A visit to the OB/GYN can make you feel vulnerable. Everyone should have a doctor to reassure them. But if you are a transgender man or non-binary person who is pregnant or trying to become pregnant, it is key that your doctor knows and respects your medical needs.

“Pregnancy should be an exciting time,” says Amanda Kallen, MD, a gynecologist and reproductive specialist at Yale Medicine. “It may not necessarily be fun all the time, but you should feel like you have a voice and are able to participate in your own care.”

Here’s how to find a gender-affirming adult OB/GYN.

There are a growing number of helpful health websites aimed at the LGBTQ+ community. These resources provide the names of many different types of providers. When it comes to transgender pregnancy care, you can look for specifics like an OB/GYN, fertility clinic, or birth support.

Learn more:

Do a quick search on the Internet. Simply type in terms like “transgender OB/GYN near me” or “transgender pregnancy care” and see what you find.

Use LGBTQ+ provider directories. These are generally not made by doctors or hospitals. But nonprofit groups like Family Equality only list providers who have taken special courses on how to provide inclusive health care to people in the LGBTQ+ community.

Try finding an affirming OB/GYN through:

Check with your insurance provider. Your health plan website may not have an LGBTQ+ search tool. But someone in customer service may be able to give you a list of OB-GYNs who work with transgender or non-binary people.

Look at doctor or hospital websites. Many clinics make it clear that they are an inclusive space. “If there is material on the website about LGBTQ or building transgender families, that would be very positive,” says Mindy Christianson, MD, medical director of the Johns Hopkins Fertility Center and associate professor of gynecology and obstetrics at the Johns Hopkins School of Medicine. Hopkins. .

The Internet can be of great help. But there’s a low-tech approach that can prove invaluable: word of mouth. Ask your friends, family, or colleagues if they visit or know an affirming OB/GYN.

You also can:

Consult people in your local LGBTQ+ community. Talk to other transgender parents about their experience with pregnancy. Or tap into your local network through Facebook groups or in-person meetings.

Consult other doctors. Your primary care doctor may know an OB/GYN who might be a good fit. This is because it is common for transgender-friendly medical providers to know each other. “I get a lot of referrals,” Kallen says.

There is still a long way to go when it comes to health equity for transgender, non-binary, or gender-expansive people. But you may find that healthcare is more welcoming than before. And there are ways to assess whether you’re in the right place.

A good first test, Kallen says, is to introduce yourself and use your pronouns. Everyone in the office must respect the way you request to be addressed. That includes the OB/GYN, nurses and registration staff.

You’ll also want to look for intake forms with:

• Gender-neutral language
• A place for your name and preferred pronouns.
• A space for your gender identity

When it comes to exams and testing, an OB/GYN with experience in transgender healthcare will think ahead. For example, Christianson opted to perform an abdominal ultrasound instead of a transvaginal ultrasound on a transgender man. And that patient didn’t have to ask for it first.

“He was very grateful afterwards,” Christianson says, “[He told us]”Thank you for making me feel comfortable.” “

Your OB/GYN should also help you plan for any potential effects on your health. For example, if you are taking testosterone, you will need to stop taking it during pregnancy. (Testosterone can harm a growing baby.) Many people do well with that temporary adjustment, but for some, not taking testosterone to get pregnant and have a baby can cause or worsen gender dysphoria. “If that’s something you’ve struggled with in the past, then it’s a good idea to seek mental health support early,” Kallen says.

Most obstetricians and gynecologists can treat transgender people during pregnancy. But this can be an emotional and stressful time. It is key that you feel safe with all your medical equipment. While all clinics should offer supportive care, “some might be better for transgender men,” Christianson says.

You can ask your OB/GYN questions to find out if it’s right for you. Here are some questions to get you started:

• How can you make visits more comfortable for transgender or non-binary people?
• Are you aware of the needs of transgender men on and off hormone therapy?
• How soon can I start taking testosterone again after pregnancy or breastfeeding?
• Have you and your staff received special training in transgender health care?
• How many pregnant transgender people have you worked with?

If an OB/GYN hasn’t worked with many transgender people, that’s not always a deal breaker. “Some people may not agree with me,” Kallen says, “but I think the most important thing is the willingness to be respectful, learn and be accommodating.”

There are general issues your doctor will discuss, including prenatal vitamins, genetic testing, and medications you take. “Everyone should have a preconception visit,” says Kallen.

When it comes to transgender pregnancy care, it’s a good sign if your doctor also asks questions like:

• How do you want to learn about labor and delivery?
• Do you know where to look for a safe space for prenatal care and childbirth?
• Do you plan to feed your baby with milk from your breast?
• If you’re not breastfeeding, do you want to know about formula?
• Do you plan to use your partner’s sperm or do you need donor sperm?
• Are you taking gender-affirming hormones or do you plan to take them in the future?
• Do you have a partner or other support system?
• How do you plan to prevent unwanted pregnancies after childbirth?

They can also explain how you plan to prevent pregnancy after giving birth. “Testosterone is not birth control,” says Kallen. “That’s not always clearly communicated.”

Review your family-building goals from the beginning, especially if you take gender-affirming hormones. Testosterone therapy does not appear to affect egg quality or reduce the chances of getting pregnant later. But it can stop your period and mask signs of fertility problems.

Tell your OB/GYN if you are having trouble getting pregnant or have questions about hormone therapy. You may be referred to a reproductive endocrinologist. These are doctors with special training in how to help people get pregnant.

“And we feel very comfortable understanding the different relationship between hormones and how testosterone plays a role,” Christianson says.