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10 Ways Care Providers Can Create Safer Space for Non-Binary Birthing People

Safe spaces that may be lacking today are possible tomorrow when we pause to listen, learn, and grow.
Andrew Rich
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Are you a care provider seeking to take better care of your non-binary clients, patients, or community members? Perhaps you’re a non-binary person hoping for better care from your providers. Or maybe you’re just a curious individual seeking to learn more about this topic. From my perspective as a white, non-binary, masculine of center birthing person, here are some ways we can do better.

Know that we’re here, there, everywhere!

Non-binary people may not disclose their identities to you, and that’s okay. You may already be serving non-binary people in your practice, even if you don’t know it. If you learn and remember that presentation and genitals don’t equal gender, you can treat each person as an individual and support them, whether or not they’ve disclosed their gender to you, and even if their expressed identity changes as you’re working together.

Make your practice better for ALL non-binary people.

Anyone can be non-binary. As you seek to provider better care for non-binary birthing people, be sure to consider each person as an individual and be thoughtful about their intersecting identities. While trans-feminine people are unlikely to be giving birth, be aware of how they might show up at your practice. If you’re offering fertility support, mental health services, or are doing any work in which you may interact with partners or co-parents, you very well may need to support trans-feminine or genderqueer people who were assinged male at birth (AMAB). Black trans women, trans feminine folks, and femme non-binary people are the most vulnerable due to oppressive and internalized racism, misogyny, and misogynoir. Go beyond inclusion and competent care for white, thin, androgynous non-binary folks who were assigned female at birth (AFAB).  

Go beyond pronouns.

Often when people make strides to be inclusive around gender, they focus on pronouns. Pronouns are great, and I encourage you to offer space for people to share their pronouns and practice using ones that are unfamiliar to you (singular they/them, as well as other gender neutral pronouns like ze/zim, etc.), but they don’t tell you much about someone’s gender. Anyone can use any pronouns and their pronouns may or may not “match” the other gender words they use. It’s best to use and respect the pronouns that people share with you and to realize that just because you know someone’s pronouns doesn’t mean you know their gender.

Listen. Ask! Use the answers. Apologize when you need to.

The only way to know someone is to listen to who they are, how they identify, and what words feel good to them. People are who they say they are. Period. Listen to the birthing people that you work with, and ask mindful and appropriate questions. Do you need to know the answer to a question to support this person within your role and scope as their provider? Awesome. Ask. If not, respect that person’s privacy and move on. Don’t stop at asking, actually use the gender words that people share with you. If you’re struggling with misgendering someone, in that moment apologize quickly (“sorry” will do just fine, don’t make it about your feelings or guilt), correct yourself, and move on. Beyond that moment, practice! practice! practice! so that you won’t continue to misgender folks in your practice so frequently.

Learn in appropriate and consensual ways.

So, those questions I mentioned above. Be mindful of how you learn about trans and non-binary inclusion. If you’re asking a client or patient a question because you’re curious or you’re “just trying to learn more about trans and non-binary people,” save your query for an internet search or a paid consultation. Your clients or patients are hiring you to provide them with care for their pregnancy or reproductive journey. If you need help learning more about caring for non-binary birthing people, YOU need to hire someone to teach and support you, or take advantage of the resources (like this one!) that non-binary folks have already created.

Understand that parent names are unique and important.

If you work with parents, chances are you’ve witnessed the unique, specific magic of each and every child-parent relationship on the planet. Words like “mom,” “mama,” “dad,” and “daddy do not fit every parent. Full stop. This isn’t just about non-binary folks, if you stop calling every birthing person you encounter “mama,” you’re going to make a lot of folks feel a lot more seen and respected. Many people dislike being called a parent name by other adults. If you need an alternative, perhaps use the birthing person’s name, or if you don’t have time to learn or don’t know their name, focus on making the interaction warm and friendly, without using first or parent names at all. If you do want to use someone’s parent name, ask them what they plan to be called. Who knows, your practice may be full of mamas, as well as babas and maddies and seahorse papas and so many other parents that you get the privilege of supporting.

Don’t assume parenting roles or preferences.

Beyond names, all aspects of parenting are unique. Don’t assume that you know what someone will or won’t be doing as a parent, and what their family structure or child caring will look like. The non-binary people you’re working with may or may not feed their babies from their bodies. They might stay at home, or work full time. They might have three co-parents or none. Be open to each person as an individual and each family as a unique community of humans doing life together in some way.

Remember, know, believe that birth isn’t inherently feminine.

Pregnancy and birth is felt by many to be a feminine experience. Many people feel affirmed as women as they go through the experience of pregnancy and birth, and many people (non-binary or not) don’t. No matter your own experiences, be willing to see the vast expanse of lived experiences beyond what you’ve felt yourself or seen in other clients. Pregnancy and birth are human experiences (and animal—we are in good company as we reproduce, experience loss, and bring life into the world) so be mindful of treating or describing pregnancy and birth as inextricably linked to womanhood or central to the female experience.

Consider autonomy and consent with ALL of the birthing people you interact with.

Many of the suggestions above have to do with autonomy, privacy, and informed consent. Prioritizing these values in your practice won’t just make safer space for non-binary people, it will better serve each and every person you work with. Whether you’re still in school or training or have been at this for decades, continually check in with yourself and reflect on how you’re treating your clients or patients as equals, respecting their autonomy and valuing their consent, and how you can continue to grow and do better.

Pass along what you know.

Don’t stop here. Always center the voices of trans and non-binary people as you work to create safer space and better care for us and trust that people are the experts in their own identities and experiences. However, if you’ve learned something about supporting non-binary birthing people, pass it along. Don’t compete to be the “best ally,” but instead point others to truths and practices that will create more affirming care for non-binary people as they build their families.

Andrew Rich | they, them, theirs | @theandrewaugust

Andrew August Rich (they/them) is a full-spectrum doula and educator located in rural Kentucky. They are a non-binary, masculine of center trans person, as well as a parent to 7-months-old-and-counting Omega (they/them) and spouse to Astrid (they/she). They’re passionate about building queer community and creating physical and digital spaces that allow people to grow, learn, and heal. Andrew offers support around a variety of sexual/reproductive and family-building experiences, including menstruation, fertility, pregnancy, birth, and postpartum.

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