WEBVTT 1 00:00:00.000 --> 00:00:05.280 Hello everyone. Welcome to this session at the Adelaide Festival of Ideas. 2 00:00:06.000 --> 00:00:12.820 My name is Sarah Keenahan from The Conversation Australia and today's session is presented by Damien Riggs 3 00:00:12.820 --> 00:00:16.580 who will speak about futurity and fertility in transgender people's lives. 4 00:00:17.180 --> 00:00:19.380 I'll now hand over to our speaker Damien. 5 00:00:23.080 --> 00:00:27.600 Good morning. I too would like to acknowledge that we gather on the lands of the Kaurna people 6 00:00:27.600 --> 00:00:30.340 and to acknowledge their sovereignty as First Nations people. 7 00:00:30.680 --> 00:00:34.800 So this is a quote that I use a lot from the work of Turner, Brian Turner, 8 00:00:35.120 --> 00:00:39.780 and he suggests that the state's interest in sexuality, and I'm going to talk today how I put in brackets, 9 00:00:39.940 --> 00:00:45.220 and gender diversity maybe, is secondary and subordinate to its demographic objective 10 00:00:45.220 --> 00:00:49.820 of securing and sustaining this connection between reproduction and citizenship. 11 00:00:50.160 --> 00:00:50.940 So what does he mean? 12 00:00:51.600 --> 00:00:56.900 Turner's focus is on the idea that increasingly to be seen as good citizens 13 00:00:56.900 --> 00:00:57.580 we need to be considered as good citizens. 14 00:00:57.600 --> 00:00:58.960 We need to be reproductive citizens. 15 00:00:59.280 --> 00:01:01.280 And we can see this in a range of different places. 16 00:01:01.500 --> 00:01:05.200 You know, the baby bonus, other incentives to people to have children. 17 00:01:05.460 --> 00:01:08.720 This is very prevalent under previous governments. 18 00:01:08.800 --> 00:01:12.500 There was a very clear mandate to people to reproduce. 19 00:01:14.080 --> 00:01:16.680 Concerns, and we're in the pieces in the conversation recently actually, 20 00:01:16.720 --> 00:01:23.060 around concerns around falling population rates, that we're not at replacement rate, 21 00:01:23.180 --> 00:01:26.400 what's going to happen to people as they age, who's going to care for people. 22 00:01:26.400 --> 00:01:29.760 So this is something that I've used in a lot of areas of my work. 23 00:01:29.840 --> 00:01:31.060 I've used it around surrogacy. 24 00:01:31.380 --> 00:01:39.140 I've used it around heterosexual first time parents to think about what brings people to that path of reproducing. 25 00:01:39.420 --> 00:01:42.440 I'm particularly interested in this around transgender people. 26 00:01:42.700 --> 00:01:46.640 I'm a researcher who does a lot of research on transgender people's lives. 27 00:01:46.880 --> 00:01:49.960 I'm also a psychotherapist and I work with transgender children. 28 00:01:50.300 --> 00:01:56.320 And so there's lots of moments where conversations about reproduction come up in all different areas of my work. 29 00:01:56.320 --> 00:02:03.860 As a clinician, I'm guided by the WPATH, which is the World Professional Association for Transgender Health's standards of care, 30 00:02:04.020 --> 00:02:07.800 which has a section on the reproductive rights of transgender people. 31 00:02:08.200 --> 00:02:12.100 But my interest over the last decade of working with transgender children, 32 00:02:12.200 --> 00:02:16.700 having conversations around reproduction, around fertility preservation, 33 00:02:16.860 --> 00:02:25.340 has been, I guess, a concern in a way that those standards of care say we should be talking to people about their fertility. 34 00:02:25.340 --> 00:02:29.820 But we don't say, should we be talking about people who don't want to have children, 35 00:02:29.940 --> 00:02:34.060 who may want to have children in a range of ways other than using their own gametes. 36 00:02:34.400 --> 00:02:37.120 So that's why I put up here reproductive rights are diverse, 37 00:02:37.440 --> 00:02:40.880 because I think the WPATH standards sort of miss that conversation. 38 00:02:41.380 --> 00:02:46.880 For me, it's about trans people having the right to store gametes, for example, 39 00:02:46.900 --> 00:02:52.580 to have access to services that aren't discriminatory, access to say, I don't want to have children, 40 00:02:52.780 --> 00:02:55.320 access to adopting and fostering children. 41 00:02:55.340 --> 00:02:58.960 Access to a whole range of different practices around reproduction. 42 00:02:59.460 --> 00:03:02.100 And of course, access to keeping children. 43 00:03:02.300 --> 00:03:08.260 If people have children and transition gender, we know there's cases where people lose custody of their children. 44 00:03:08.420 --> 00:03:10.560 So that's another part of reproductive rights. 45 00:03:10.820 --> 00:03:16.940 So to me, it's much more complex trans people's reproductive rights than just the right to bear children. 46 00:03:17.400 --> 00:03:20.860 So when we think about, oh, that's bigger for you than it is for me back there. 47 00:03:21.180 --> 00:03:25.320 When we think about this idea of this injunction to reproduction, 48 00:03:25.340 --> 00:03:29.000 this mandate to reproduce, I was sort of thinking, you know, 49 00:03:29.020 --> 00:03:31.760 we were encouraged with our size to put lots of images on. 50 00:03:31.860 --> 00:03:33.120 It's easier than lots of text. 51 00:03:33.320 --> 00:03:35.320 And I was thinking, how do I capture that? 52 00:03:35.560 --> 00:03:39.240 And so what I did was just a Google image search for the word family. 53 00:03:39.640 --> 00:03:42.560 And this is the first page of Google images for family. 54 00:03:42.620 --> 00:03:47.480 And every single image is a family that involves children. 55 00:03:47.780 --> 00:03:53.420 And I think that really speaks a lot to what I'm thinking about today here around what we think about as family, 56 00:03:53.540 --> 00:03:55.320 what it means to reproduce our children. 57 00:03:55.340 --> 00:03:55.860 And so I think that the idea of having children, 58 00:03:56.380 --> 00:04:02.580 here really seems to be limited to reproduction of ourselves through having children. 59 00:04:02.860 --> 00:04:05.380 So we might think about this as the word perinatalism, 60 00:04:05.420 --> 00:04:07.760 which is the idea that having children, 61 00:04:07.880 --> 00:04:10.980 raising children should be central to all of our lives as adults. 62 00:04:11.180 --> 00:04:14.440 It should be part of what we think of as a normal trajectory. 63 00:04:14.620 --> 00:04:17.640 We get older, we leave home, we get a job, we find a partner, 64 00:04:17.720 --> 00:04:20.080 we potentially get married or have a partnership. 65 00:04:20.160 --> 00:04:21.100 We have children. 66 00:04:21.240 --> 00:04:24.000 This is the trajectory that's expected of most people. 67 00:04:25.340 --> 00:04:29.820 And so the idea that wasn't expected of transgender people was expected that if you transition gender, 68 00:04:29.980 --> 00:04:32.320 you have particular medical interventions, 69 00:04:32.580 --> 00:04:34.200 you would not be able to reproduce. 70 00:04:34.440 --> 00:04:37.260 And indeed, historically, it was seen that you should not reproduce. 71 00:04:37.920 --> 00:04:40.360 In some states, not South Australia anymore, 72 00:04:40.540 --> 00:04:41.780 but in many Australian states, 73 00:04:41.900 --> 00:04:44.600 it is still the case that to change your birth certificate, 74 00:04:44.720 --> 00:04:49.000 you need to have had surgeries that would have prevented your capacity to reproduce. 75 00:04:49.280 --> 00:04:53.000 And that's why this topic of fertility preservation is really important. 76 00:04:53.520 --> 00:04:54.800 But as I've added here, 77 00:04:55.340 --> 00:04:57.420 and we can understand this probably quite simply, 78 00:04:57.600 --> 00:04:59.820 that pronatalism is gendered. 79 00:04:59.820 --> 00:05:02.040 It's really focused on one group of people. 80 00:05:02.200 --> 00:05:05.140 It's mainly focused on people assigned female at birth, 81 00:05:05.380 --> 00:05:07.020 people we often think of as women, 82 00:05:07.100 --> 00:05:10.100 but for transgender men who were assigned female at birth, 83 00:05:10.160 --> 00:05:11.020 that is also true, 84 00:05:11.200 --> 00:05:13.540 is this push that you have a uterus, 85 00:05:13.640 --> 00:05:15.020 you can produce eggs, 86 00:05:15.100 --> 00:05:16.500 you should want to bear children, 87 00:05:16.740 --> 00:05:17.920 you should want to raise children. 88 00:05:18.060 --> 00:05:21.460 So it's very gendered, this push to reproduce. 89 00:05:22.380 --> 00:05:25.220 One of my entry points into this talk today was, 90 00:05:25.340 --> 00:05:27.720 I was thinking about a great paper by Emily Martin. 91 00:05:28.360 --> 00:05:31.400 She's an anthropologist and she wrote a paper in the early 90s. 92 00:05:31.400 --> 00:05:33.380 I think I've read it many, many times. 93 00:05:33.480 --> 00:05:34.700 I reread it a few weeks ago. 94 00:05:35.060 --> 00:05:38.800 I think it's no less true now than it was when she published it in 91. 95 00:05:39.320 --> 00:05:43.960 She looked at a whole lot of gynaecological reproductive textbooks 96 00:05:44.440 --> 00:05:46.880 and looked at how they represented sperm and eggs. 97 00:05:46.980 --> 00:05:48.220 And it really was that narrative. 98 00:05:48.260 --> 00:05:52.140 We all know that the sperm who does all the work, 99 00:05:52.180 --> 00:05:54.020 who has the agency, 100 00:05:54.020 --> 00:05:55.760 who penetrates the egg, 101 00:05:55.800 --> 00:05:56.960 and the egg just sits there and waits. 102 00:05:57.240 --> 00:06:00.640 And that narrative that actually really doesn't reflect 103 00:06:00.640 --> 00:06:03.680 what science tells us was the case in 91. 104 00:06:03.680 --> 00:06:05.220 If you look at those textbooks now, 105 00:06:05.260 --> 00:06:08.880 that same sort of narrative of sperm being the agentic force 106 00:06:08.880 --> 00:06:11.260 and the sperm being the passive recipient 107 00:06:11.260 --> 00:06:12.720 is still just as evident. 108 00:06:13.020 --> 00:06:16.540 And when I again did a Google image search for sperms and eggs, 109 00:06:17.060 --> 00:06:19.020 you found lots of just medical images, 110 00:06:19.700 --> 00:06:21.180 but the ones that weren't medical images, 111 00:06:21.360 --> 00:06:22.580 this is what they look like. 112 00:06:22.640 --> 00:06:24.000 So we have this very masculine image 113 00:06:24.020 --> 00:06:26.620 of sperm with a top hat. 114 00:06:26.880 --> 00:06:30.480 The egg here is pink and has lipstick on. 115 00:06:30.780 --> 00:06:34.300 So it's very sort of gendered understandings of gametes. 116 00:06:34.360 --> 00:06:37.240 A sperm isn't a male. 117 00:06:37.420 --> 00:06:38.820 An egg isn't a female. 118 00:06:39.620 --> 00:06:42.600 But these are very gendered understandings of gametes. 119 00:06:43.080 --> 00:06:44.080 So some more. 120 00:06:44.160 --> 00:06:47.820 This is a lovely collection that I paid to access from Shutterstock. 121 00:06:48.020 --> 00:06:52.680 It was these very heterosexual gendered images of sperms and eggs. 122 00:06:52.740 --> 00:06:54.000 So then we have these baby sperms. 123 00:06:54.020 --> 00:06:55.640 I'm not quite sure how that works. 124 00:06:56.060 --> 00:07:01.920 But it reinforces this idea that gametes are gendered. 125 00:07:01.920 --> 00:07:04.660 It's not just that there are two different types of gametes 126 00:07:04.660 --> 00:07:06.500 and one's called sperm and one's called eggs, 127 00:07:06.640 --> 00:07:10.420 but one is gendered as male and one is gendered as female. 128 00:07:10.800 --> 00:07:14.540 Another little cartoon here, we have Mr Sperm meets Mrs Egg. 129 00:07:14.700 --> 00:07:18.280 So again, it's this really normalising of a male, 130 00:07:18.380 --> 00:07:19.640 something that's treated as male 131 00:07:19.640 --> 00:07:21.760 and something that's treated as female coming together. 132 00:07:21.800 --> 00:07:23.640 And here it's by, you know, 133 00:07:23.640 --> 00:07:26.880 I presume an IVF clinician bringing these two gametes together. 134 00:07:27.300 --> 00:07:29.100 So this is a big word. 135 00:07:29.180 --> 00:07:30.900 I've been throwing out a lot of big words today. 136 00:07:31.080 --> 00:07:34.020 But cisgenderism, my colleague Gavi Ansari, 137 00:07:34.180 --> 00:07:36.200 he coined this term. 138 00:07:36.320 --> 00:07:37.100 He uses this... 139 00:07:37.100 --> 00:07:39.800 So we might have in the past used the word transphobia 140 00:07:39.800 --> 00:07:42.980 to talk about discrimination that transgender people face. 141 00:07:43.220 --> 00:07:47.580 But Gavi suggests that cisgenderism is much bigger than just transphobia. 142 00:07:47.660 --> 00:07:50.260 Transphobia is when someone goes out of their way 143 00:07:50.260 --> 00:07:52.360 to purposefully hurt someone, 144 00:07:52.360 --> 00:07:53.980 to deny someone their rights, 145 00:07:54.000 --> 00:07:55.640 to commit violence against them. 146 00:07:56.360 --> 00:07:57.860 Cisgenderism is more systemic. 147 00:07:58.200 --> 00:08:00.760 It's about how in our everyday lives 148 00:08:01.360 --> 00:08:03.360 are transgender people's lives dismissed, 149 00:08:03.600 --> 00:08:05.260 told that they're not true, 150 00:08:05.400 --> 00:08:06.480 that it's not a real thing, 151 00:08:06.620 --> 00:08:08.100 that you're making it up, 152 00:08:08.120 --> 00:08:08.980 that it's a choice. 153 00:08:09.440 --> 00:08:11.120 So Gavi's definition, 154 00:08:11.420 --> 00:08:12.500 I should have put quotes around this, 155 00:08:12.600 --> 00:08:15.020 is that cisgenderism is an ideology 156 00:08:15.020 --> 00:08:18.200 that delegitimises people's own understandings 157 00:08:18.200 --> 00:08:19.540 of their bodies and genders. 158 00:08:19.740 --> 00:08:22.060 So if someone comes along, a woman, 159 00:08:22.780 --> 00:08:24.300 who was assigned male at birth 160 00:08:24.300 --> 00:08:26.200 and she hasn't chosen or doesn't want to 161 00:08:26.200 --> 00:08:27.720 or can't afford to or hasn't yet 162 00:08:28.420 --> 00:08:30.500 had surgery that she may want to have 163 00:08:30.500 --> 00:08:31.720 and she still has her penis, 164 00:08:31.920 --> 00:08:33.220 and someone says to her, 165 00:08:33.300 --> 00:08:34.720 well, you're not a woman, then you're a man. 166 00:08:34.840 --> 00:08:35.980 And I'm going to call you he. 167 00:08:36.280 --> 00:08:38.560 And I'm going to find out what your other name was 168 00:08:38.560 --> 00:08:39.600 and I'm going to call you by that. 169 00:08:39.660 --> 00:08:40.900 Because I don't accept you're a woman. 170 00:08:41.340 --> 00:08:42.920 That's a form of cisgenderism. 171 00:08:43.180 --> 00:08:45.580 Same as when we see often in the media, 172 00:08:45.640 --> 00:08:47.540 we see media reports of transgender people 173 00:08:47.540 --> 00:08:50.640 and it will talk about born female, born male. 174 00:08:50.840 --> 00:08:52.020 Their name used to be this. 175 00:08:52.360 --> 00:08:54.080 Here's some pictures of them when they were this. 176 00:08:54.300 --> 00:08:56.420 These are all forms of cisgenderism 177 00:08:56.420 --> 00:08:59.520 that really challenge transgender people's gender. 178 00:08:59.840 --> 00:09:01.060 Question it as legitimate. 179 00:09:02.240 --> 00:09:04.140 Well, I hope that's big enough for you to see. 180 00:09:04.220 --> 00:09:06.780 So I also looked at reproductive texts 181 00:09:06.780 --> 00:09:10.200 and examples of when we're talking about reproductive bodies. 182 00:09:10.520 --> 00:09:12.520 And again, they're very clearly marked. 183 00:09:13.240 --> 00:09:14.600 This is a male body, 184 00:09:14.760 --> 00:09:16.920 so a body that has a penis, that has testes, 185 00:09:16.920 --> 00:09:17.800 is a male body. 186 00:09:18.140 --> 00:09:20.420 And a female reproductive system here 187 00:09:20.420 --> 00:09:22.340 is one marked by a female. 188 00:09:22.360 --> 00:09:22.920 So this is the female that has the uterus 189 00:09:22.920 --> 00:09:25.740 and fallopian tubes and ovaries. 190 00:09:25.800 --> 00:09:28.480 So again, this really reinforces this idea 191 00:09:28.480 --> 00:09:30.880 that particular bodies are marked by gender 192 00:09:30.880 --> 00:09:32.180 in very particular ways. 193 00:09:32.460 --> 00:09:35.560 And this one, which I think it does it even more clearly 194 00:09:35.560 --> 00:09:38.460 and actually then links it to the whole purpose 195 00:09:38.460 --> 00:09:42.200 of bodies, of reproductive organs and of gametes 196 00:09:42.200 --> 00:09:43.040 is to reproduce. 197 00:09:43.500 --> 00:09:45.980 So it says the overall function of the reproductive system 198 00:09:45.980 --> 00:09:47.540 is the production of offspring. 199 00:09:48.060 --> 00:09:51.320 Of course, for some people that isn't the case. 200 00:09:52.360 --> 00:09:57.700 some people are born without their reproductive organs, some people have surgeries that remove 201 00:09:57.700 --> 00:10:01.740 their reproductive organs for a range of reasons, that's not just limited to transgender people. 202 00:10:02.100 --> 00:10:08.660 But this really reduces bodies in a very gendered way to this very specific binary that is problematic 203 00:10:08.660 --> 00:10:13.520 for transgender people. So my interest I guess in today's talk, there was a very long-winded 204 00:10:13.520 --> 00:10:18.100 introduction to that, but it was as I was saying to Sarah before, it was about trying to find a 205 00:10:18.100 --> 00:10:22.380 way to tell a story today that would be interesting to you hopefully and would make sense. 206 00:10:22.640 --> 00:10:27.140 And I had the whole talk a bit back to front when I first put it together and realised I needed to 207 00:10:27.140 --> 00:10:31.040 give you some of that background thinking to think about what I'm going to talk about next. 208 00:10:31.420 --> 00:10:38.280 So this is I guess my core question, how does when we talk about men have sperm and sperm is male 209 00:10:38.280 --> 00:10:44.100 and penises are male and these reproductive bodies are female and this is what it means to be female 210 00:10:44.100 --> 00:10:47.500 and all the things, all the assumptions I've just talked about, 211 00:10:48.100 --> 00:10:52.360 what does that mean for transgender people? What does it mean for transgender people whose bodies 212 00:10:52.360 --> 00:10:56.980 may be configured in different ways to those assumptions? What does it mean for transgender 213 00:10:56.980 --> 00:11:02.880 people when they hear those messages that if you have sperm you are male, if you produce eggs you 214 00:11:02.880 --> 00:11:07.620 are female? Certainly some transgender people resist that, we're certainly hearing more and more 215 00:11:07.620 --> 00:11:11.500 as the last decade has gone past, particularly about transgender men 216 00:11:11.500 --> 00:11:17.640 bearing children. So this is two transgender men who were pregnant and bore children, 217 00:11:18.100 --> 00:11:21.980 we may know the man on the left really well which was Thomas Beattie, so there was a very, 218 00:11:22.060 --> 00:11:28.360 a lot of media reports about Thomas in the late 2000s, around 2009, he was on Oprah, 219 00:11:28.640 --> 00:11:34.860 he was all over the media. Is this the first pregnant man? That was often the media headlines 220 00:11:35.740 --> 00:11:40.720 and I'm not certainly, don't want to suggest that there's more acceptance of transgender men now 221 00:11:40.720 --> 00:11:45.920 that we are doing a study looking at transgender men's experiences of reproduction, but certainly 222 00:11:45.920 --> 00:11:48.080 we are seeing more about transgender men. 223 00:11:48.100 --> 00:12:18.080 Also, has transgender has 224 00:12:18.080 --> 00:12:21.680 as having retained these reproductive organs that are marked as female. 225 00:12:22.040 --> 00:12:25.780 So it's this sort of questionable position that people like Thomas 226 00:12:25.780 --> 00:12:30.180 have put in around looking masculine, being men, 227 00:12:30.500 --> 00:12:33.880 but doing something that is treated as traditionally feminine, 228 00:12:34.040 --> 00:12:35.180 which is reproducing. 229 00:12:35.480 --> 00:12:38.400 When it comes to transgender women, and I'm going to talk about this a bit more 230 00:12:38.400 --> 00:12:40.340 when I put up some examples from our research, 231 00:12:41.280 --> 00:12:45.580 it's much harder to find conversations about transgender women as mothers 232 00:12:45.580 --> 00:12:48.220 in the media, in public narratives. 233 00:12:48.520 --> 00:12:52.560 I think some of that is around that gendered nature of reproduction. 234 00:12:52.920 --> 00:12:57.700 So we think about particular bodies, the job of particular bodies is to reproduce, 235 00:12:57.920 --> 00:12:59.540 and those are bodies marked as female. 236 00:13:00.420 --> 00:13:01.860 So transgender men are not female, 237 00:13:02.020 --> 00:13:05.460 but their bodies are marked by society often as female. 238 00:13:05.720 --> 00:13:10.720 So I think that's my sort of unpacking of why there might be some acceptance 239 00:13:10.720 --> 00:13:13.040 of transgender men having children, 240 00:13:13.180 --> 00:13:15.220 whether people are accepting transgender men 241 00:13:15.220 --> 00:13:15.560 as mothers or as mothers. 242 00:13:15.580 --> 00:13:17.860 So men having children is a different question, 243 00:13:18.040 --> 00:13:21.160 but it's about particular bodies that are meant to reproduce. 244 00:13:22.160 --> 00:13:25.460 Transgender women's bodies, so women who are not born with a uterus, 245 00:13:25.480 --> 00:13:26.600 who are not born with a vagina, 246 00:13:28.220 --> 00:13:31.600 are not marked in that same way as meaning to reproduce. 247 00:13:31.920 --> 00:13:35.080 So this is a particular woman, you may have seen her and her daughter, 248 00:13:35.140 --> 00:13:37.140 who's written a great book called Introducing Teddy, 249 00:13:38.660 --> 00:13:40.860 about being transgender and what that means. 250 00:13:41.140 --> 00:13:43.340 And the woman who wrote it, her mum is transgender, 251 00:13:43.480 --> 00:13:44.820 and she spoke about this publicly. 252 00:13:45.000 --> 00:13:45.400 That's why. 253 00:13:45.580 --> 00:13:46.940 I've put her picture up there. 254 00:13:47.240 --> 00:13:51.740 But if you try and find stories about transgender women not bearing children, 255 00:13:51.900 --> 00:13:54.420 but breastfeeding children, there are certain examples of that. 256 00:13:54.540 --> 00:13:56.220 It's really hard to find in the media. 257 00:13:56.300 --> 00:13:58.780 There's not a lot of talk about this in the media, 258 00:13:58.840 --> 00:14:02.660 even though it's very well known that, you know, anyone can induce lactation. 259 00:14:03.140 --> 00:14:05.760 Transgender women can, a partner may bear a child, 260 00:14:05.860 --> 00:14:07.580 a surrogate may bear a child for them. 261 00:14:07.760 --> 00:14:10.420 They could certainly induce lactation and feed their child, 262 00:14:10.500 --> 00:14:12.280 and there are cases of that happening. 263 00:14:12.520 --> 00:14:14.420 There's not a lot of talk about it in the media. 264 00:14:15.120 --> 00:14:15.560 There's a lot of talk about it in the media. 265 00:14:15.560 --> 00:14:18.340 There's been a little bit of talk recently about experimentation 266 00:14:18.960 --> 00:14:20.620 around uterus transplants. 267 00:14:21.140 --> 00:14:24.500 There's been some successful births from uterine transplants, 268 00:14:24.600 --> 00:14:25.600 not with transgender women. 269 00:14:26.880 --> 00:14:29.320 So then, of course, I think that's led to conversations 270 00:14:29.320 --> 00:14:32.260 around could this technology be used with transgender women? 271 00:14:32.660 --> 00:14:34.880 And again, we have the same gendered language 272 00:14:34.880 --> 00:14:37.660 around could men really get pregnant? 273 00:14:37.840 --> 00:14:40.200 Well, we're talking about transgender women in this article. 274 00:14:40.320 --> 00:14:41.160 So we're not talking about men. 275 00:14:41.240 --> 00:14:41.960 We're talking about women. 276 00:14:42.800 --> 00:14:45.160 But again, it's the same sort of idea 277 00:14:45.160 --> 00:14:48.780 of reducing people to something about their gender 278 00:14:48.780 --> 00:14:51.000 that connects to their reproductive organs. 279 00:14:51.240 --> 00:14:53.580 So not acknowledging transgender women as women. 280 00:14:54.460 --> 00:14:57.600 So all of this has been percolating in my mind 281 00:14:57.600 --> 00:15:00.340 for quite a number of years now, and certainly with regards 282 00:15:00.340 --> 00:15:04.280 to working with the young people I work with and needing 283 00:15:04.280 --> 00:15:06.960 to have conversations with them around fertility preservation. 284 00:15:08.020 --> 00:15:10.400 So we, I did a presentation 285 00:15:10.400 --> 00:15:12.540 at the Fertility Society Conference last year 286 00:15:12.540 --> 00:15:14.660 around fertility preservation and really came 287 00:15:15.160 --> 00:15:17.560 to be aware that there was very little data 288 00:15:17.560 --> 00:15:19.620 around this topic in Australia. 289 00:15:20.000 --> 00:15:22.300 So we launched a survey at the beginning of this year, 290 00:15:22.380 --> 00:15:23.980 and we had an amazing response. 291 00:15:24.100 --> 00:15:28.080 We had 409 trans and non-binary people respond within a month, 292 00:15:28.240 --> 00:15:30.200 which is sort of unheard of, I think. 293 00:15:30.240 --> 00:15:32.920 It was very, people were very keen to speak to us. 294 00:15:33.220 --> 00:15:35.860 And so what I'm going to put up now is just a few excerpts. 295 00:15:35.900 --> 00:15:39.300 We did a lot of, you know, questions, tick box sort 296 00:15:39.300 --> 00:15:40.680 of questions that I'm not going to talk about, 297 00:15:40.780 --> 00:15:42.600 and I've talked about elsewhere, and we're going to publish 298 00:15:42.600 --> 00:15:44.940 on that, but we also put some open 299 00:15:44.940 --> 00:15:45.140 in terms of the research that we're doing. 300 00:15:45.140 --> 00:16:06.820 And so what you can do is you can pull up homeoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshoshosh 301 00:16:06.820 --> 00:16:09.960 ones who are really getting this strong message from the healthcare clinicians 302 00:16:09.960 --> 00:16:14.320 you should want to reproduce. You were born with a uterus, you were born with 303 00:16:14.320 --> 00:16:18.640 ovaries, why would you not have a child? So these are all quotes from the 304 00:16:18.640 --> 00:16:22.580 participants. I feel like the counseling I received over emphasized the 305 00:16:22.580 --> 00:16:26.900 importance of parenthood, especially genetic parenthood. I'm assigned female 306 00:16:26.900 --> 00:16:29.940 at birth and I have never wanted to have children and that decision has been 307 00:16:29.940 --> 00:16:35.300 constantly undermined. The insistence that I consider fertility was, should be 308 00:16:35.300 --> 00:16:38.920 was, very much consistent with the kinds of responses I would receive being a 309 00:16:38.920 --> 00:16:42.820 child-free woman. So again this person really maps out a lot of what I'm saying 310 00:16:42.820 --> 00:16:46.960 today which is this idea that for transgender men or for non-binary people 311 00:16:46.960 --> 00:16:51.200 who were assigned female at birth there's still this message that you have 312 00:16:51.200 --> 00:16:55.840 these organs, reproductive organs, that we think should do their job. We think they 313 00:16:55.840 --> 00:17:01.400 should reproduce and so for these sample of people if they felt like the messages 314 00:17:01.400 --> 00:17:04.820 they were receiving were the same messages that women receive even though 315 00:17:04.820 --> 00:17:05.280 these particular responses were not the same. 316 00:17:05.300 --> 00:17:09.760 This was we're not women. I'm not someone who ever wanted kids. I was assigned 317 00:17:09.760 --> 00:17:13.280 female at birth and it's been an issue that society and even those close around 318 00:17:13.280 --> 00:17:17.980 me have insisted I will change my mind on. I have not. Having my fertility 319 00:17:17.980 --> 00:17:21.780 brought into a space where I do not want to be identified as female is upsetting 320 00:17:21.780 --> 00:17:26.140 to me and this takes us back to that you know when I put up the funny images of 321 00:17:26.140 --> 00:17:31.260 the gametes. There's a lot of problems around the use of language and lots of 322 00:17:31.260 --> 00:17:35.260 the young people I work with say look I went to a fertility counselor, I went to 323 00:17:35.300 --> 00:17:38.820 talk about possibly doing fertility preservation and they kept talking 324 00:17:38.820 --> 00:17:42.780 about sperm or they kept talking about eggs. Well I don't want to think about 325 00:17:42.780 --> 00:17:47.060 those terms. I know I've got gametes and I could store them but I don't want to 326 00:17:47.060 --> 00:17:51.280 think about those terms because I'm not a girl or I'm not a boy and I don't like 327 00:17:51.280 --> 00:17:56.100 how those terms are gendered. So there was a lot of disengagement from 328 00:17:56.100 --> 00:18:00.700 information that the young people I work with were hearing which to me and as I 329 00:18:00.700 --> 00:18:04.260 wrote for Sarah in the conversation really brings up issues of informed consent. 330 00:18:04.260 --> 00:18:14.700 If you're not listening to the information you're being given by a medical professional because it's too distressing, because it's so gendered, what kind of consent are you or are you not giving? 331 00:18:15.080 --> 00:18:27.820 Another person said there can be pressure from uneducated family, partners or friends to not transition for fear of our future as parents, particular for AFAB as assigned female at birth, people with social pressure to have maternal instincts. 332 00:18:27.820 --> 00:18:36.240 So it's the same idea of family members not being supportive of someone's gender transition because that will mean they may not be able to reproduce. 333 00:18:36.560 --> 00:18:42.840 And for people assigned female at birth, that's a particular pressure that you have these reproductive organs, you should use them. 334 00:18:44.640 --> 00:18:48.440 And in other people, I mean there were certainly some people in our sample who had done fertility preservation. 335 00:18:48.840 --> 00:18:52.440 There was 30 people out of the 400. 336 00:18:52.680 --> 00:18:55.960 There was 60 people out of our sample who had children. 337 00:18:56.220 --> 00:18:57.580 And there was maybe another 60. 338 00:18:57.820 --> 00:18:59.060 There was a lot of people who wanted children in the future. 339 00:18:59.240 --> 00:19:00.980 So it's not as though no one wanted children. 340 00:19:02.060 --> 00:19:04.600 But that probably adds up to around half. 341 00:19:04.920 --> 00:19:09.620 So there was a lot of people who didn't want children, who were very clear that children weren't of interest to them. 342 00:19:09.840 --> 00:19:13.300 They had made that decision, but their decisions were being second-guessed. 343 00:19:14.080 --> 00:19:15.940 And by medical professionals. 344 00:19:16.480 --> 00:19:18.580 Someone else said I do not want children at all. 345 00:19:18.660 --> 00:19:27.720 I feel that preservation, fertility preservation, in case you change your mind, is demeaning to me as it feels like doctors are second-guessing my decision and trying to instil doubt in me. 346 00:19:27.820 --> 00:19:33.000 And this is something that I really am very careful around with the young people that I work with. 347 00:19:33.120 --> 00:19:38.640 That historically there has been this narrative, preserve your fertility just in case. 348 00:19:38.740 --> 00:19:40.280 We do this with oncology patients. 349 00:19:40.620 --> 00:19:44.220 The same logic maps across to transgender young people. 350 00:19:44.360 --> 00:19:47.060 And I'm really wary about this idea of just in case. 351 00:19:47.760 --> 00:19:48.580 It's expensive. 352 00:19:49.100 --> 00:19:49.860 It's invasive. 353 00:19:51.000 --> 00:19:56.200 It's not guaranteed that if you preserve your fertility at 14, those gametes are going to be viable at 24. 354 00:19:56.340 --> 00:19:57.800 If you decide you want to. 355 00:19:57.800 --> 00:20:03.120 If you want to be happy at 24, you don't decide until you're 34, they're probably not likely to be viable. 356 00:20:04.000 --> 00:20:07.380 So it's making a promise on something that may not be deliverable on. 357 00:20:07.660 --> 00:20:11.760 And it's also making people make choices about a really big what if. 358 00:20:14.100 --> 00:20:18.780 Another person said people who indicate they don't want biological children should have their wishes respected. 359 00:20:19.200 --> 00:20:27.020 A lot of doctors seem far too focused on retaining the viability of reproductive organs in case the owner changes their mind, which I think is a great quote. 360 00:20:27.020 --> 00:20:38.640 And it is this sort of disjuncture between the owner of the organs knowing what they do and don't want to do, and medical professionals saying maybe you don't really know what you want to do. 361 00:20:38.800 --> 00:20:40.760 Because this is what these organs are supposed to do. 362 00:20:40.880 --> 00:20:42.820 This is what you should want to do with them. 363 00:20:43.520 --> 00:20:46.660 And there was lots of other examples of this. 364 00:20:46.780 --> 00:20:51.400 And I think really important to note that all of those examples were people assigned female at birth. 365 00:20:51.860 --> 00:20:53.200 Most were transgender men. 366 00:20:53.340 --> 00:20:54.440 Some were non-binary people. 367 00:20:55.300 --> 00:20:57.000 None of our transgender women were assigned female at birth. 368 00:20:57.000 --> 00:20:59.340 And most of the transgender women who participated made those same comments. 369 00:20:59.420 --> 00:21:01.120 They were not getting those same messages. 370 00:21:01.440 --> 00:21:06.880 They were not getting the message, well you should store sperm because you should want to have children. 371 00:21:07.040 --> 00:21:08.160 You should want to be a mother. 372 00:21:08.720 --> 00:21:12.740 You have, you know, create a child made of your sperm. 373 00:21:13.240 --> 00:21:14.940 They were not getting those same messages. 374 00:21:15.360 --> 00:21:21.060 Even though of the 30 people who had done fertility preservation and of the 60 people who had children, 375 00:21:21.280 --> 00:21:24.680 a majority in each group were women, were transgender women. 376 00:21:25.680 --> 00:21:26.980 Transgender women were not. 377 00:21:26.980 --> 00:21:31.660 And so we are in general getting that same message as transgender men from fertility specialists, 378 00:21:31.880 --> 00:21:36.940 from counsellors, from healthcare providers, that they should want to store their sperm. 379 00:21:37.060 --> 00:21:38.260 They should want to have children. 380 00:21:38.460 --> 00:21:43.880 So again, it's this very gendered understanding of bodies that normally, you know, 381 00:21:43.980 --> 00:21:48.200 there's this expectation upon women to reproduce, to be mothers. 382 00:21:48.400 --> 00:21:51.540 But transgender women are not experiencing that same expectation. 383 00:21:52.840 --> 00:21:56.960 So I guess my suggestion today is that there is research out there. 384 00:21:56.980 --> 00:21:59.600 There is research out there on transgender people and reproduction, a little bit. 385 00:22:00.380 --> 00:22:03.920 There is a growing body of research on transgender people and parenting. 386 00:22:05.080 --> 00:22:08.080 And we've done some of that research, colleagues and I. 387 00:22:08.260 --> 00:22:12.960 But I think inherently that research is limited by cisgenderism. 388 00:22:13.120 --> 00:22:14.840 It's limited by these assumptions. 389 00:22:15.200 --> 00:22:22.100 I think we repeatedly say low numbers of transgender people compared to the general population have children. 390 00:22:22.460 --> 00:22:24.240 And there's all these reasons that people suggest. 391 00:22:24.560 --> 00:22:26.460 People are more focused on gender transition. 392 00:22:26.980 --> 00:22:28.160 People are scared of discrimination. 393 00:22:28.740 --> 00:22:30.140 People have other interests. 394 00:22:30.540 --> 00:22:35.660 Transgender people are critical thinkers and they are critical of the idea that everyone should have children. 395 00:22:35.760 --> 00:22:42.020 There's lots of reasons given for why transgender people don't have children on par with the general population. 396 00:22:42.440 --> 00:22:43.600 Some of those might be true. 397 00:22:43.680 --> 00:22:44.640 Some of them might be not true. 398 00:22:44.960 --> 00:22:53.180 But my suggestion today is that what might also be true is how transgender people can imagine their reproductive futures, 399 00:22:53.420 --> 00:22:55.740 the options they feel available to them, 400 00:22:55.740 --> 00:22:59.880 are potentially limited by the interactions they have with professionals, 401 00:23:00.180 --> 00:23:03.320