Your BIRTH Partners

"A Womb of Their Own" Q&A: Trans & Non-binary Birth Care

November 23, 2020 Season 2 Episode 10
Your BIRTH Partners
"A Womb of Their Own" Q&A: Trans & Non-binary Birth Care
Q&A with Cyn & Ray
Feedback from Audience Members
Your BIRTH Partners
"A Womb of Their Own" Q&A: Trans & Non-binary Birth Care
Nov 23, 2020 Season 2 Episode 10

During Trans Awareness Week, we hosted a screening of the film, "A Womb of Their Own" and had the opportunity to do a Q&A with the filmmaker Cyn Lubow and queer non-binary midwife Ray Rachlin.
In this Q&A we discussed expanding our understanding of gender beyond traditional masculine & feminine roles, we identified some best practices for birth pros to adopt in their care to be more inclusive, discussed the challenges of systemic change & actions to take forward,  and we heard from community members across the disciplines on the film impact and the state of trans birth care.

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Show Notes Transcript Chapter Markers

During Trans Awareness Week, we hosted a screening of the film, "A Womb of Their Own" and had the opportunity to do a Q&A with the filmmaker Cyn Lubow and queer non-binary midwife Ray Rachlin.
In this Q&A we discussed expanding our understanding of gender beyond traditional masculine & feminine roles, we identified some best practices for birth pros to adopt in their care to be more inclusive, discussed the challenges of systemic change & actions to take forward,  and we heard from community members across the disciplines on the film impact and the state of trans birth care.

Support the show (

Maggie, RNC-OB  0:05  
Welcome to Your BIRTH Partners, we are here to break down barriers and cultivate community as we discuss issues that impact pregnancy, birth and postpartum. We welcome you no matter what your background is, and are so excited to learn together. Today we are sharing a conversation, a Q&A that we recently had during Trans Awareness Week around the film "A Womb of Their Own," we were blessed to have the filmmaker Cyn Lubow and our own Ray Rachlin midwife of Refuge Midwifery, who came together to answer questions from our audience about what it means to navigate pregnancy and birth as a trans or non variant person, and how we as birth professionals can best contribute to safer and inclusive birth care practices that help everyone in our care to be more comfortable as they navigate this journey. So I am very excited to share that conversation with you. On to the show! 

Welcome, everyone. I am Maggie Runyon. I am a birth nurse and educator advocate, and the founder of Your BIRTH Partners. So I'm just really excited to have this conversation today and following up from the film. So our our whole goal at Your BIRTH Partners is to bring professionals together to step out of our silos and create better, more inclusive, equitable care for folks who are pregnant and have babies. So I am really glad to have you here. So Cyn and Ray, if you want to just introduce yourselves a little bit and give a little context for why you're here. Cyn, go for it, you're our special guest!

Cyn, Filmmaker  1:39  
Okay, well, I made this film, as I said, between 2013 2016 I just wanted to explore the diversity of gender. And I thought a good way to capture people's attention and and to break down people's assumptions and people's ideas about gender that are that we tend to cling to rigidly I would pair masculine-identified people with pregnancy. And then people would be forced to question the assumptions. And then once I had done that, if I could then keep doing that throughout the film, that they could come out with a more inclusive, more fluid understanding of what gender could and couldn't be. And I'm happy to answer any questions anybody has about film or anybody in it for me,

Maggie, RNC-OB  2:30  
Thank you so much for being here.

Cyn, Filmmaker  2:32  
Thank you for doing this.

Ray, CPM  2:33  
So I'm Ray Rachlin, I'm a certified professional midwife and lactation counselor in Philadelphia, serving kind of like Philly and South Jersey, my practice is refuge midwifery. And I got really involved in kind of promoting affirmative reproductive care for trans people, especially in the childbearing year, about like five years ago now. And part of my practice, pre pandemic was like educating healthcare providers on trans inclusive birth care. And in my own practice, about 10% of my clients are trans and non binary. So it's community that I'm a part of, and is like a really big part of my heart, and that I get to kind of serve in a couple of different ways. 

Maggie, RNC-OB  3:12  
Wonderful, getting to partner with you on all of this. So yes, we have our first question coming in from Christine: "I wonder if you could explore with me, during the film, one person observed that being pregnant take strength, and that they found they were able to lean into their masculinity in this regard, can you please share some thoughts on the concept of strength and gender?"

Cyn, Filmmaker  3:33  
I mean, I find whatever I tried to talk about gender, I get caught up in the archetypes of male and female that there are pros and cons to ascribing to but try to talk about, about male and female and breaking down our rigid ideas of it. It's inherent in the process of trying to talk about male and female that we can't talk about it without rigid ideas about it. So you know, archetypally, we think of strength as being associated with men. And obviously, we, you know, we want women to be associated with strength as much as we as men being associated with strength. So, it just makes it very difficult to even talk about what what is gender, what is male and female, anyway, and how do we how do we talk about it? Obviously, men have strengths, women have strengths. All men don't have the same strengths necessarily all women don't have the same strengths necessarily. But we do associate pregnancy with a certain vulnerability, a certain you know, need for protection and rest and things that we think of as sort of weaker things. And I was one of the people I wasn't the only one but I was one of the subjects who who said that I experience pregnancy is also as a strength, as a strong thing. And I didn't want to be, you know, a wilting flower, or whatever you would say about the traditional image of well, of a pregnant woman, nor do I think that it fits because being pregnant is not for the weak or faint of heart. It's, it's, it takes, you know, everything you got to do it. So it was, you know, I was speaking to wanting to transform, that association of pregnancy with weakness. You know, we associate traditionally femininity with weakness as well. So pregnancy and femininity, weakness, all have traditionally gone together. And for those of us who are trying to disrupt those associations, I think it's important to remember that whenever they, whenever there is some attempt to show man what it's like to be pregnant, you know, people pretty much all agree "Oh, wow, that, you know, I don't know too many men who could stand that" as, as Robin Williams, just to say, out, try to pass a bowling ball through your penis, and then you'll know what it's like to be pregnant, and to deliver babies. That's just one of the concepts that I wanted to completely disrupt. And I, even at the time, you know, this was a long time ago, obviously, that's why I enjoyed so much. Taking pictures of me, you know, when big pregnant belly lifting weights, you know, I'm showing muscles, because that was my version of disrupting. Did that answer the question? I'm not sure...

Ray, CPM  6:51  
it does. And also, I think I really appreciated that like the documentary brought that into the narrative, because anyone who's like in the birth world knows that like pregnancy and birth, really, possibly the most gendered experiences we have in our culture. And there's this like, a lot of assumptions about gender and bodies and how like people experience thing and that like, also the strength that people may be experienced has to do with femininity, or like, you know, motherhood, where in fact, you know, the body, or the reproductive organs you have and like your experience of gender, like don't actually have much to do with each other. They do for some people and not for others. And pregnancy can be a really like, you know, empowering masculine experience for some and a disempowering masculine experience for others or feminine, you know, there's just no, you know, I think we just like really have lots of opportunity to, like, start challenging the assumptions we have around who gets pregnant and like how they experience their bodies. Because the truth is, like, you know, pregnancy can be dysphoric for folks of all genders. But if we make assumptions about where strength comes from, or how people are experiencing it, we like lose the opportunity to actually support them. 

Maggie, RNC-OB  8:01  
Yeah, I think that's a good point. I know, you know, AK Summers, commented about, you know, just that idea of, I'm just gonna have to settle in for like a hard nine months here and just kind of muscled through it at that. So absolutely, for some people, it is going to be a way to find strength in whatever, you know, kind of energy you're pulling from and that for some people, it's going to remain hard and something that you're kind of settling into. We have a question coming in here. Layla: "Do you have any advice for prepubescent trans kids about fertility preservation before starting hormone therapy, so they may have the opportunity for a biologic parenthood in the future?" 

Ray, CPM  8:39  
I can answer that one. So, for those who don't know the only life transforming hormone therapies that permanently impact fertility is puberty suppression, and then hormone use. So if gametes don't have a chance to mature, then they aren't really able to be used in the future. And there is like some technology, trying to harvest immature gametes to bank and then use later and it's pretty experimental success rates are fairly low. It's also extremely invasive to like, do procedures on like, maybe a 13 year old girl's testicles. So I think first and foremost, like hormone therapy saves lives. And the priority always should be on like doing life saving hormonal therapy during therapy. And we can do some informed choice on the current available options, but like they aren't great. And oftentimes, like hormone affirming therapy is much more of a priority than having a genetically related child. And that's kind of what I think sometimes genetically related children is something that parents of trans children feel really strongly about and in like, how much suicidality there is among trans teens. For me, it's not as much of a priority. And I don't know because fertility preservation for very young people like not a priority and like, you know, fertility technologies, I'm not really sure when they're going to improve, but success rates are definitely like under 20%. 

Maggie, RNC-OB  10:03  
Thank you for speaking to that. And another follow up to that: "Ray, your work showcasing how to show up. For QT birthing folks, as a midwife has really inspired folks to think outside the binary in our work. Can you talk about some basic steps that you encourage birth workers to show up for the needs of trans and non binary birthing folks and community?"

Ray, CPM  10:23  
Yes, I think first and foremost is use gender inclusive language when talking about pregnancy, birth parenting, with everybody get used to taking gender, the gender experience of pregnancy, like out of it, and just like talking about pregnant people, instead of like pregnant women. And in doing that, you create more space to like recognize, you know, the person you're caring for as an individual. And not there's like this weird, like loss of self identity, when we call people Mama, that we're trying to, like, help bring personhood back and like doing gender inclusive cares about benefiting anyone who's sitting in front of you, not just trans clients, or patients. And also, if you're using gender inclusive language all the time, you won't mess up. The next thing is having that, you know, like working with whatever health system that you're in to, like have like gender inclusive language and gender inclusive trainings, like, you know, so having like forums having websites, informed choice documents, images. If queer people and non binary people and trans people don't see themselves in your healthcare setting, they're not going to know that as well. Same with like, on your website, or a page. And you know, if you haven't gotten training and have done an experience working with trans people, like there is a lot of like, available trainings, you can definitely pay trans birth workers to really teach you how to be more inclusive. And then when it comes to actually the opportunity to care for someone who's trans or non binary, be really explicit about what you do and don't know, like, when it comes to trans health, like most things we don't know, you know, because, you know, the research is mostly qualitative. It's done on like, you know, a good study of like, in trans health is often like 40 people, and they're mostly white and middle class. So there really doesn't tell us a ton of information about the people who are most at risk of experiencing harm in our system. And like self reported data is like not like it is a part of like understanding like Health and Science, but it's not, we don't have good ability to do evidence based care. So just being really explicit about what we do and don't know where points of tension might come up. Like if you have an Electronic Health Record system that doesn't offer trans inclusive options, you know, or pronouns, like the like, like mentioning where that might come up as issues and also trying to be a bridge as an advocate to like, you know, do more procedures in house, or facilitate like doing a soft handoff to other providers to reduce incidence of discrimination, and generally also, like, continuity, and like reducing how many people a trans person sees like, improves the chance of like not experiencing discrimination. So for healthcare providers, it's doing more things in house and like writing plans for continuity. And for doulas, it's really vetting your referrals and like, helping them come up with plans with their providers to like have more continuity to protect wellbeing.

Cyn, Filmmaker  13:08  
In addition to the rounds on electronic records, it's also really important to notice if the person's you know legal name is is what follows them on their electronic records and is not what it says for them their dead name and is not the name it that they go by. So it's really important to if there's not a way of managing that on the electronic file to be sure that you use the right name.

Maggie, RNC-OB  13:37  
Erica has a good follow up to that: "As a medical student, I find the healthcare aspect of this room especially fascinating. Can you talk a little bit about the healthcare experience of those in the film had? Did you find that their health care providers were affirming of their identities? Or were their negative experiences?"

Cyn, Filmmaker  13:51  
Yeah, you know, if I had known how, how useful important the film would be for people in birth care, I probably would have probed that more, but as it happened with the people that I ended up working with as subjects there, there wasn't a lot of, certainly not trauma there. There weren't a lot of problems that they report, I did ask them about it. And I didn't get a lot of juicy stuff from them. And I don't think that's representative of the field in general. Less so now, but at the time so I you know, some of them were in the Bay Area, and they worked with educated trans inclusive midwives at home or, or even, you know, in institutions where, where they did better some of them. Morgan, I think talked about, I think it was a friend of theirs who made signs and put them up around the birthing room saying, This is my gender. This is my name. This is my partner. My partner and I call each other... with instructions just posted right there, so that anybody who came in and out had the information they needed. But yeah, didn't hear any horror stories. Ray, I imagine you have.

Ray, CPM  15:05  
I mean, I'm in this like, interesting subset of doing home birth where like, what we know from like research is that trans people upon birth set rates far greater than the general population. So, for example, for instance, you know, general population, like 9% of people are using midwives 1.36% are having home birth or birth center birth. And for trans non binary people in the literature, we have like 45 to 50% are using midwives and 20% are happening out of hospital. So, birth center and home birth. So you know, we're, we're seeing this because people are in part trying to protect themselves, you know, and like, I think like, you know, queer understandings of bodies and like midwifery care, like have a lot in common and also, when you have a known provider, and you know, who's gonna be in your environment for your birth, like, you are more protected from discrimination. And also, like, homebirth is definitely not right for everybody or appropriate for everybody, either. There's like some pretty awful stuff in the literature, I haven't had like, bad experiences, and like, you know, transferring trans and unlearning books to the hospital. But I've also like been able to set up a really good co care situation, and like there are, you know, good hospital providers that can do serve trans people well, during birth, and also like, I'm in a large city that has a larger population. And they're going to be places that it's safer to just, you know, like, not be like not disclose that you're trans or non binary and just kind of go under the radar. And they're also people that don't have those options and may experience a lot of discrimination may not. So it's a really wide gamut.

Cyn, Filmmaker  16:44  
Yeah, heartened by the the midwifery schools that have contacted me that are very serious about booting all this in their in their training seems like there's really a very concerted national, maybe international effort to update people.

Maggie, RNC-OB  17:02  
Yeah, absolutely. circling back around.... Susanna had asked about, you know, "how do we increase the number of trans affirming providers, hospital doctors, and to follow up with that. So most of my experiences as a birth nurse in the hospital setting, and that there's sometimes this kind of tension between not having a very long time to establish a relationship with people that are all of a sudden in our care, compared to, you know, working with a midwife in the community or a doula. So you know, if you can speak either, you know, for your personal experience, your professional experience, what are the ways that we can kind of bridge that gap when people are suddenly, you know, in our care, and we don't have as long of a time to develop relationship? Essentially, how do we get to know them and support them without prying unnecessarily into details about their gender?

Ray, CPM  17:50  
I think the first thing is that like, you know, you can ask, like, have your pronouns like really like explicitly on your badge, like, introduce yourself by name and pronoun every single time. And that gives people the opportunity to say their pronouns. And you just ask what people's pronouns are, they don't tell you and you ask what parenting terms they're going to use, and what their baby's name is, what they're calling their baby. Like, there's lots of ways to, like create connection in a short period of time without being like, Are you having a boy or a girl, or I think like, Mama is really a shorthand for, like, don't remember your name, or I'm trying to create connection, when in fact, like, take the time to write their name, but I think it's just like asking, and then using the terms that they use, and not asking any invasive questions about their gender or body, like, you know, there's, you know, like stuff with, like, you know, why? Why do you want to be pregnant, if you think you're a man, like, that really doesn't matter, it absolutely doesn't matter. So, like, don't ask it just like, you know, like, trans cares, trauma informed care, assume that the person is like, not had a positive experience in their body, and you're going to find a little bit more gently, you know, like, ask for consent before touching, like, ask about preferences for procedures that involve the chest or genitals, like if maybe they don't want a resident doing cervical checks, you know, and that should also be true for everyone that we care for, as well. But just like kind of taking, taking the time to like, slow down and like not make as many assumptions like really makes a really big difference, asking open ended questions about how or they're going to feed their baby or who's going to be supporting them afterwards. And then, like, you know, oftentimes, like the advocacy of like one or two providers on the labor floor, like does get like trans inclusive training to happen with like, EHR with like, intake questions. So even if like, not everyone on the floor is competent, there's at least like one or two people each shift. So if someone who's like trans or non binary comes in, I've definitely had this experience where like, I got to the hospital, I'm like "hi, I'm transfering with a trans patient" and like, they send us a nurse with blue hair, and it's amazing, you know, like so even if not every one of the floors, they're able to provide trans care, like there's been some baseline training and some people are really there and ready to do the advocacy and they can continue to work to bring the rest of the labor for their

Cyn, Filmmaker  20:00  
Right, I'm guessing that you also either use general gender neutral terms for body parts. Or ask them what what words they use for body parts, like birth canal instead of vagina or something.

Ray, CPM  20:17  
Yeah, cervical checks instead of vaginal exams. Sometimes I'll just call things a front hole. Yeah, chest instead of breast or interchanging or saying feeding at the nipple. 

Maggie, RNC-OB  20:28  
Oh, and then Claire has a question: "I work with an organization who supports pregnant people in new parents experiencing postpartum depression anxiety. in British Columbia, Canada, we're working hard to create more inclusive care, we finally have a 2SLGBTQ plus support group ran by queer facilitator, yay. Can you speak a bit about the mental health impacts of trans non binary parenting, and how, as Mozi says, women, we can better meet the needs of our clients, it's not always possible to hook them up with a career counselor right away. And we're really mindful that our one career counselors carry huge emotional weight."

Cyn, Filmmaker  20:59  
Wow, maybe do some trainings for the staff. I'm not sure if this is volunteer. I mean, I think, as with many on many topics, queer people, you know, when they're going to be that vulnerable, it's really helpful to be seeing somebody who's, who's actually queer. It's very hard to fake that. And it depends on how much being queer is a mental health issue for them for. For the majority of queer people, being queer is not their issue. And they don't necessarily need any treatment any different than anybody else. But it is still important to use the right language to use our pronouns, to use the right name, to not make any assumptions, which, you know, good mental health counselors, I'm going to make assumptions anyway. But a certain level of education just in familiarity. One of the reasons I wanted to do the film was that and the way said it's being useful is that I wanted people who didn't have access to experiences with trans and non binary queer people to get of the experience just by watching the film on a flyball. What are these people look like? What do they talk like? What do they sound like? What you know, what, what, what's their experience from their mouths? What What was it feel like to be around, you know, somebody like this, if you've never been around, something like that, and we know from all kinds of discrimination, with all kinds of communities that the more experience one on one experience that you have with, with people, the less discriminatory thoughts and feelings that you know, the more they go down, or dissipate. So, since there are people that just don't run into anybody who's trans, I mean, that's less and less true, because now people see people on TV, and, you know, they're, they're famous people have come out as trans and, and so on. But having starting out, not experimenting on actual people, but by having a little bit of exposure, without having to have somebody be or exposure, I was hoping that would make some inroads so that when people did encounter actual trans people, or non binary people, they would have some precedent in their minds for like, Oh, yeah, yeah, I've seen that before. And that's, that's not like, blowing my mind right now. So I my point was, I guess, to, to get as much exposure as possible, and, and at least some things against education, and to try to get more queer therapists.

Maggie, RNC-OB  23:48  
I mean, that absolutely came through for me, you know, watching the film is someone not, you know, part of the queer community, a huge exposure just to different, you know, just the fluidity of gender and I think you were able to really effectively show a lot more of the nuance that goes through it really pushing way beyond that binary that so many of us have kind of had ingrained through society. We have another question coming in. 

Ray, CPM  24:16  
I am looking through and I see a question about educating other birth workers. Yes. And I know for me like I like to have like different opportunities like this do when a trans inclusive birth worker education and I do that a lot of my Instagram and also a really big fan of paying trans people for this labor and paying them really well. There's a couple folks that are doing this. There is king yaa, there's moss the doula, there's love over fear wellness, are like Tristen just started Trans fertility and family equality council like there are like places to go to like get this screening and I think people who are cis should be paying trans people for this information?

Maggie, RNC-OB  25:02  
Absolutely, absolutely. And we'll, we'll send out a link to some of the other resources for everyone when we kind of like follow up from doing the training. So that sounds great. And then, you know, going to going from there, Susanna had asked "Furthermore, what do you think is like the crucial kind of pivot points for organizing for change on a bigger level within healthcare society, at large?"

Cyn, Filmmaker  25:28  
Personally, I think exposure is a big part of it, I really felt feel like what people see on TV and in social media now to his influences a lot of what they think about the world. And I think that marriage equality came out of, you know, what I was talking about before, more and more and more people being exposed through television, to queer people. I mean, we know that people always been surrounded by queer people, but but it wasn't safe to come out. So they didn't know it. But Ellen came out. And we got more and more representation everywhere. People just got more comfortable with like, "oh, they're just people like they are no, no big deal." And, and I think that, that breaks through that. Obviously, there's, there are things to learn, but that breaks through the resistance to learning them.

Ray, CPM  26:27  
This question feels huge, and I think I'm also in a very pessimistic moment, and feeling like trans health has gone back a bit and the pandemic, in terms of rights and options, you know, I do think exposure to our stories, that our families is a big part of it, like normalizing this, but also it kind of takes like advocacy and organizing at every level, you know, it takes it, I see my role, you know, as a home birth midwife, both and like, raising up the families that I serve, and then also trying to like support there being other trans competent providers and birth workers around me that I can refer to and have a robust support system for, like transporting people in Philadelphia. And we need more of those folks also in the hospital, doing advocacy in the hospital and in clinics, doing advocacy with front desk staff, and at like acupuncture offices, because like, you know, in, like in this area, like there's not a pregnancy chiropractor, I could send trans people into, there's just all these places that, you know, even though like we're it's becoming more visible, and our stories are like being shared more, there's still like, there's just so many gaps in so many layers, and now like within the limitations on people and support people, that puts trans folks at higher risk of experiencing discrimination, because there's not like a support person or buffer advocate who could like go to an ultrasound. So, and I don't, I haven't seen ways around that yet. I don't know, I think by birth is definitely like the most gendered experience we have in our society. So changing it to be inclusive of queer and trans and non binary and like non normative families is going to take a ton of work and possibly a generation to shift the mindset.

Cyn, Filmmaker  28:11  
For sure, seems like, you know, point taken that that part of the training for not just midwives, and doulas and childbirth educators, but chiropractors and acupuncturist and doctors, and, you know, anybody who comes in contact with somebody around health and bodies and mental health should have that as a required part of work and how we get there. That's not my area.

Maggie, RNC-OB  28:39  
Yeah, absolutely. I would say that it takes takes time. And, you know, I'm grateful for you for making this film. And it's an option for people to get exposure, and I'm seeing, you know, a lot of the comments that people have, you know, here at the showing and wanting to bring it back and share that. And it does seem like there's, you know, changing there, I know, Kristen was commenting on the generational differences in the perception, acceptance of transgender may suggest empowering, you know, the medical, nursing, pa, physician students, you know, to change the healthcare system that you know, starting with younger people who are just getting out there and haven't been, you know, broke down by the system quite as much already that that's definitely an inroad there. And then, I know one of things we had talked about Cyn, if you want to speak to it a little bit, it's kinda like the representation within the film in terms of what we kind of want to see next as we keep talking about trans and non binary folks.

Cyn, Filmmaker  29:34  
I wanted as much diversity as I could access and afford, I had no budget. So I wanted diversity and where the person was around the pregnancy process, age, location, geographical location, race, class, education, you know, experience of gender where they were on the spectrum or if there is a spectrum even in terms of gender identity, I didn't know any of the subjects other than myself, of course, before starting this project. So I was amazed I found any. And I spent two years trying to find as much diversity as I could, as I could find. And I kept hitting my head against the wall trying to get racial diversity. And it was the, it's my, you know, biggest regret that I was at, I totally failed at that. I got close. And then, you know, things didn't work out. I talked to a bunch of people about why I was having so much trouble. And of course, that opens up a whole new, whole area about racism and white supremacy and the forces in our world. But I would still like to see a more racially inclusive version of my objectives done. And I don't know whether that'll ever happen for me or someone else will do it. Because I think it's really important different cultures and different races and different different perspectives and experiences are really important to this topic.

Maggie, RNC-OB  31:07  
Ray, do you know of any other resources that that would speak to a broader?

Ray, CPM  31:13  
 I think a lot of the resources are happening in community. So you know, the kind of, like trans birthing community is on Facebook, it's on Instagram, it's on like, tiktok, which makes me feel old. But you know, like, I think, because their resources aren't set up for us, like it's happening, kind of like in informal networks, and like people who are building like, you know, support and power, there's a really large Facebook group called birthing, breastfeeding trans people and allies has a trans only birthing group. There are some groups around like, non binary folks who are trying to get pregnant right now. And they get pregnant. Like, there's, yeah, the community is like happening online.

Cyn, Filmmaker  31:55  
And that's new. I mean, that's exploding. As far as I can tell, even, you know, whatever that was six, seven years ago, when I started this, I found people on YouTube, and I begged them to be part of my film. And but you know, tiktok wasn't around and trans families and allies, I always forget the name of their that group, but they, they they weren't around yet. It's great. What, how much the support is spreading? 

Ray, CPM  32:25  
Yeah, there's like a lot more online community. But definitely the stories that get lifted up are typically like white middle class stories, for sure. So I think probably, you know, as a white person, you know, the stories that we don't see are the ones that are like not being told to us.

Cyn, Filmmaker  32:39  
Yeah. And and, understandably, though, don't want to be told to us.

Maggie, RNC-OB  32:45  
Well, I think we've covered all of the questions, if anyone has anything else burning questions that they wanted to throw out there. I'll give a couple more minutes for that.

Cyn, Filmmaker  32:55  
Or does anybody want to be unmuted? So you can ask?

Maggie, RNC-OB  32:59  
Yeah, if anyone wants to come off there and come on to the mic if they want to, or share anything about, you know, resources, you find helpful, any of your experience that kind of speaks this topic, we would welcome more voices on here. Let's see, let me find you.

Missy, CNM  33:12  
I was just gonna say one thing that happened, I'm a certified nurse midwife, I work in a private practice. I'm in Oak Park, Illinois, which is just west of Chicago, but we serve the Chicagoland area. And one of the best things that happened to us is having our first trans birthing patient a couple of years ago. So one of the things I would say to the other providers that are on the call is that one thing that was helpful is like we had all of our literature that we usually give to people and unfortunately for him, he had to do a lot of the educating, which is part of why I was like amen to paying people for their labor, because we need to be acknowledging that trans folks aren't the only people that need to be educating and, you know, sometimes they just want to be a patient, which is fine, but we went through the folder and he essentially like he pointed out a lot of things to us that we didn't even look at even though like my lens as a queer midwife was there. I'm also assist fam like, you know, person, so I'm not it's it's looking at all the lenses like, doesn't matter so much that I'm a queer midwife, but I also was not as sensitive to trans inclusive care as I needed to be. So like, for instance, our TDAP vaccine had a bunch of stuff about pregnant women on it, and I didn't even look at that she, you know, maybe, but we just handed out with our patient education. So I think that like, it's helped me take a closer look. And so I just wanted to comment on that. In that, you know, I guess the point being translation shouldn't always be our teachers, but sometimes, like, I think that this particular patient was very receptive to us and chose us particularly because we are a practice that supports physiologic birth and kind of birthing in your own terms and we are in hospital. The last thing I'll say, you know, it's unfortunate like part of what I did to protect him as a provider was to self select all the nurses that would be a part of his care. You And it's really sad that that's what I had to do. But when I knew he was coming in, I was the midwife on call. So I talked to the charge nurse and kind of figured out who it was, that would not be an asshole to him. And you know, that's the world we live in. And I think that in the last four years in this administration, it's been much worse. I'm hopeful that it will maybe get better. But I'm hoping that we get to a point, I'm really proud that a lot of the providers that I work with Hi, Morgan, Hi, Dr. Bratman, other people are on this call and are invested. And I think that that's a gift. So I'm just grateful to be a part of this.

Ray, CPM  35:38  
Thank you spoke to a couple of things that like just that went well, though, you know, like you like protecting your patient in the hospital choosing like nurses that were like going to be a do a better job, keeping them safe. Something I didn't mention is, when it's your first time caring for a trans person, it can be great to just acknowledge that you don't know things and that, like, they're gonna educate you because like the research and like the national transgender discrimination survey is like almost all trans people are educating their providers about their health care needs. So if you just like start with that shared understanding, and like, you know, ask them like, do you want me to read anything to make better understand how I can serve you or like, this is like, I tell people at the beginning of care, like, if I do something that doesn't work for you, I respond well to direct feedback, or you can shoot me an email, you know, like, let them know, like how to call you out. And kind of just builds trust to create more opportunities for like, both learning and like you change your practice. So the next person doesn't have to teach you these lessons. Yeah, for sure.

Missy, CNM  36:31  
I agree. And yeah, I think that that was the gift too, is that he felt space, or he felt safe in our space to be like, hey, Missy, like this. sheet is not cool. Let's talk about how to change it. Thanks for letting me share.

Maggie, RNC-OB  36:45  
Thank you, Missy. Appreciate sharing. Would anyone else like to come on and share?

Cyn, Filmmaker  36:50  
Also, if people don't have questions? I would be interested to know if anybody wants to respond. What surprised you in the film? And or was there any, is there anything that you will do differently now that you've seen the film?

Maggie, RNC-OB  37:04  
Aaliyah, I am going to find you.

Aaliyah, doula  37:07  
I am very new to the birth world. I come from a culinary background and got into the both worlds June or July of this year. I'm going through a full spectrum doula training with birthing advocacy, doula training right now, and I identify as queer, but I, I come from a background that's open with like, religion and spirituality, but very, like, aggressively strict when it comes to gender roles. And I'm a twin and my twin identifies as trans. And so I have been part of his journey of learning about himself, which has taught me so much about myself and changing my labels, and how I want to be viewed in the world. And this film was so enlightening for me and so beautiful. And I feel so much sadness and disappointment for the world we live in, because our trans siblings have to educate us on how to best serve them, and how they have to fight to just be seen as valid people and how they want to be viewed in the world, and how they feel most comfortable in their bodies. And this film was so beautiful to me, because it was just, let's sit down and talk to some folks about their life and their experience. And it's not a lot of times that I'm learning about a marginalized community. It's very much a cis white view of this community and the things you need to know about them and the things you they'll they'll mention some things that are very important, but just gloss over the general topic. And I like how laid back and comfortable this film came across as it came across is a very respectful conversation that I would have with some folks that I know who are open with how they identify and move through the world and are willing to share that with other people. And the way you approached this project, and the information you shared with us in a way you shared it with us was so beautiful to me, and just how simple and straightforward it was. And I just wanted to express gratitude in that. And this is something that I'm really sad to say is new to me. It's something I'm still learning about. And trans rights a trans justice is something that I regularly fight for on top With the anti racism work that I'm doing on top of the queer inclusion work that I'm doing, it's just another layer of equity work for me. And the fact that something like this is so big and important in my eyes is disappointing, but also really awesome. And I just wanted to express gratitude to both of you, because I follow you Ray on a lot of the things that you do and blows my mind and how just amazing and wonderful both of you seem as people, and just the work you're doing in the world is awesome. So thank you for that. And I'm super excited to see where we are at as a community in 10 years and the strides we can make with just the what I see is little things that like, the little everyday things that we do, that can turn into projects like this that can shift so many perspectives and share so much knowledge with the more mainstream world. So thank you.

Cyn, Filmmaker  41:10  
Thank you for the work you do. 

Ray, CPM  41:12  
Yeah, thank you. Also, that reminds me I should plan something myself and another queer midwife are working on a project called Queer Conception Stories. And right now we're seeking submissions of LGBTQ folks who created families through some form of help, you know, whether it's donor sperm, donor eggs, donor uteruses, and just kind of how they made their decisions and created their families to be a guidebook for other queer and trans people who are earlier on in this process. So I'm going to put that in the chat. Please share it widely. The deadline for submitting your stories the end of February.

Maggie, RNC-OB  41:45  
Wonderful. Would anyone else like to share? Karen...

Karen, birthworker  41:49  
Hey, everyone. So I am a new birth worker. I just started my labor doula postpartum child brush, lactation, infant massage, you name it, I'm doing it. As a straight white woman. I am taking king yaa's birthing beyond that binary, I have one transgender friend, and a grand niece, she hasn't come out as transgender. But it seems that she's heading in that direction. So I want it to be able to take these courses and watch this movie to help better understand so that when because it's going to come out is that I'm going to come I'm going to come across someone who is transgender, and being a birthing person. And I want to be able to be educated, and not use the wrong pronouns, but be able to treat them with the respect that they deserve, just like every other birthing person. So I just wanted to say thank you so much for letting me be part of this. letting me be able to see this video, when I first started the birthing beyond binary class, they had talked about it and Lorenzo happened to be speaking at our very first class. So I was like, Oh, my God, how can I get my hands? Can I get a DVD, you know, to watch this. And then when I saw this, that it was being offered to watch and screen I was like, Oh my god, I gotta get in on it. I got to see it. So thank you very much. It was very insightful. It was just amazing. It really was.

Cyn, Filmmaker  43:28  
Thank you.

Maggie, RNC-OB  43:29  
Yes, thank you. And Karen. I'm also doing king yaa's birthing beyond the binary course. And I know someone else was just, Gloria shared their information in the comments. But yeah, I believe they might still be accepting registration, if you want to kind of roll into it and get a little bit more information there. Or hopefully this will be the first of many times that they're offering this but yeah, you can only find them on you know, Instagram, Facebook, and I can look up their website to to link to that, because it's a great resource.

Karen, birthworker  43:58  

Maggie, RNC-OB  43:59  
Great class so far. Someone else wanted to share... Leila.

Leila, med student  44:03  
Thanks so much. I just wanted to share with you all a glimmer of hope in that. We've had a lot of hope with the conversation so far. But some people may seem pessimistic about where we're headed and the resources that are currently available. And I just wanted to share that I'm a medical student at Case Western in Cleveland. And in two of our courses, one of our courses, they're elective, so not everybody is taking them but a lot of students are and one of them is LGBT health elective where there's a section on queer family building and educating medical students that sometimes families aren't even just two people and consist of multiple people who've contributed to a birth into a pregnancy and we're gonna rear that child and also in our breastfeeding elective there's a section on breast and breast feeding and lactation care for trans patients. So I just wanted to share that it is making It's way also into the medical curriculum and people are learning a lot more about it and are engaged in it.

Cyn, Filmmaker  45:07  
Yay!  Thank you for sharing that. That's very wonderful to hear. Yeah, that's awesome. My, my younger son is in his first year of medical school, and it hasn't happened yet. But we'll see.

Maggie, RNC-OB  45:20  
Yeah, I mean, it's heartening to hear that it is just getting more and more into the medical training and that we're having more access to it.

Cyn, Filmmaker  45:30  
I've wondered about that for for transmen, who are birth caregivers as well, whether they get discriminated against for masculine gender? What, what? Whether a man or or a trans?

Ray, CPM  45:45  
Oh, definitely, definitely, yeah, I'm a non binary midwife. And I think I experienced the most discrimination from other birth workers than like anywhere else in my life. Wow.

Cyn, Filmmaker  45:55  
Wow. That sucks. 

Ray, CPM  46:00  
Maggie, can I do one more plug?

Absolutely, yes, please. Sorry, Shosh was just on the zoom just reminded me. I teach a class called Beyond the Baster, which is for if you have queer trans folks in your life, who were trying to get pregnant and don't know how to, or how to create a family as a workshop just don't like, and you know, the DIY side of building a family. And we're going to do the next one in January. It's been traditionally open to birth workers. We're going to do a separate one for birth workers a little bit later in 2021. But you can be follow me on Instagram we're about to, that's where information about it will be. 

Maggie, RNC-OB  46:34  
Yes. And I have taken that course it is excellent. So I will I will second that. So definitely check it out. Thank you, Ray. Well, we will wrap up then. Just want to say thank you so much. I really appreciate Cyn, thank you for creating this film and this opportunity to have these conversations and dig deeper. Ray, thank you for joining us and letting us all of your personal and professional experience on this topic. I really appreciate you both. 

Thanks for tuning in. We love to talk birth and would love to talk about it with you. Please join the conversation by finding us on Facebook, Instagram or Twitter, we're Your BIRTH Partners on all platforms. We also welcome you to join our new community Facebook group. So there we'll have a chance to talk more as we navigate these issues together as birth pros who see the future as collaborative, inclusive, and equitable. We look forward to growing that community with you. You can also check out our show notes if you want links to the research that was shared today. And we'll be highlighting some other trainings and birth workers who specialize in helping birth professionals to create inclusive and safer practice environments for everyone in their care. We look forward to hearing from you about what struck you about the film, what other questions you had, what you loved about the QA and what you want to see next from us as we keep pushing out more educational offerings. Till next time

Q&A with Cyn & Ray
Feedback from Audience Members