conditions, being lesbian and/or trans. In this way, precautionary practices of protecting the offspring of trans people become, paradoxically, a method of social control through safeguarding against reproduction of some of the very same characteristics held by some trans parents themselves. It also raises the specter of panoptics of the womb and epistemic injustice as it simultaneously reflects elevation of the epistemic authority of medical professionals and erosion of the epistemic privilege of trans gestational parents (Freeman, 2015).
This work aims to make room for further consideration of testosterone therapy during pregnancy for trans people, with a call to more fully consider their mental and physical health alongside predominant precautionary approaches for safeguarding the normativity of their offspring. Doing so attends not only to the social control functions of working to prevent non-normative bodies and people, and the artificial binarization of sex and gender in medicine and society, but also that between mental and physical health as it insists upon increased attention to the mental health concerns and well-being experienced by trans people before, during, and after pregnancy.