Providing Care to Trans Clients: Considerations for Pregnancy, Birth, and Post-Partum Care and Support Presentation by: Andy Inkster, MA Health Promoter LGBTQ Parenting Network Sherbourne Health Centre Toronto Alanna Kibbe, RM Registered Midwife Seventh Generation Midwives Toronto Drawing on their professional experiences, Alanna Kibbe, RM, who is a practicing midwife with Seventh Generation Midwives in Toronto, and Andy Inkster, who is a health promoter for the LGBTQ Parenting Network, will provide an overview of specific concerns of providing appropriate prenatal, birth, and postpartum care and support for trans parents.  Trans people experience birth both as pregnant people themselves, and through a co-parent’s pregnancies.  Pregnancy and birth are very gendered experiences in our culture, which present an implicit challenge to trans people.  That challenge is also an opportunity for care providers to provide a high level of client-centred care, while examining the gendered component of their own practice.  The intended audience for this workshop is midwives, doulas, nurses, and other birth professionals who have an interest in providing trans-competent support and care to their clients.

1. Birth & Beyond Conference • October 3 2014 • London, ON
Andy Inkster, MA
Health Promoter
LGBTQ Parenting Network
Sherbourne Health Centre
Toronto
Alanna Kibbe, RM
Registered Midwife
Seventh Generation Midwives
Toronto
333 Sherbourne Street, Toronto, Ontario M5A 2S5 • (416) 324-4100 ext. 5276 • ainkster@sherbourne.on.ca
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Providing Care to Trans Clients:
Considerations for Pregnancy, Birth,
and Post-Partum Care and Support

2. Workshop Description
Drawing on their professional experiences, Alanna Kibbe, RM, who is a practicing
midwife with Seventh Generation Midwives in Toronto, and Andy Inkster, who is a
health promoter for the LGBTQ Parenting Network, will provide an overview of
specific concerns of providing appropriate prenatal, birth, and postpartum care and
support for trans parents. Trans people experience birth both as pregnant people
themselves, and through a co-parent’s pregnancies.
Pregnancy and birth are very gendered experiences in our culture, which present an
implicit challenge to trans people. That challenge is also an opportunity for care
providers to provide a high level of client-centred care, while examining the gendered
component of their own practice.
The intended audience for this workshop is midwives, doulas, nurses, and other birth
professionals who have an interest in providing trans-competent support and care to
their clients.
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3. Agenda
 Learning about trans: What does trans mean?
 Trans inclusive language for the childbearing year
 Complexities of Conception – planned or
unplanned
 Pregnancy – social & physical changes
 Birth – choices, hopes, and plans
 Postpartum & lactation – Creating a supportive
environment
 Transition to parenting
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4. Who is trans?
 What does trans
mean?
 What is gender identity?
 Medical procedures?
27% of trans people in
Ontario are parents
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5. 5
Image from “The Cost of Gender” film
www.costofgender.com/

6. Inclusive language for
the Childbearing Year
Breastfeeding
Pregnant Woman
Mother
Chest feeding, lactation
Pregnant Person
Parent
Other examples?

7. Complexities of Conception
 Planned
 Fertility services
 Partners with sperm
 Known donors
 Unplanned
 Trans people can still get
pregnant & can still impregnate
 Parenting choices
 Who is in a family?
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8. Fertility Support
(in)Fertility support is generally
cisnormative and heterocentric
Still Trying:
LGBTQ fertility
peer support group
Once a month at
Sherbourne Health Centre
Toronto
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9. Pregnancy - Social
Pregnancy is very gendered
 1st trimester – Disclosure
Disclosing pregnancy
may mean coming out as trans
 2nd – 3rd trimester
Clothing & social gendering
Being pregnant can mean being
gendered in a very different way
Implications of social intrusion and expectations of pregnancy
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10. Clinic space?
Client records? Posters?
Health promotion materials?
Forms?
Language?
How is your care
gendered?
Information? Washrooms?

11. Birth
 Types of birth choices:
 C-section
 Hospital
 Birth Centre
 Home
 Birth Hopes vs. Plans
 When plans change
 Keeping birth environments safe
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12. Making Birth
Environments Safe
 Preparing staff
 Expectations of the birth worker vs needs of the client
 Creating safe space anywhere!
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13. Postpartum
 Supportive home, supportive environments
 Defining family
 Transition to parenthood
 Hormonal changes
 Paperwork, registration
 Restarting testosterone
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14. Lactation
 Supporting lactation
 Birth parent lactating
 Non birth parent and lactation
 Challenges and choices
 Supporting NOT lactating
 Lactation and gendering
 Many ways of bonding with baby
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15. 15
Family Planning Courses
Dykes Planning Tykes
This course emphasizes donor insemination, adoption,
and co-parenting for lesbian, bi, and queer-identified
women.
12 week & Weekend Intensive
Daddies & Papas 2B
Emphasizes adoption, surrogacy, and co-parenting for
gay, bi, and queer-identified men.
12 week
Queer & Trans Family Planning(s)
Depends on participant interest and need.
Weekend
Joint programs of
Queer Parenting Programs at The 519 Church Street Community Centre
LGBTQ Parenting Network at Sherbourne Health Centre.

16. 16
Queer & Trans Family Planning
A weekend course for people of diverse family
structures and identities, including gender queer, trans,
bisexual, poly, pan or omni-sexual, dyke, butch, femme,
boi, lesbian, gay, queer, or other, and their partners.
Outside Toronto? Join us for the weekend!
Fall 2014 Session
Friday, November 28 - Sunday, November 30
at Sherbourne Health Centre, Toronto
$125+ HST per person, sliding scale available
Register online: lgbtqpn.ca/planning
Joint programs of :
Queer Parenting Programs at The 519 Church Street Community Centre
LGBTQ Parenting Network at Sherbourne Health Centre

17. Further Training
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Rachel Epstein
Coordinator
LGBTQ Parenting Network
Sherbourne Health Centre
333 Sherbourne Street
Toronto, ON
M5A 2S5
(416) 324-4100 ext. 5219
repstein@sherbourne.on.ca

18. Andy Inkster
Health Promoter
LGBTQ Parenting Network
Sherbourne Health Centre
333 Sherbourne Street
Toronto, ON
M5A 2S5
www.LGBTQParentingNetwork.ca
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(416) 324-4100 ext. 5276
ainkster@sherbourne.on.ca
/LGBTQPN
@LGBTQPN

19. Alanna Kibbe
Registered Midwife
Seventh Generation Midwives Toronto
Head Midwife, Sunnybrook Health Sciences Centre
SEVENTH GENERATION MIDWIVES TORONTO | 525 DUNDAS ST E, SECOND FLOOR | TORONTO | ON | M5A 2B6 | PHONE 416-530-7468 | FAX 416-530-7478
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(416) 530-7468
akibbe@sgmt.ca
SEVENTH GENERATION MIDWIVES TORONTO
525 DUNDAS ST E, SECOND FLOOR
TORONTO ON
M5A 2B6
WWW.SGMT.CA

20. 20
The Queer-Positive
Pre-Natal Class
A weekend community-building course for people of diverse family
structures and identities who are expecting a newborn, whether
through birth, adoption or surrogacy. Come find out about the stages
of birth, creating a birth plan, life after giving birth, understanding
newborns, self-advocacy strategies, and much more. Partners, co-parents,
surrogates and other support people are welcome.
Fall 2014 Session
Friday, October 17 – Sunday October 19, 2014
at The 519, Toronto
$125+ HST per person, sliding scale available
Contact: cveldhoven@The519.org

21. Report: Transforming Family
Trans Parents and their Struggles, Strategies, and
Strengths
44 Page report describing the
experiences of trans parents
Recommendations to social service,
health, legal, and educational
institutions.
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22. Transforming FAMILY
A ten minute documentary that jumps directly into an
ongoing conversation among trans people about
parenting. It is a beautiful snapshot of current issues,
struggles and strengths of transexual, transgender and
gender fluid parents (and parents to be) in North America
today.
www.LGBTQpn.ca/trans-parenting/
The film was directed by Rémy Huberdeau in
collaboration with the LGBTQ Parenting Network, and
with support from: The Community One Foundation and
The Centre for the Study of Gender, Social Inequities
and Mental Health.
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23. Info Sheets
LGBTQ Parenting Recognition
 Birth Registration in Ontario
 Second Parent Adoption
in Ontario
 Declarations of Parentage
in Ontario
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Coming soon!

24. Other References
Bauer G, Boyce M, Coleman T, Kaay M, Scanlon K. Who
are Trans People in Ontario? Trans PULSE e-Bulletin, 20
July, 2010. 1(1). Downloadable in English or French at
http://www.transpulseproject.ca.
http://www.glaad.org/transgender/trans101
The 519 Church Street Community Centre Glossary
Available from Rainbow Health Ontario:
http://www.rainbowhealthontario.ca/glossary
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