Jacob Stokoe

Firstly, can you talk us through your journey with transition and then pregnancy — did you know you wanted to carry a baby before you began to transition?

I first realised I was trans in my early twenties. I saw a YouTube video of a trans man who, in his early videos, looked like I did at the time. And as he took testosterone and changed, I realised, that’s me. That’s what I want to do.

When I first started taking testosterone, I was told that it would make me infertile, but it was a life-saving medication for me, so I didn’t feel as though I had a choice. There was also no option of egg-saving or fertility preservation — nothing like that. At the time, I was incredibly poor — I’d lost contact with family, and I was in an abusive relationship. It was a really vulnerable time, and testosterone kept me going in a lot of ways, so I just dealt with the grief of perceived infertility. For six years, I was under the impression that I was infertile.

Then, in 2013, I met my now-husband, and I made the decision that I wanted to consider pregnancy. It went similarly to realising I was trans — I saw representation online and found a really good community. I also read a book called “Where’s The Mother?” by a Canadian trans dad called Trevor MacDonald, and it gave me a profound realisation that this was something I could do. And the grief that I’d been holding for my infertility suddenly became a possibility.

So I stopped testosterone and went into the big unknown of whether or not I could conceive. When you take testosterone, your periods stop. I hadn’t had a period for six years, so I didn’t know if I was infertile. I had a really confusing few months where I didn’t know if I wasn’t having a period because I was infertile or if I wasn’t having a period because I was pregnant — I called it Schrödinger’s pregnancy. (Laughs)

But eventually I did have a period, and once my periods were regular (about a year after my first missed testosterone shot), I fell pregnant within the first month.

Did you experience any dysphoria during your pregnancies?

I expected the dysphoria to be so much worse than it was. It was bad, it did exist, but it was nowhere near what I expected it to be.

A big part of that is that I’d already gone through a masculinising puberty, and a lot of those things don’t undo, which I didn’t know in advance. In my pregnancy photos, I still have a beard, I still have a hairy chest. I still had a low voice throughout. And although I could see the subtleties of where my beard wasn’t quite as full or my chest hair wasn’t quite as thick, to the casual observer, I still seemed masculine enough for me to be comfortable.

But I did have some dysphoria. The biggest area I felt this around was my chest. The lack of hair plus the growth of my chest were quite dysphoric. But then, after my baby was born, I held a lot of grief that I couldn’t feed my children in the way I might have wanted to had I never had chest surgery. I felt stuck in this complex space, where I was experiencing grief and dysphoria about the same thing on both sides.

The other aspect was around people using the right language. I experienced relentless indirect misgendering. Direct misgendering would be calling me a woman or using “she/her” pronouns for me, which I experience very rarely because of my masculine presentation. But I did experience indirect misgendering — every letter that I received talked about pregnant women, spaces I needed to access were called “woman-only spaces”, the toilets were only for women… and that was really so much more impactful than I could have ever expected because it just didn’t stop.

Can you talk to us about Transparent Change and the work you’re doing to create better experiences for trans birthing people?

Transparent Change is a CIC (a community interest company), and the community I aim to benefit, with everything I do, is trans people. You may have noticed that Transparent Change is also Trans Parent Change…

It’s such a great pun!

Thank you! I’m really proud of the name but also my company because everything I do is to make the next generation of trans people's lives better. And while, at the moment, I very much want to focus on perinatal care, fertility and parenting, my aim is to expand and eventually provide support to professionals in all walks of life who are supporting vulnerable people. 

There are so many points in a trans person's life, or anybody's life, where we're vulnerable and we access care providers. And, more than anything, we need to be supported. So while my community of interest is trans people, I support them by facing the professionals who look after them. That means providing the kind of training where people can get it wrong, ask questions, and come away feeling confident.

I'm aware that, in our current society, people are really scared of saying the wrong thing. And that level of fear leaves us, as trans people, walking on the eggshells that other people put around us.

Absolutely. It makes people scared to even be around trans people…

Exactly. I find that a lot of people are crying out for LGBTQIA+ training because they’re starting to recognise how in the dark they are.

And how do you find that the training is received by healthcare professionals?

So far, I’ve only really received positive feedback. What I hope is that people can go away from the training and make changes. I'm really starting to feel more and more that it's about other people, cis allies in particular, shouldering some of the responsibility of changing the world. A lot of people don’t know anything about trans identities other than what they see in the media.

What are your thoughts on the media backlash to inclusive practices and terms like “chest feeding”?

I truly feel that it’s a targeted and deliberate attack. They [the media] read good things, and they deliberately misconstrue them for an agenda. For example, the Brighton & Hove guidance on general inclusion very carefully centred cis women, and yet that was still taken and ripped apart.

So I try to be really careful in everything I do. I try to make sure that no screenshot could be taken out of context and used to harm trans people. That's my fear — that people could take my work and create something false from it. But, at the same time, we can't live in constant fear because we need to educate.

I haven't yet been directly targeted by the papers, but I know it could happen. I’ve watched as, one by one, my colleagues, my peers, have broken a bit. And there's times that I have broken and had to stop working purely because of the level of transphobia that is existing out there in the world right now.

At times, it feels like the task is insurmountable. But, at the point that I break, at the point that I stop, then it really does become insurmountable because I'm not moving forward. I don't have answers as to how to do it right. I just keep trying to do my best. 

Are there any common misconceptions around being pregnant and trans that you’d like to address?

There are quite a few! Some basic questions… did I have to stop testosterone to get pregnant? Yes. Did taking testosterone harm the baby in any way? No. Because at the point that I got pregnant, my hormones were the same as a cis woman’s.

I think there's a misconception that being trans and pregnant would inherently be dysphoric. Now, for some people, it absolutely is, and I don't want to take away from their experiences, but for me, it felt like a very natural thing that my trans body could do. And actually, for one of the first times, I felt very grateful to be trans, because cis men don't get to do this.

I made a human from scratch that didn’t exist in the world before. That’s incredible. And to get to do that as a trans person, bringing both masculinity and femininity into my pregnancy. A question I got sick of seeing on social media was, “why would you, as a man, choose to have the most womanly experience?” But it wasn’t womanly. At best, it felt gender-neutral, and at times it genuinely felt masculine because it was my transmasculine body doing it.

And when it comes to dysphoria, it’s not about taking away all the harm. It's about harm reduction. One of the things that would have made my pregnancy much easier is if I had been seen and recognised and held in my gender in every moment, from the signs on the door, to the emails I received, to the language used with me in the room.

It couldn’t have stopped the fact that I was going to have chest dysphoria. But it could have taken away some other aspects of dysphoria and discomfort.

On your social media, you talk about the postpartum experience as a trans person — how was this for you?

I expected pregnancy to be the hard bit, and then I’d give birth and just be a dad. But, oh my goodness, postpartum was the hardest time. There was no language for who I was to my baby — I expected to just be a dad, but I wasn’t. It's not that I was more than a dad, it's that I was different.

I'd done a really big thing, and nobody saw it because I was invisible in my postnatal body. Five days after giving birth, I went to the supermarket, and I was carrying my newborn baby in a sling on my body. And my sister was congratulated on the baby.

There were times when I did try to explain that I'm trans and I gave birth, but then it stopped being about congratulating a new parent and started being, “oh, isn’t it interesting that you're trans?”

I craved having an easy word that encompassed all of what I was, and the closest I had was “mother”. But “mother" is so gendered in our society that it felt really uncomfortable. I ended up calling myself a “(m)other” and by bracketing off the “m” I recognised my otherhood in motherhood.

I love that so much. One final thing… what is a question that you had about trans pregnancy at the start of your journey and could you answer that question now for anyone wondering the same thing?

The biggest question I had was, “has testosterone made me infertile?” and this question is still getting asked every week by people because we, as a community, have been told testosterone makes you infertile.

My answer, as someone who has taken testosterone for six years, is that there is no evidence that taking testosterone impacts your fertility. We can't say for certain that an individual's fertility won't be affected, and ultimately we need more data to be clear on what the impacts are. But we currently don't have any good evidence to suggest that your eggs will be impacted. However, you do need to stop taking testosterone to get pregnant.

That being said, testosterone is not a good contraceptive. People have gotten pregnant on testosterone, and if that happens you must stop taking it immediately if you wish to continue the pregnancy. 

But testosterone absolutely doesn’t have to limit you.