CHICAGO – One-and-a-half-year-old Zayn Brady-Davis jumped up and down on her father's lap on a sunny park bench beside a model yacht pool on the South Side, where her father used to sit by the rocks and watch boat races as a kid.
"Jump! Jump!" Myles Brady-Davis whispered, lifting Zayn in the air before pulling her into a caress, punctuating it all with a kiss on the cheek.
Brady-Davis, who uses gender-neutral pronouns, is transmasculine and nonbinary. They were assigned female at birth but know themself to be masculine, and their gender identity falls outside the categories of man and woman. At the end of 2019, they gave birth to their first child, Zayn.
"Zayn is very energetic, outgoing, full of love and full of life," said Brady-Davis, 39, who works for LGBTQ advocacy group Equality Illinois. "She’s just an amazing child."
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Brady-Davis is just one of many transgender, nonbinary and other gender-nonconforming people worldwide who have given birth. The topic gained public attention this month when several U.S. lawmakers used the terms "pregnant people" and "birthing people" at a congressional hearing, spurring critique from colleagues and a swirl of backlash on social media.
But at the heart of the question is real families living ordinary lives – people who want to see their experiences reflected in the language used by lawmakers and medical professionals so they can ensure the health and safety of themselves and their loved ones.
"Building a family is a universal desire," said Trystan Reese, 38, an educator and consultant who trains medical professionals on LGBTQ inclusion.
Based in Portland, Oregon, Reese and his partner, Biff, adopted two kids, Hailey and Lucas, in 2016. The next year, Reese gave birth to his son, Leo.
"Families like mine, like ours – transgender families, LGBT families – we want the same things that everyone else does," Reese said.
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'It's important we have technical accuracy'
About 5.6% of U.S. adults identify as LGBTQ, and 0.6% identify specifically as transgender, according to a Gallup poll released in February. Among Generation Z adults – those 18 to 23 – nearly 16% identify as LGBTQ, and about 2% identify as transgender.
"The reality is, hundreds and maybe thousands of transgender people like me have given birth all over the world over the last at least 21 years that we know of," Reese said, referencing a friend he said gave birth "very quietly" decades ago.
In an effort to acknowledge that reality, several lawmakers used the terms "pregnant people" and "birthing people" at a congressional hearing this month on "America’s Black Maternal Health Crisis."
"I am committed to doing the absolute most to protect Black mothers, to protect Black babies, to protect Black birthing people and to save lives," Rep. Cori Bush, D-Mo., a nurse and mother of two, said, detailing her own experiences of neglect during pregnancy by doctors who she said dismissed her reports of pain. Both of her babies were born prematurely.
The U.S. has the highest maternal mortality rate among industrialized countries, according to the Commonwealth Fund, a private U.S.-based foundation. And Black women are three times more likely to die from a pregnancy-related cause than white women, according to the Centers for Disease Control and Prevention. For trans and nonbinary people, researchers say there's no good data yet.
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Bush's inclusion of gender-neutral language at the hearing mirrored phrasing included in a series of bills introduced in recent months. The Black Maternal Health Momnibus Act of 2021 and the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act, which aim to improve reproductive health outcomes among people of color, refer to "pregnant and postpartum individuals."
Laws have only recently started to include gender-neutral language, Reese said. Several state bills enacted in 2019 use gender-neutral language. And the pandemic has spurred some states to take a critical look at health-care-related laws and update terminology, Reese said.
The Affordable Care Act, passed in 2010, did not use gender-neutral language, but it did prohibit discrimination on the basis of sex, which the Obama administration interpreted broadly. Last week, the Biden administration announced it would reverse Trump-era policy and protect transgender people against sex discrimination in health care once again.
"Until the ACA went into effect, it would have been, for example, very hard for me to get my insurance to cover my pregnancy expenses because if you are legally male in the system it would have been able to deny coverage," Reese said.
Several organizations that have endorsed the pending federal legislation – including Every Mother Counts, the Black Mamas Matter Alliance and In Our Own Voice: National Black Women's Reproductive Justice Agenda – told USA TODAY they support the inclusive language.
"We are attempting to get better reproductive health care for all people who can get pregnant and who can give birth. It’s really that simple," said Marcela Howell, president and CEO of In Our Own Voice. "Transgender and gender-nonconforming people are meeting a medical profession that doesn’t understand how to treat them in the same way the medical profession doesn’t necessarily listen to Black women who complain about issues around their pregnancy."
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Some lawmakers, however, have taken issue with the language. Rep. Nancy Mace, R-S.C., who spoke at the hearing, reacted to the terminology.
"'Birthing people' – you mean women or moms? The left is so woke they're stripping from women the one thing that only we can do," Mace wrote May 6.
Mace's office did not respond to USA TODAY requests for further comment.
Monica McLemore, a nurse and professor at the University of California, San Francisco who studies reproductive health, rights and justice, said she was "happy and impressed" by Bush’s words. McLemore said she cried and nodded along as she watched Bush's testimony live.
"It was really empowering and scientifically accurate that she used terms like 'birthing persons' and 'pregnant-capable people,' which is the word that I use, because it’s important we have technical accuracy," McLemore said. "That’s why I think people are uncomfortable. Because we like heuristics. We like shortcuts."
Jenna "JB" Brown, who is transmasculine and nonbinary, "translates" educational materials for pregnant people who are left out in those shortcuts.
Brown works as a full-spectrum doula – someone who offers support through the full spectrum of pregnancy outcomes – in private practice through Love Over Fear Wellness educational services center and wrote "Queer + Pregnant: A Pregnancy Journal," which Brown describes as "a pregnancy journal that won’t assume your gender, sexuality, relationship status or lifestyle."
"The fact of the matter is, not all pregnant people are women," Brown said. "And so the moment that we use in legislation or in research 'woman' or 'womanhood' to describe pregnancy, we’re losing a people right off the bat."
People of 'many different genders can be pregnant and give birth'
When Brady-Davis came out at 5 years old, they said they didn't have the vocabulary to express what they were experiencing.
"I didn’t come out as trans because I didn’t know that language then, but I knew that all the way down to my core I was masculine," Brady-Davis said. "I always wanted to be my father. He had this amazing thick beard, and I was like, I want that!"
Growing up, Brady-Davis said they knew trans women existed but didn’t meet a Black transmasculine person until they were 25, when they walked into a community health center to inquire about medically transitioning and met two at once.
"And I broke because that was the first time I’d even seen myself outside of myself. It was a moment where I was like, oh, I’m not an alien, there are other people out here like me," they said.
Brady-Davis and their wife, Precious Brady-Davis, who is a transgender woman, married in 2016 and began thinking about growing their family. "As I saw my brother and sisters have kids, I wanted that, too," Brady-Davis said.
Pregnancy was "scary," they said. The day of their baby shower, they went to the store to purchase an outfit and had the police called on them when people working at the store mistook their baby bump for a bundle of stolen clothes.
"It was scary for me only because I’m viewed in the world as a Black man – a Black man who is navigating this space with high anxiety because I have a belly and I look different," they said. "That was the scary part for me, just navigating the streets of Chicago as a Black man with precious cargo inside of me."
As a person of color, Brady-Davis said they were initially "nervous" about the perinatal mortality rate but knew they had the support of family, friends and culturally competent medical professionals. Brady-Davis said their doctor at Northwestern Memorial Hospital "went behind the scenes" to train the hospital staff – from the anesthesiologist all the way to the security personnel.
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Dr. Juno Obedin-Maliver, a practicing OB-GYN and assistant professor at Stanford University School of Medicine who specializes in the reproductive health care needs of sexual and gender minority people, said it was "very rare" to see people using terms like "pregnant person" when she started working in LGBTQ health care 13 years ago.
"Now, it’s much more in the lexicon. So I think there’s a growing awareness, but it has not just infiltrated into all of our systems," she said. Electronic medical records systems, for example, have not been updated, she said. If a patient's gender is listed as male, she can't chart on their pregnancy history.
When Brady-Davis gave birth to Zayn at the end of 2019, they said their doctor informed them they would have to be listed as the "mother" on Zayn's birth certificate.
So they, along with Equality Illinois and civil rights organization Lambda Legal, worked with the Illinois Department of Public Health to revise the state's birth certificate system to better recognize the gender identities of trans parents and became the first trans couple in the state of Illinois to have their identity correctly stated on their child's birth certificate.
"There’s still so much that has to be done," Brady-Davis said.
'It’s time to start making space for us'
Many people contacted for this story were hesitant to share their experiences publicly. Brady-Davis acknowledged they were mentally and emotionally preparing to be attacked online after the story's publication, as has happened before.
"It’s definitely a time in which there is a heightened level of violence and attack against transgender people," said Kris Hayashi, executive director of the Transgender Law Center in Oakland, California.
At the same time lawmakers are making more frequent use of gender-neutral language, transgender people are facing dozens of state-level bills aimed at banning medical treatments for young people and restricting participation in sports. Last year, at least 44 transgender people were killed in the U.S. – the country’s deadliest year on record.
One person who recently gave birth spoke to USA TODAY on the condition of anonymity for fear of being targeted.
Eli, 25, of Georgia is transmasculine and gave birth to his second child earlier this month. He gave birth to his first child 2½ years ago and came out to family two months before becoming pregnant with his second child, whom he and his husband named for a Star Wars Jedi.
"I'm just really grateful for all my friends and family who helped me transition while being pregnant, which is a very confusing experience," he said on the phone Saturday, one day after coming out on Facebook.
Eli said he prefers to refer to himself as a "parent," but his daughter still calls him "mommie." Seeing his own experience reflected in inclusive language has been an emotional experience, he said. When his husband first showed him the CDC's COVID-19 guidance for "pregnant and recently pregnant people," Eli said he broke down.
"I cried when I saw that," he said. "It’s validating to be included in something you’re part of."
Eli, Brady-Davis and Reese said they feel similarly about the language used in the new slate of proposed federal legislation. The inclusive language is not intended to "take away" from or "impose" on women, Brady-Davis said.
"They need their space. All power to them," Brady-Davis said. "We also have to realize that trans people have always existed. We will always be here. So it’s time to start making space for us."
Meanwhile, transgender and gender-nonconforming people nationwide continue to navigate their journeys as parents.
Eli and his family sit together to watch anime.
At the Reese household, Trystan, Biff, Hailey and Lucas are preparing to celebrate Leo's fourth birthday with ice cream cake and a new Legos set.
"What we really hope that people take away is the universality of love and the desire to have a family – to bring more love into the world," Reese said.
And at the model yacht pool on Chicago's South Side, Brady-Davis gives Zayn her binky and places her in the stroller for her nap.
They'll soon be in Hawaii for their family's first vacation away.
"I just can’t wait to be on the beach with my baby and my family," they said.
Follow Grace Hauck on Twitter: @grace_hauck.