It was May 2020, I was five months pregnant when I walked into the perinatal office, referral in hand, and said, “My name is Kayden Coleman and I have an appointment here at 2:00 p.m.”
The receptionist looked at me — disregarding the paperwork I was holding — and said, “There’s no way you have an appointment here because this is a women’s only facility.”
I presented her with my paperwork and without so much as an apology, the receptionist handed me additional paperwork to fill out and sent me on my way.
I mean, I get it — I am a transgender man with a full beard and top surgery. When I navigate the world, I am not outwardly perceived as someone who is transgender. So I can understand why it might have been jarring to see me standing in the medical office that day. However, it was difficult enough for me to walk into a facility that is made for, and caters to, women, let alone to explain my situation to a receptionist in front of a waiting room full of people. But what choice did I have? I am a person with a uterus. I was pregnant and in need of care.
In the moment, all I could think about was how it shouldn’t be happening. Transgender men exist and have existed for a long time, and deserve safe, respectful, and equitable treatment. Trans men were even present at the Stonewall Riots in 1969, a pivotal moment in LGBTQIA+ history and the reason why we celebrate Pride month during the month of June.
But let’s back up a bit. I am a Black, queer, transgender man who lives in Texas. I have given birth twice since I began my transition. While I did not have to navigate pregnancy here in Texas, my experiences show how hard it is to receive reproductive care as a trans man.
Both of my pregnancies were challenging. Not because of my health or transition, but because our systems are not set up to care for, or even acknowledge, the unique needs of trans men needing reproductive care.
Reproductive healthcare — such as pregnancy, birth control, and abortion — are deeply ingrained in American society as pertaining only to women. But when we deem types of healthcare as “women only” spaces, we aren’t only excluding trans people like myself — we are excluding nonbinary and intersex people.
Yet exclusion for trans, nonbinary, and intersex people doesn’t only mean leaving us out of conversations. It means harm. It means lack of informed care. It means consequences that could be catastrophic to someone’s life and well being.
In Texas, the Black maternal mortality rate is nearly three times higher than white women according to the state’s own data analyzed by the Texas Women’s Healthcare Coalition. Research has found that Black people face systemic barriers, like medical racism, and lack of access to health insurance that contribute to that rate. As a Black transgender man, all of those barriers apply to me, along with the fear of discrimination due to transphobia and homophobia.
Before I get into more of my personal experiences, let’s chat a bit about the current political climate. In May, as the Texas Legislature was in its final push of session, I counted 128 anti-trans bills under consideration. Texas led the nation in anti-trans bills filed this session, with proposals ranging from blocking access to gender-affirming healthcare to criminalizing gender identity itself through “gender identity fraud” laws.
House Bill 229 exemplified this overreach by attempting to define “sex” based solely on biological reproductive systems. Other bills targeted bathroom access, school policies, and medical care. What unites these efforts is their shared premise: that gender can be reduced to simple biological categories determined at birth. As it stands, House Bill 229 is currently awaiting for Governor Greg Abbott to sign.
This premise is fundamentally flawed. Chromosomes are not sex — the Olympics abandoned chromosome testing decades ago when too many athletes discovered their assigned sex didn’t match their genetics. Genitals are not sex either — intersex people exist with ambiguous genitalia that defies binary classification. Reproductive organs don’t define sex — women born without uteruses remain women, as do men born without testes.
What Texas lawmakers have sought to do is police and censor how people perform gender. These bills aren’t about biology; they’re about control. They create an impossible standard that even cisgender people can’t consistently meet, while denying transgender people the right to exist authentically.
Meanwhile, Texas’s abortion laws compound this assault on bodily autonomy. Texas criminalizes abortion except when the mother’s life is at stake — which had to be clarified in a bill that passed this session after documented instances of women losing their lives due to delays in critical care.
The combination creates a legislative framework designed not to protect anyone, but to eliminate transgender people from public life while simultaneously restricting all people’s reproductive choices. It’s governance by ideology rather than science, with real people paying the price.
Although I didn’t give birth in Texas, my experiences navigating reproductive healthcare as a trans man have been traumatic. To start, though I was assigned female at birth and had all of the symptoms of pregnancy, I was not given a pregnancy test the numerous times I went to my doctor. This was my first pregnancy and – according to my doctors I was unable to even get pregnant because I was on testosterone and had been for years prior. I was in and out of the doctors office at least 4 times before I gave myself a pregnancy test after laying on my stomach and feeling like there was a pillow underneath me.
The result? I didn’t find out that I was pregnant until I was more than five months pregnant — nearing the end of my second trimester and beyond most gestational limits under abortion laws. Thus, I had my right to choose stolen away from me.
After finding out I was pregnant, there was the nightmare of navigating insurance. Insurance companies absolutely refuse to acknowledge that transgender people exist. So much confusion and trauma could be avoided by simply adding an option for assigned female at birth or assigned male at birth instead of just male and female. But those options weren’t available to me, and I had to change my gender back to female in my insurance information in order to have my OB-GYN care covered. The change resulted in repeated misgendering.
Imagine you’re a trans man, with a beard, and top surgery, sitting in a crowded waiting room and having someone loudly refer to you as Mrs. Coleman across the room. Now imagine how embarrassing it must be to not only answer, but then have someone question whether you’re in the right place. “Mr. Coleman it seems they have you down to see the OB-GYN, are you sure that’s correct?”
There have been too many times when I have had to walk into offices labeled “women only,” where the walls are adorned with (mostly white) women and not a masculine presenting or even visibly queer person in sight. I’ve waddled into my OBGYN’s office at eight and nine months pregnant, stared and gawked at. Not only by patients but by staff as well.
I remember very vividly going to my OB’s office and being told to sit and wait after I attempted to check in. The women behind the desk spoke in their native language and literally pointed at me while doing so. They let me wait, and after almost a half hour, I asked what the issue was. One of the women said, voice raised, “Sir are you pregnant?”
When I was going to be induced due to preeclampsia during my first pregnancy, I had to prove to the security guard that I was supposed to be going to labor and delivery.
As a cisgender assumed Black trans man, I am perceived as a man first, even in reproductive spaces and while navigating pregnancy. Black men are often seen as aggressive, violent and intimidating so I had to be very careful about how I addressed every situation. Taking up for myself could have very well led to being seen as a threat. During my second pregnancy, there was a nurse who was supposed to be taking my blood. She was shaking so violently out of fear that she couldn’t steady her hand. I had to call and have her removed from my room. I was laying in a hospital bed, hooked up to a magnesium drip IV due to high blood pressure and I was still seen as a threat to her.
Recently, I conducted a survey for Black trans masculine individuals regarding reproductive health. In that survey I asked about discrimination in healthcare spaces. Of the 90 individuals who participated, 22.2% said they’ve experienced discrimination based on gender identity, 6.7% said they’ve experienced discrimination based on race, and 38.9% said they’ve experienced both racial and gender identity discrimination.
That is a total of 67.8% of respondents who said they’ve experienced discrimination in medical spaces. And unsurprisingly, 70% of the 90 respondents said they avoid reproductive healthcare spaces due to fear of discrimination.
Let’s break that down one step further: Dozens of people said they avoid seeking out the reproductive care they need out of fear.
That is what it is like living in a world that refuses to make room for you.