My Brother's Pregnancy and the Making of a New American Family
Evan, who stopped his hormone treatments before trying to get pregnant, chest-feeds his newborn son in their Massachusetts home Elinor Carucci for TIME By Jessi Hempel September 12, 2016 7:48 AM EDT W hen the call came, my brother was at work in the open office in Cambridge, Mass., he shares with seven colleagues who, like him, help run clinical trials for a drug developer.
埃文在试图怀孕前停止了激素治疗，他在马萨诸塞州的家中给刚出生的儿子喂奶。埃莉诺·卡鲁奇为《时代》杂志撰稿。杰西·亨佩尔，美国东部夏令时间 2016 年 9 月 12 日上午 7:48 当接到电话时，我哥哥正在马萨诸塞州剑桥的开放式办公室工作。他和七名同事一起工作，这些同事和他一样，帮助一家药物开发商开展临床试验。
The phone number came up blocked, so he knew it must be the doctor.
电话号码被屏蔽了，所以他知道一定是医生打来的。
He stood up, unsteady on his feet.
他站了起来，脚步有些不稳。
Was he a little nauseous?
他是不是有点恶心？
Or was that just adrenaline?
或者这只是肾上腺素？
He ducked into the hallway in search of quiet.
他躲进走廊寻求安静。
My brother Evan, 35, is a stocky guy of medium height with a trimmed, fuzzy blond beard and two gem studs in each earlobe.
我的兄弟埃文 (Evan) 35 岁，身材矮胖，中等身材，留着修剪整齐、毛茸茸的金色胡须，耳垂上各有两颗宝石耳钉。
He usually wears a Red Sox hat, and when he’s nervous, he’ll remove it and obsessively bend the rim.
他通常戴着红袜队的帽子，当他紧张时，他会摘下帽子并强迫性地弯曲帽缘。
But on that September afternoon, both of his hands were clutching his phone, the right one cupping the left for privacy.
但在九月的那个下午，他双手紧握手机，右手托着左手以保护隐私。
“Hello?”
“你好？”
“This is Dr. Kowalik,” said the voice.
“这是科瓦利克医生，”那个声音说道。
The identification was unnecessary.
身份识别是不必要的。
Ania Kowalik is a reproductive endocrinologist at a clinic called Fertility Solutions in Dedham, Mass.
阿尼亚·科瓦利克 (Ania Kowalik) 是马萨诸塞州戴德姆一家名为生育解决方案的诊所的生殖内分泌学家。
They’d spoken regularly for more than six months.
他们已经定期通话六个多月了。
Evan, who was born female, had wanted to be a parent since he was very young, when he played with dolls just a bit longer than the other kids.
出生为女性的埃文从很小的时候起就想成为一名父母，当时他玩洋娃娃的时间比其他孩子长一点。
He’d helped pay for college by nannying triplets.
他通过保姆三胞胎来帮助支付大学费用。
And when he first came out to friends as transgender at 19, changing his name and beginning his long physical transformation, he didn’t stop adding to the list of baby names in the back of his journal: Kaya, Eleanor, Huxley.
当他 19 岁时第一次向朋友公开自己是跨性别者、改变自己的名字并开始漫长的身体改造时，他并没有停止在日记后面的婴儿名字列表中添加：卡亚、埃莉诺、赫胥黎。
Evan knew he should feel excited.
Evan知道他应该感到兴奋。
But instead, he felt a chill of anxiety and anticipation.
但相反，他却感到一丝焦急和期待的寒意。
He’d wanted this for so long, he later told me, and had been close to getting it.
他后来告诉我，他想要这个已经很久了，而且已经接近实现了。
Then, four months earlier, he’d miscarried after Kowalik told him she couldn’t find a heartbeat during his first ultrasound.
然后，四个月前，科瓦利克告诉他，她在第一次超声波检查中找不到心跳，他流产了。
She was brief: Evan was pregnant.
她简短地说：埃文怀孕了。
Kowalik told him he had low levels of progesterone, a hormone that helps maintain a healthy pregnancy, and prescribed some pills for him to start taking right away.
科瓦利克告诉他，他的黄体酮水平较低，黄体酮是一种有助于维持健康怀孕的激素，并给他开了一些药，让他立即开始服用。
“Congratulations,” she said after a pause.
“恭喜你，”她停顿了一下后说道。
“This is a good start.”
“这是一个好的开始。”
Evan isn’t sure how long he stood in the hallway after the call.
埃文不确定接到电话后他在走廊里站了多久。
People from other offices brushed by him, caught up in their work.
其他办公室的人与他擦肩而过，都在忙着自己的工作。
He called his partner, and her gasp was loud enough that Evan held the phone away from his ear momentarily.
他打电话给他的伴侣，她的喘息声太大了，埃文暂时把电话从他耳边拿开。
He pulled up a calculator to figure out his due date.
他拿出计算器算出预产期。
I’d have no reason to tell you about this moment in my brother’s life were it not for the fact of his gender.
如果不是因为我哥哥的性别这一事实，我就没有理由告诉你我哥哥生命中的这一时刻。
Now that gay marriage is legal, the social battleground has shifted to new frontiers, frontiers that include the most private aspects of people’s lives.
既然同性婚姻合法，社会战场已经转移到新的前沿，这些前沿包括人们生活中最私密的方面。
Transgender Americans have gained greater visibility and acceptance as stars like Caitlyn Jenner and Laverne Cox have trained a pop-culture spotlight on trans issues.
随着凯特琳·詹纳 (Caitlyn Jenner) 和拉弗恩·考克斯 (Laverne Cox) 等明星将流行文化聚焦于跨性别问题，跨性别美国人获得了更大的知名度和接受度。
Corporate leaders across the Fortune 500 have moved to protect their transgender employees.
财富 500 强企业领导人已采取行动保护其跨性别员工。
And in May, the Obama Administration declared that all public schools must treat students equally regardless of their gender identity, classifying inner feelings of maleness and femaleness as protected by the government.
今年五月，奥巴马政府宣布所有公立学校必须平等对待学生，无论其性别认同如何，并将男性和女性的内在情感列为政府保护的对象。
We have come to the point where the President of the United States can candidly and comfortably discuss gender fluidity.
我们已经到了美国总统可以坦诚、轻松地讨论性别流动性的地步。
We have also come to the point where the backlash against these rapid changes has manifested in sometimes surreal fashion, as it did earlier this year during the so-called battle of the bathroom, when about half of all states joined lawsuits against the Obama Administration.
我们还发现，对这些快速变化的强烈抵制有时以一种超现实的方式表现出来，就像今年早些时候所谓的“厕所之战”期间所发生的那样，当时大约有一半的州加入了针对奥巴马政府的诉讼。
There have been reports of increased violence directed at transgender people.
有报道称，针对跨性别者的暴力行为有所增加。
At least 21 trans Americans were murdered in 2015, according to the Human Rights Campaign, up 62% from the year before.
据人权运动称，2015 年至少有 21 名跨裔美国人被谋杀，比前一年增加了 62%。
And that was before the mass murder in June at an Orlando nightclub, the deadliest incident of violence against LGBT people in U.S. history.
那是在 6 月奥兰多一家夜总会发生大规模谋杀之前，这是美国历史上针对 LGBT 人群最致命的暴力事件。
Pregnancies like Evan’s—and the many that are likely to follow—will stretch our cultural perceptions of gender norms even further.
像埃文这样的怀孕——以及许多可能发生的怀孕——将进一步拓展我们对性别规范的文化认知。
Americans are just starting to open up to the idea that you may be born into a female body, but believe that you are really a man.
美国人刚刚开始接受这样一种观念，即你可能出生在女性身体中，但相信你实际上是一个男人。
But what if you are born into a female body, know you are a man and still want to participate in the traditionally exclusive rite of womanhood?
但是，如果您出生在女性身体中，知道自己是男性，但仍然想参加传统上专属的女性仪式怎么办？
What kind of man are you then?
那你是什么样的人呢？
This question can bother people.
这个问题可能会困扰人们。
It can make them uncomfortable.
这会让他们感到不舒服。
That’s partly why, when Evan texted me to say, “I’m pregnant!” I was excited for him, but also frightened.
这就是为什么当埃文发短信给我说“我怀孕了！”时的部分原因。我为他感到兴奋，但也感到害怕。
I thought about what strangers might say to my bearded, big-bellied little brother when he was nine months along.
我想到当我满脸胡须、大腹便便的弟弟九个月大时，陌生人可能会对他说些什么。
And I wondered, Would he be safe?
我想知道，他会安全吗？
I am six years older than Evan.
我比埃文大六岁。
We also have a middle sister, Katje.
我们还有一个二姐，Katje。
As a trio, we’ve always resembled one another, but Evan and I were the most alike.
作为一个三人组，我们总是彼此相似，但埃文和我是最相似的。
We still have the same patterns of speech and the same slight roll to our shoulders that we inherited from our grandmother on our dad’s side.
我们的说话方式和肩膀的轻微滚动仍然是从我们父亲那边的祖母那里继承来的。
Once, when Evan was in college at Oberlin and I was in grad school at the University of California, Berkeley, he flew across the country to visit me.
有一次，当埃文在奥柏林上大学而我在加州大学伯克利分校读研究生时，他飞越全国来看望我。
When he got off the plane, we were both wearing the same thing: puffy down vests over long-sleeved ultimate-frisbee T-shirts and baseball caps worn backward.
当他下了飞机时，我们都穿着同样的衣服：蓬松的羽绒背心搭配长袖极限飞盘 T 恤，棒球帽反戴。
By then, my brother had already come out to himself and friends as trans, but he didn’t tell me until 2003, when he started taking hormones.
那时，我哥哥已经向自己和朋友出柜了，但他直到 2003 年才告诉我，当时他开始服用激素。
He called me to say that when he came for my graduation, I should call him Evan.
他打电话给我说，当他来参加我的毕业典礼时，我应该叫他埃文。
Over the next few months, I watched his body change.
接下来的几个月里，我看着他的身体发生了变化。
He started binding his chest with a thick bandage wrap.
他开始用厚绷带包扎胸部。
His hair began to thin.
他的头发开始稀疏。
His hips disappeared and were replaced by thick muscles around his chest.
他的臀部消失了，取而代之的是胸部周围厚实的肌肉。
But mostly, I remember his hands.
但最重要的是，我记得他的手。
We both have the same small hands, the same indelicate, stubby fingers.
我们都有同样的小手，同样粗短的手指。
I watched the hair grow thick over his knuckles, which were my knuckles.
我看着他的指关节（也就是我的指关节）上的毛发变得浓密。
I felt sad that, feature by feature, I was losing my doppelgänger.
我感到悲伤的是，我逐渐失去了自己的分身。
The transition was messy.
过渡过程很混乱。
Our parents were supportive but distracted.
我们的父母很支持我们，但也心不在焉。
They were in a protracted divorce after my father had, at 50, come out as gay.
在我父亲 50 岁出柜后，他们陷入了旷日持久的离婚。
Katje and I dated women, and I would kid Evan that being gay wasn’t rebellious enough in our family; he had to do us one better and change gender.
Katje 和我和女人约会过，我会跟 Evan 开玩笑说，在我们家里，同性恋还不够叛逆。他必须让我们变得更好并改变性别。
Looking back, I regret these jokes.
现在回想起来，我对这些笑话感到后悔。
They were a crass way to cover the pain of knowing that the childhood we all shared–the one in which we were three round-faced, pigtailed girls in matching dresses–had been a charade for my brother.
它们是一种粗俗的方式来掩盖痛苦，因为我们知道我们共同的童年——我们是三个圆脸、扎着辫子的女孩，穿着相配的衣服——对我哥哥来说是一场游戏。
I said the wrong things all the time.
我一直说错话。
That first year Evan looked strange to me, like a butch lady or a girly man.
第一年的埃文对我来说看起来很奇怪，就像一个男性化的女士或一个女性化的男人。
He went through a sped-up version of puberty that brought changes to his voice and testosterone-fueled impulses he didn’t understand.
他经历了一个加速的青春期，这给他的声音带来了变化，也带来了他不理解的睾酮刺激的冲动。
I often she’d him by accident.
我常常无意中遇见了他。
I’d forget and call him by his given female name, or refer to him as her.
我会忘记并用他的女性名字称呼他，或者称他为“她”。
And in an attempt to sound interested and supportive, I asked him invasive and personal questions, often in mixed company.
为了表现出兴趣和支持，我经常在混合的场合问他一些侵入性的个人问题。
Once, during a brunch with our extended family, I asked him about whether he planned to alter his genitals.
有一次，在与我们大家庭一起吃早午餐时，我问他是否打算改变自己的生殖器。
“Jessi,” he said, raising his right eyebrow in that way we both do.
“杰西，”他说，像我们一样抬起右眉毛。
“I don’t talk about your vagina in front of Aunt Rosie.”
“我不会在罗西阿姨面前谈论你的阴道。”
Thirteen years later, no one mistakenly she’s my brother.
十三年后，没有人误认为她是我的兄弟。
Physically, he is transformed.
从身体上来说，他发生了转变。
He’s 5 ft.
他身高 5 英尺。
6 in., just tall enough that he makes a respectable short guy.
6英寸，身高刚刚好，足以让他成为一个受人尊敬的矮个子。
Before his pregnancy, he injected hormones into his thigh once weekly to lower his estrogen while boosting his testosterone.
在怀孕之前，他每周一次向大腿注射激素，以降低雌激素，同时提高睾酮水平。
He elected not to have top surgery, the double mastectomy that many trans men undergo, because he is allergic to most antibiotics.
他选择不进行顶级手术，即许多跨性别男性所接受的双乳房切除术，因为他对大多数抗生素过敏。
Also, he knew he might one day want to nurse a baby.
而且，他知道有一天他可能想给婴儿喂奶。
So he wears two compression-tank binds made by a company called Underworks beneath his shirt.
因此，他在衬衫下面佩戴了两条由一家名为 Underworks 的公司制造的压缩罐绑带。
“It hurts, but I’ve gotten used to it,” he told me.
“很痛，但我已经习惯了，”他告诉我。
“I imagine it’s like some women getting used to high heels.”
“我想这就像有些女性习惯了高跟鞋一样。”
We have come to the point where the President of the United States can candidly and comfortably discuss gender fluidity.
我们已经到了美国总统可以坦诚、轻松地讨论性别流动性的地步。
His transformation is as much social as it is physical.
他的转变不仅是身体上的，也是社会上的。
It’s not just that Evan looks like a guy.
埃文不仅仅是看起来像个男人。
For nearly a dozen years, the world has responded to him as a guy.
近十几年来，世界一直以男人的身份回应他。
At first, particularly when he was with other men who didn’t know he was trans, this made him nervous–like he would somehow say the wrong thing and out himself.
起初，特别是当他和其他不知道自己是跨性别者的男人在一起时，这让他很紧张——就好像他会以某种方式说错话然后自己走出来一样。
But now he’s comfortable.
但现在他很舒服。
To medical professionals, he’s a trans guy, but to the rest of the world and to himself, he’s just a guy.
对于医疗专业人士来说，他是一个跨性别者，但对于世界其他地方和他自己来说，他只是一个男人。
In 2013, when Evan made an appointment with his primary-care physician at the Boston LGBT health center Fenway Health, he was the first prospective birth father his doctor had seen.
2013 年，当埃文与波士顿 LGBT 健康中心芬威健康中心的初级保健医生进行预约时，他是他的医生见过的第一位准生父。
Several years earlier, a few trans men who, like my brother, had undergone hormone treatment but kept their reproductive organs, had begun consulting physicians about pregnancy and speaking openly about wanting to give birth.
几年前，一些像我兄弟一样接受过激素治疗但保留生殖器官的跨性别男人开始向医生咨询有关怀孕的问题，并公开谈论想要生育。
In 2008, Thomas Beatie posed for People magazine, bare-chested with a rotund belly, and went on Oprah to talk about his pregnancy.
2008年，托马斯·贝蒂为《人物》杂志拍摄写真，赤裸上身，大腹便便，并在奥普拉节目中谈论他怀孕的事情。
Trans men began to trickle into fertility clinics more frequently.
跨性别男人开始更频繁地进入生育诊所。
When Andy Inkster was turned away from a Massachusetts clinic in 2010 because he was told he was “too masculine” to have a baby, he sued for gender discrimination.
2010 年，安迪·英克斯特 (Andy Inkster) 被马萨诸塞州一家诊所拒绝进入，因为他被告知“太男性化”，不适合生孩子，他因性别歧视而提起诉讼。
The case settled a few years later; Inkster sought out another clinic and later gave birth to a daughter.
几年后，此案得到了和解。英克斯特找到了另一家诊所，后来生下了一个女儿。
What happened to Inkster is not uncommon.
Inkster 的遭遇并不少见。
Medical care of all kinds is complicated for trans Americans.
对于跨裔美国人来说，各种医疗保健都很复杂。
Roughly 1 in 5 have been turned away by a medical professional at some point, according to the National Transgender Discrimination Survey.
根据全国跨性别歧视调查，大约五分之一的人曾在某个时候被医疗专业人员拒绝过。
Published in 2011 by the National Center for Transgender Equality and the National LGBTQ Task Force, it is one of the largest surveys about trans people, with 6,456 respondents.
该调查由国家跨性别平等中心和国家 LGBTQ 工作组于 2011 年发布，是关于跨性别者的最大调查之一，共有 6,456 名受访者。
Half of them reported that they’d had to teach the medical professionals they visited how to treat them.
其中一半人报告说，他们必须教他们拜访的医疗专业人员如何治疗他们。
That’s why, until my brother tried to get pregnant, he mostly avoided doctors.
这就是为什么，在我哥哥试图怀孕之前，他大多避开医生。
There is very little research about trans pregnancies.
关于跨性别怀孕的研究很少。
One of the only medical papers addressing the topic was written in 2015 by the University of California, San Francisco’s Dr. Juno Obedin-Maliver and Harvard Medical School’s Dr. Harvey Makadon.
仅有的一篇涉及该主题的医学论文是由加州大学旧金山分校的 Juno Obedin-Maliver 博士和哈佛医学院的 Harvey Makadon 博士于 2015 年撰写的。
They noted that, in form and function, getting pregnant as a trans man is not that different than getting pregnant as a woman.
他们指出，从形式和功能上来说，跨性别男性怀孕与女性怀孕没有什么不同。
Most of the time, trans men stop taking testosterone, and their bodies begin ovulating again.
大多数时候，跨性别男性会停止服用睾酮，他们的身体会再次开始排卵。
(Testosterone doesn’t necessarily preclude a pregnancy.
（睾丸激素不一定会阻止怀孕。
Some trans men may have unintentional pregnancies while taking it.) If their partner is biologically male, trans men may try to conceive without medical intervention.
一些跨性别男性在服用该药物时可能会意外怀孕。）如果他们的伴侣在生理上是男性，跨性别男性可能会在没有医疗干预的情况下尝试怀孕。
My brother has a female partner, so he inseminated using donor sperm.
我哥哥有一个女性伴侣，所以他使用捐赠者的精子受精。
It took a while.
花了一段时间。
The first time Evan tried, five years ago, he was unsuccessful.
五年前，埃文第一次尝试，但没有成功。
He took a break before starting again three years ago.
三年前，他休息了一段时间才重新开始。
He stopped his T shots, Kowalik prescribed two medications to trigger ovulation and monitored Evan’s body throughout the process to get the timing right.
他停止了 T 注射，Kowalik 开了两种药物来触发排卵，并在整个过程中监测 Evan 的身体，以确保时机正确。
Evan estimates that the entire process, including medication, doctor visits, co-pays and ultrasounds, cost him close to $12,000 over the course of several years.
埃文估计，整个过程，包括药物治疗、就诊、自付费用和超声波检查，几年来花费了他近 12,000 美元。
That’s expensive, but it can cost much more.
这很昂贵，但成本可能更高。
If home insemination doesn’t work, trans men may turn to other fertility treatments, like in vitro fertilization.
如果家庭授精不起作用，跨性别男性可能会转向其他生育治疗，例如体外受精。
Each round of IVF costs an average of $12,400, and often, by that point, aspiring parents have already invested a considerable sum in earlier, unsuccessful methods.
每轮 IVF 的平均费用为 12,400 美元，而且通常到那时，有抱负的父母已经在早期不成功的方法上投入了大量资金。
If the physical process of getting pregnant is fairly straightforward, transgender birth parents often face more challenges when it comes to mental health.
如果怀孕的身体过程相当简单，那么跨性别亲生父母在心理健康方面往往面临更多挑战。
Obedin-Maliver and Makadon referred to two recent studies that highlighted psychological issues involved with trans pregnancies.
奥贝丁-马利弗和马卡顿提到了最近的两项研究，这些研究强调了与跨性别怀孕有关的心理问题。
In both cases, the sample sizes were too small to be statistically relevant, but significant themes emerged.
在这两种情况下，样本量都太小，不具有统计相关性，但出现了重要的主题。
For one, the birth parents were often lonely.
其一，亲生父母常常感到孤独。
And they reported complex feelings about their gender identity.
他们报告了对自己性别认同的复杂感受。
“While having a family is something that many transgender individuals want, pregnancy can lead men to acknowledge that they still have female reproductive organs, which for many can be difficult, however rewarding the pregnancy may ultimately be,” they wrote.
他们写道：“虽然拥有一个家庭是许多跨性别者想要的，但怀孕可以让男性承认他们仍然拥有女性生殖器官，这对许多人来说可能很困难，无论怀孕最终可能会带来什么回报。”
My brother has a good friend, also trans, who’d gotten pregnant a year earlier.
我哥哥有一个好朋友，也是跨性别者，一年前怀孕了。
He’d had a rough pregnancy because he felt a traumatizing disconnect between his masculinity and the female attributes of his body.
他的怀孕经历很艰难，因为他感到自己的男性气质和身体的女性特质之间存在着一种令人痛苦的脱节。
He took medical leave from work for much of the time and was relieved to restart testosterone immediately after his child’s healthy birth.
他大部分时间都请病假，并在孩子健康出生后立即重新启动睾丸激素，这让他松了一口气。
I spoke to another trans dad who had given birth to his son at age 20.
我采访了另一位跨性别爸爸，他在 20 岁时生下了儿子。
He said the pregnancy catapulted him into depression.
他说怀孕让他陷入了抑郁症。
“It was as if all the things I’d hated about my body were re-emerging, and I felt awful about myself,” he told me.
“就好像我讨厌身体的所有东西都重新出现了，我对自己感觉很糟糕，”他告诉我。
Evan didn’t have this experience.
埃文没有这样的经历。
“It was a gamble,” he said.
“这是一场赌博，”他说。
“I didn’t know how I’d feel, but it turns out I just feel like it’s really cool that my body can do this.”
“我不知道我会有什么感觉，但事实证明我只是觉得我的身体能做到这一点真的很酷。”
Evan estimates that the entire process, including medication, doctor visits, co-pays and ultrasounds, cost him close to $12,000 over the course of several years.
埃文估计，整个过程，包括药物治疗、就诊、自付费用和超声波检查，几年来花费了他近 12,000 美元。
When I called Obedin-Maliver to discuss the research, she cautioned against drawing any conclusions about trans pregnancies based on a few conversations.
当我打电话给奥贝丁-马利弗讨论这项研究时，她警告不要根据几次谈话就得出任何关于跨性别怀孕的结论。
“Take two pregnant women and their experiences will be different and we don’t ascribe that to their womanhood,” she said.
“以两名孕妇为例，她们的经历会有所不同，我们不会将其归因于她们的女性身份，”她说。
“We have to be careful about that and not say there’s one trans-man experience going through pregnancy.”
“我们必须小心这一点，不要说有一个跨性别者经历过怀孕。”
Trans men compare notes among themselves and seek support and advice on the Internet.
跨性别男人相互交换意见，并在互联网上寻求支持和建议。
My brother and I belong to a private Facebook group called Birthing and Breast or Chestfeeding Trans People and Allies.
我和我的兄弟属于 Facebook 上一个名为“出生和乳房”或“胸喂跨性别者和盟友”的私人群组。
It has about 1,780 members.
它有大约 1,780 名成员。
A list of guidelines spells out who can join the group: “People on the transfeminine spectrum, those who are genderfluid, nongender folks, transmasculine individuals, and cisgender allies.” (I am cisgender.
一份指南清单列出了谁可以加入该团体：“跨性别女性、流动性别人士、非性别人士、跨男性个体和顺性别盟友。” （我是顺性别。
This means that my self-identity conforms to the gender of my biological sex.
这意味着我的自我认同符合我的生理性别。
I was born a girl, and I feel like a woman.)
我生来就是个女孩，但我感觉自己像个女人。）
My brother turns to this group when he has questions about chest-feeding–the term trans men have adopted for nursing–or choosing a trans-friendly pediatrician.
当我的兄弟对母乳喂养（跨性别男性用于护理的术语）或选择对跨性别友好的儿科医生有疑问时，他会转向这个小组。
For many members, it is a primary source of community.
对于许多成员来说，它是社区的主要来源。
One trans dad told me he believes he would have killed himself during the early months of his pregnancy if he hadn’t found friends through the group.”When I went off the hormones [to get pregnant], all the mental-health stuff I had as a teenager came back,” he told me, referring to a time in his adolescence when he was deeply depressed.
一位跨性别爸爸告诉我，如果他没有通过这个团体找到朋友，他相信自己会在怀孕的最初几个月自杀。“当我为了怀孕而停用荷尔蒙时，我青少年时期的所有心理健康问题都回来了，”他告诉我，指的是他青春期时陷入深深抑郁的那段时期。
“My online friends were the only people who got me.”
“我的网上朋友是唯一能理解我的人。”
Just how many trans people have given birth?
到底有多少跨性别者生过孩子？
I asked Makadon, who is also the director of education and training at Fenway Institute, a division of Fenway Health.
我询问了马卡登，他也是芬威健康部门芬威学院的教育和培训主管。
He couldn’t even guess, but he said he expected to see the numbers rise based on the increasing number of trans patients coming to the clinic.
他甚至无法猜测，但他表示，随着来到诊所的跨性别患者数量不断增加，他预计数字会上升。
Fenway currently sees more than 2,000 of them, a figure that has doubled in less than a decade.
芬威目前有超过 2,000 名这样的人，这个数字在不到十年的时间里翻了一番。
He said that, as he visits hospitals across the country, he hears a lot of stories about health providers treating pregnant trans men.
他说，当他走访全国各地的医院时，他听到了很多关于医疗服务提供者治疗怀孕跨性别男人的故事。
“There’s more of it than we know that people aren’t tracking,” he told me.
“人们没有追踪的事情比我们知道的还要多，”他告诉我。
“There’s a lot of people just doing it.”
“有很多人都在这么做。”
As doctors prescribe hormones, it is becoming standard practice for them to talk with patients about reproduction.
当医生开激素处方时，与患者谈论生殖问题正成为他们的标准做法。
“We get questions about cryopreservation,” says Obedin-Maliver, referring to the process of freezing healthy eggs.
“我们收到了有关冷冻保存的问题，”奥贝丁-马利弗说，他指的是冷冻健康卵子的过程。
Although there’s no data to suggest that regular testosterone treatments will prevent trans men from growing healthy eggs later, some of them elect to do this before starting testosterone treatment.
尽管没有数据表明定期睾酮治疗会阻止跨性别男性以后产生健康的卵子，但他们中的一些人选择在开始睾酮治疗之前这样做。
Says Obedin-Maliver: “Trans men want to know what their options are.”
奥贝丁-马利弗说：“跨性别男人想知道他们的选择是什么。”
During my brother’s first trimester , he only wanted to eat Fla-Vor-Ice pops, Sour Patch Kids and hard-boiled eggs.
在我哥哥怀孕的前三个月，他只想吃 Fla-Vor-Ice 棒棒糖、Sour Patch Kids 和煮鸡蛋。
He threw up constantly.
他不断地呕吐。
Normally, Evan worked until 7 each day, came home for dinner and then answered a few more emails before bed.
通常，Evan 每天工作到 7 点，回家吃晚饭，然后在睡觉前回复几封电子邮件。
But once he was pregnant, his body stopped cooperating.
但一旦他怀孕了，他的身体就不再配合了。
At 8:30 p.m., no matter where he was, he fell asleep.
晚上8点30分，无论身在何处，他都睡着了。
By November, he could tell his supervisor had started to wonder why he was “slacking off.” It was time to tell his employer.
到了 11 月，他可以看出他的主管开始怀疑他为什么“偷懒”。是时候告诉他的雇主了。
During his next trip to his company’s Oxford headquarters, Evan scheduled a meeting with the woman in charge of human resources.
在下次前往公司牛津总部时，埃文安排了与负责人力资源的女士会面。
That morning, he found himself in an office with an open plan; even the conference rooms had glass on three sides.
那天早上，他发现自己身处一间开放式的办公室里。甚至会议室的三面都有玻璃。
He had just vomited in the bathroom.
他刚刚在浴室里吐了。
He tried to fight his nausea as he saw the HR lead approach.
当他看到人力资源主管走近时，他试图抑制恶心。
She was a short woman with a high voice and a warm demeanor who, Evan thought, was more or less his age.
她是个身材矮小的女人，声音高亢，举止温暖，埃文想，她的年龄与他差不多。
He straightened his tie and followed her into an exposed conference room.
他理了理领带，跟着她走进了一间暴露的会议室。
Evan took a moment to center himself, to quell his anxiety.
埃文花了一些时间让自己集中注意力，平息他的焦虑。
There would never be an easy time for this conversation.
这次谈话绝不会轻松。
He had to get it out.
他必须把它拿出来。
“It wasn’t that I expected her to have a negative reaction,” my brother said.
“我没想到她会有负面反应，”我哥哥说。
“I just had no idea at all.”
“我根本不知道。”
He told the woman he wanted to share some personal information.
他告诉那位女士他想分享一些个人信息。
“I am transgender, which you might know because of my health care paperwork,” he said.
“我是跨性别者，你可能因为我的医疗保健文件而知道这一点，”他说。
Paperwork, according to my brother, is how many transgender people are inadvertently outed in the workplace.
据我哥哥说，文书工作是多少跨性别者在工作场所不经意间被出柜的原因。
An employer will send a letter to Social Security or to the Internal Revenue Service to verify a new hire’s personal information; the agency will respond that the wrong gender has been listed.
雇主将致函社会保障局或国税局，以核实新员工的个人信息；该机构将回应称列出了错误的性别。
(Evan’s friends call this a “no-match letter.”) Evan had lived with the possibility that at any moment this could surface, since he’d started the job six months earlier.
（埃文的朋友们称这封信为“不匹配的信”。）自从六个月前开始这份工作以来，埃文就一直面临着这种情况随时可能浮出水面的可能性。
Maybe this woman had known he was trans all along, he thought.
他想，也许这个女人一直都知道他是跨性别者。
It turned out she hadn’t.
结果她没有。
She nodded as he spoke and didn’t seem fazed.
当他说话时，她点点头，看上去并不感到困惑。
She asked why my brother was bringing it up.
她问我哥哥为什么要提起这件事。
“Well, I’m pregnant,” he told her.
“好吧，我怀孕了，”他告诉她。
A moment passed.
过了一会儿。
Then, bit by bit, her face broke into a smile.
然后，她的脸上渐渐绽开了笑容。
“Well, this is unexpected, but that’s great!” she said, and the tension flooded from my brother’s shoulders.
“嗯，虽然有点出乎意料，但也太好了！”她说，我哥哥的肩膀上充满了紧张。
She told him about her two little girls and how wonderful parenthood was.
她向他讲述了她的两个小女儿以及为人父母的美好经历。
My brother sat there with her, talking about spit-up and dance recitals, and he remembers feeling like part of a club he’d always looked into from the outside.
我哥哥和她坐在一起，谈论口水和舞蹈表演，他记得感觉自己就像是他总是从外面观察的俱乐部的一部分。
The normal things that happen to normal parents would be his things, he thought.
他想，发生在普通父母身上的普通事情就是他的事情。
For the most part, this is how it went when my brother told people he was expecting.
在大多数情况下，当我哥哥告诉人们他正在怀孕时，事情就是这样的。
“With most folks, I phrased it, ‘Well, you know my partner and I are having a baby, and it works best for our family that I carry the baby,'” he told me.
“对大多数人来说，我的说法是，‘好吧，你知道我和我的伴侣正在生孩子，我带着孩子对我们的家庭来说是最好的，’”他告诉我。
It usually took them a few minutes.
他们通常需要几分钟的时间。
Then, as best they knew how, they said supportive, kind things.
然后，他们尽可能地表达了支持和善意的话。
Our mother started knitting a sweater for the baby.
我们的妈妈开始为宝宝织毛衣。
His dermatologist said, “That makes all the sense in the world.” When he finally screwed up the courage to tell his supervisor a few weeks after his Oxford trip, she asked how she could be supportive.
他的皮肤科医生说：“这很有道理。”在牛津之行几周后，当他终于鼓起勇气告诉主管时，她问她如何才能提供支持。
Evan took a moment to center himself, to quell his anxiety.
埃文花了一些时间让自己集中注意力，平息他的焦虑。
There would never be an easy time for this conversation.
这次谈话绝不会轻松。
He had to get it out.
他必须把它拿出来。
This positive attitude is less surprising when you consider that my brother didn’t tell many people he didn’t know well.
考虑到我哥哥没有告诉很多他不熟悉的人，这种积极的态度就不足为奇了。
He didn’t need to.
他不需要。
Even at full term, he never looked pregnant.
即使足月，他也从未看起来怀孕过。
He looked like a guy with a beer belly.
他看上去就像一个有着啤酒肚的家伙。
He wore collared shirts to work, often with sweater-vests, and when he couldn’t button the shirts any longer, he bought bigger ones.
他上班时穿有领衬衫，通常搭配毛衣背心，当他无法再扣衬衫的扣子时，他就买更大的衬衫。
When his pants stopped buttoning, he wore them lower and got suspenders.
当他的裤子不再扣扣子时，他就把它们穿得更低，并穿上了背带。
“People talk about the attention you get when you’re pregnant, and for the most part that was absent for me,” he said.
“人们谈论怀孕时所受到的关注，而我在很大程度上却没有受到关注，”他说。
No one rubbed his belly, asked when he was due or commented that he was carrying the baby low so it must be a boy.
没有人抚摸他的肚子，问他预产期是什么时候，也没有人评论说他把孩子抱得很低，所以一定是个男孩。
“Mostly I liked that, because I don’t like body attention normally,” he added, “but there’s also a loss.”
“主要是我喜欢这样，因为我通常不喜欢身体的关注，”他补充道，“但也有一种损失。”
One April afternoon, when Evan was< in his eighth month, he stopped by Goodwill to sift through baby clothes.
四月的一个下午，当埃文八个月大时，他来到 Goodwill 筛选婴儿衣服。
He took a few outfits to the counter.
他拿了几件衣服到柜台。
Evan opened his wallet, and the woman behind the register noticed the small ultrasound snapshot he kept tucked inside.
埃文打开钱包，收银机后面的女人注意到他藏在里面的小型超声波快照。
She looked at his belly, and smiled at him.
她看着他的肚子，对他微笑。
His blood ran hot.
他的热血沸腾了。
“That felt incredible!” he said.
“那感觉太不可思议了！”他说。
“She read me!
“她读懂了我！
She got me.”
她抓住了我。”
Evan’s midwife was Clare Storck .
埃文的助产士是克莱尔·斯托克。
Really, that’s her name.
真的，这就是她的名字。
She’d been catching babies for five years at a practice attached to Mount Auburn Hospital in Cambridge, but she’d been working with expectant mothers for most of her adult life as a doula.
她在剑桥奥本山医院附属诊所接生已有五年，但成年后的大部分时间她都在担任导乐师，与准妈妈们一起工作。
My brother was her first male birth parent.
我哥哥是她的第一个男性亲生父母。
When Evan arrived at the midwifery center for his first appointment, he filled out an intake form, but the receptionist had trouble entering his information: if she checked the “male” box, she couldn’t open an obstetric record for him.
当埃文到达助产中心进行第一次预约时，他填写了一份入院表格，但接待员在输入他的信息时遇到了困难：如果她勾选了“男性”框，她就无法为他打开产科记录。
This was a problem throughout the pregnancy–medical forms and insurance claims are not set up to allow people like Evan to be honest about their medical needs.
这是整个怀孕期间的一个问题——医疗表格和保险索赔的设立并不是为了让像埃文这样的人诚实地表达他们的医疗需求。
At first, he fought this at every turn.
起初，他处处与此作斗争。
When his health insurance refused to cover his pregnancy test because he was male, he spent several hours explaining his situation to a representative, waiting on hold and explaining it again.
当他的健康保险因他是男性而拒绝承保他的妊娠测试时，他花了几个小时向代表解释他的情况，等待并再次解释。
“My sex is female, and my gender is male,” he told the rep.
“我的性别是女性，我的性别是男性，”他告诉代表。
She was able to override the system and get the cost reimbursed, but he had to call back and do the same thing every time he had an appointment.
她能够超越系统并获得费用报销，但他每次预约时都必须回电并做同样的事情。
Eventually, Evan decided it wasn’t worth the effort to fight weekly for coverage.
最终，埃文认为每周为报道而奋斗是不值得的。
He called his insurer and asked that his gender be changed to female.
他打电话给他的保险公司，要求将他的性别改为女性。
“When I get insurance letters, they don’t say ‘sir’ or ‘ma’am.’ They say ‘Dear Evan Hempel,’ and that’s just fine.
“当我收到保险信时，他们不会说‘先生’或‘女士’。他们会说‘亲爱的埃文·亨佩尔’，这很好。
At the end of the day, it was just frustrating to get denial after denial of services,” Evan said.
归根结底，服务遭到一次又一次的拒绝，真是令人沮丧。”埃文说。
Despite the initial software limitation, my brother got excellent care from the midwifery practice at Mount Auburn.
尽管最初受到软件限制，我的兄弟还是从奥本山的助产士诊所得到了极好的护理。
Practitioners had received some training from Makadon, who had visited recently from Fenway to lead a grand rounds–an hour-long lecture open to anyone on staff at the hospital–on trans births.
从业人员接受了马卡顿的一些培训，马卡顿最近从芬威来访，主持了一场关于跨性别婴儿的盛大巡演——一场长达一小时的讲座，向医院的任何工作人员开放。
They shared notes on Evan’s preferred gender pronouns and terms for his body, and he had regular appointments with Storck, who listened to his baby’s heartbeat, checked in to see how he was feeling and referred him to an acupuncturist when he developed back pain.
他们分享了埃文喜欢的性别代词和身体术语，他定期与斯托克会面，听他宝宝的心跳，检查他的感觉，并在他出现背痛时将他转介给针灸师。
Several weeks before the birth, I interviewed Storck, who has an ebullient personality, about her experience treating Evan.
在孩子出生前几周，我采访了性格热情的斯托克，讲述了她治疗埃文的经历。
She was supportive of my brother’s choice to get pregnant.
她支持我哥哥怀孕的选择。
We both marveled at the technological advances and social changes that have enabled my brother’s efforts to make a family.
我们都对技术进步和社会变革感到惊叹，正是这些进步和社会变革使得我哥哥能够努力建立一个家庭。
“If physiologically your body can do this, and you’re comfortable with the process and still want to present as a man, you can,” she said.
“如果从生理上来说你的身体可以做到这一点，并且你对这个过程感到满意并且仍然想表现得像一个男人，你就可以，”她说。
“And that’s awesome.”
“那太棒了。”
My nephew arrived on the day he was expected.
我的侄子在他预计的那天到达了。
“I’m not sure he’s mine,” my brother texted from the hospital.
“我不确定他是我的，”我哥哥在医院发短信说。
“I’ve never been on time to anything in my entire life.” Six days later, my partner and I drove to Boston to meet the baby.
“我这辈子从来没有准时过任何事情。”六天后，我和我的伴侣开车去波士顿见孩子。
When we arrived, Evan had just finished chest-feeding.
当我们到达时，埃文刚刚吃完奶。
He answered the door in pajama bottoms and a nursing tank, with the baby swaddled in the crook of his right elbow.
他穿着睡裤和哺乳箱来开门，右肘弯处裹着婴儿。
Evan handed my nephew to me, and right away, the baby began squalling, his mouth gnawing at my arm.
埃文把我的侄子递给我，婴儿立刻开始嚎叫，他的嘴咬着我的手臂。
I handed him back to my brother, who gestured for all of us to sit at the big wooden kitchen table and then started chest-feeding again.
我把他交还给我哥哥，他示意我们大家坐在厨房的大木桌旁，然后又开始喂奶。
If physiologically your body can do this, and you're comfortable with the process and still want to present as a man, you can.
如果从生理上来说，你的身体可以做到这一点，并且你对这个过程感到满意并且仍然想表现得像个男人，那么你就可以。
"And that's awesome."
“那太棒了。”
We sat there like that, in the kitchen of my brother’s second-floor apartment, munching on the lemon bars my mom had made, as the summer daylight stretched into evening.
我们就这样坐在哥哥二楼公寓的厨房里，嚼着妈妈做的柠檬棒，夏日的日光一直延伸到傍晚。
The baby ate and slept and ate some more, his right arm curled up to his chin.
婴儿吃着睡着了，又吃了一些，他的右臂蜷缩到下巴处。
Evan recounted the birth, giving us a blow-by-blow.
埃文向我们详细讲述了出生的过程。
He and his partner had arrived at the hospital just after midnight, he said, and as they lumbered toward the receiving room, a nurse passed them.
他说，他和他的伴侣在午夜刚过就到达了医院，当他们缓慢地走向接待室时，一名护士从他们身边经过。
“Can you imagine what she must have been thinking?” my brother asked.
“你能想象她当时在想什么吗？”我哥哥问道。
Here were a woman and a man walking toward the maternity ward.
一个女人和一个男人正走向产房。
The woman was weighed down with suitcases, a backpack and the paperwork folder.
这名女子背负着沉重的手提箱、背包和文件文件夹。
The man carried nothing but a purple yoga birthing ball, and every few steps, he’d push it up against the wall, lean over it and moan.
这个男人只带着一个紫色的瑜伽分娩球，每隔几步，他就把它推到墙上，靠在上面呻吟着。
Evan snickered, and soon we were all laughing at the thought of it.
埃文窃笑起来，很快我们都因为这个想法而笑了起来。
I asked Evan if childbirth had changed how he thought about his gender.
我问埃文，分娩是否改变了他对自己性别的看法。
Wasn’t there some part of him that questioned his masculinity?
他的内心难道没有质疑过他的男子气概吗？
Since he’d first come out, I’d watched him challenge our binary notions of gender–male or female, boy or girl, husband or wife.
自从他第一次出柜以来，我就看到他挑战我们的性别二元观念——男性或女性、男孩或女孩、丈夫或妻子。
And yet I still had questions.
但我仍然有疑问。
Were you always a boy trapped in a girl’s body, I wanted to ask him, or are you really a girl who got lost for a decade?
我想问他，你一直是一个被困在女孩身体里的男孩，还是你真的是一个迷失了十年的女孩？
“You know, people who are not trans talk about being ‘trapped in a body.’ But that’s not really the way my friends talk about it,” he said.
“你知道，非跨性别者谈论‘被困在身体里’。但我的朋友们并不是这样谈论的，”他说。
“I was always Evan.
“我一直是埃文。
I always had these parts.
我一直都有这些零件。
I always just felt like me, and like I was a guy.”
我总是感觉自己就是我，就像我是一个男人。”
As I puzzled over this, he gulped milk from a glass with a blue sea horse on it.
当我对此感到困惑时，他从杯子里喝了一杯牛奶，杯子上有一只蓝色的海马。
There are sea horses all over their home–on onesies and bibs, in drawings and stitched on blankets.
他们家里到处都是海马——在连体衣和围嘴上，在图画中，在毯子上缝着。
It has become Evan’s emblem, because like my brother, the male sea horse gives birth after carrying eggs in a protective pouch on his belly.
它已经成为埃文的标志，因为像我的兄弟一样，雄性海马在肚子上的保护袋中携带鸡蛋后分娩。
A sea horse’s masculinity is not threatened by gestation; it is reinforced by it.
海马的男性气质不会因怀孕而受到威胁；它被它强化了。
Evan will continue to chest-feed for a while.
埃文将继续母乳喂养一段时间。
Eventually, he’ll begin taking testosterone again.
最终，他将再次开始服用睾酮。
His beard will fill out, and the fuzz will return to his knuckles.
他的胡须会长满，指关节上也会长出绒毛。
His chest will shrink to the point where his bind will be comfortable to wear again.
他的胸部会缩小到可以再次佩戴舒适的程度。
To outsiders, his family will look like any other–a tossed-together group of kids and adults raising one another.
在外人看来，他的家庭看起来和其他家庭没什么两样——一群孩子和大人混在一起，互相抚养长大。
At night, my brother will watch his son lift a tiny fist above his head as he sleeps and know what all parents know: this baby is a miracle.
晚上，我哥哥会看着他的儿子在睡觉时举起小拳头举过头顶，他知道所有父母都知道的事情：这个婴儿是一个奇迹。