As many have undoubtedly heard, Oprah Winfrey introduced "the first pregnant man" to viewers of her April 3rd show this past week. Thomas Beatie appeared, six months pregnant, with his wife Nancy and his obstetrician, Dr. Kimberly James (by satellite hookup). You can see the complete show here, including a video clip with an ultrasound recording of the fetal heartbeat.

So what's going on here? Well, Thomas was born in a female body and named Tracy, but Tracy always self-identified as a male. As an adult, Tracy decided to undergo a biological "sex change" by having female breast tissue entirely removed, and by taking daily doses of testosterone, which produced a manly body and a scraggly beard. Thomas met Nancy, and five years ago, they became legally married as "husband and wife," in the state of Oregon. Then Thomas and Nancy decided they wanted to have children. The problem was that Nancy had previously undergone a hysterectomy to remove a diseased uterus; Thomas, meanwhile, still had his intact. So, he stopped taking testosterone, which allowed him to undergo ovulation, and then used artificial insemination (through his intact vagina) to get pregnant.

Now, in purely biological terms, this is not a big deal -- human embryo takes up residence in human uterus and develops into a normal 6 month fetus. What's more interesting is the legal status of their marriage because the constitution of the state of Oregon states explicitly that "only a marriage between one man and one woman shall be valid or legally recognized." Now that Thomas is pregnant, how does Oregon decide whether Thomas is a man or a woman?

One choice is to go strictly by chromosomes: those with a Y are male, and those without are female. But, a small percentage of persons born with a Y actually develop an entirely female body (the most common cause is androgen insensitivity syndrome), and less frequently, male bodies can develop without a Y. So this strategy is flawed.

A second approach is the "conugal conception of marriage," which is favored by the Vatican and its Catholic supporters. According to Professor Robert George of Princeton University, who was instrumental in crafting the (failed) U.S. constitutional ammendent that would ban gay marriage, only "sexually complementary spouses" should be allowed to marry. According to this definition, Thomas and Nancy would be fine, because (as Thomas explained to Oprah), his sex change therapy allows him to engage in sexual intercourse with his wife (watch the video for more details). On the other hand, men whose sex organ is surgically removed, as treatment for cancer, should not be allowed to marry according to George.

{One fascinating little aside to this story is the repeated video clips - shown on ABC - of a shirtless, pregnant Thomas.  If Thomas was a woman, the FCC would be screaming at ABC, and the network would be subject to heavy fines.  But a bare chested man is no big deal.}

The third approach is to go with the way in which people identify themselves. As Thomas articulated, "it's not a male or female desire to have a child. It's a human desire . . . I have a very stable male identity." In other words, being a male and being pregnant are not necessarily incompatible. So what about "real" men -- born with a male body and no uterus -- could they become pregnant too? Surprisingly, science tells us that yes, men could (although might hurt), as I'll explain and illustrate in my next post.

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