Q&A: The 'pregnant Man'

What's the story?An American female to male transexual called Thomas Beatie has given birth to a baby girl in the state of Oregon.

How is that possible?Beatie, a trans-man, was born a woman, but underwent testosterone injections and gender reassignment surgery ? commonly known as a sex change. He had surgery to remove his breasts and flatten his chest. Although legally recognised as a man, the 34-year-old kept his female reproductive organs when he changed sex 10 years ago. He decided to try to have a baby because his wife, Nancy, was unable to have children because she had a hysterectomy after suffering severe endometriosis.

How did he get pregnant?Two years ago, Beatie halted his bi-weekly testosterone, did not take any extra oestrogen, progesterone or fertility drugs to aid his pregnancy and after four months, his menstrual cycle began again. However, it is unusual that Beatie was able to restart his periods after stopping the testosterone injections. It is uncommon for the female hormone oestrogen to return and for the person to ovulate again - let alone become pregnant. Beatie lost twins in the first attempt two years ago after suffering an ectopic pregnancy. He and his wife went through nine different doctors before opting for a DIY insemination from an anonymous sperm donation, which proved successful.

Why did Beatie retain his female sex organs?Only a small number of female to male transsexuals undergo genital surgery because - at best - the results only vaguely resemble a penis. According to transgender activist Christine Burns "manufactured penises still look a bit odd". Some may not work well enough to urinate let alone function sexually. The quip among gender reassignment surgeons is: "It's easier to build a hole than a pole." The cost of the procedure ? around ?50,000 ($100,000) ? is also a deterrent in the US, where surgery is not covered by health insurance schemes.

Consultant psychiatrist James Barrett, who specialises in gender identity disorders, said it is "highly unusual" for a woman who has undergone a sex change to want to get pregnant because that does not fit with their new gender role. But Beatie told the Oprah Winfrey Show: "I feel it's not a male or female desire to have a child. It's a human need. I'm a person and I have the right to have a biological child."

When did he give birth?Beatie went into labour early yesterday and had to be rushed to hospital. Today, Beatie told People magazine that his newborn was "healthy and doing well". He said: "The only thing different about me is that I can't breastfeed my baby. But a lot of mothers don't."

What concerns were there over his pregnancy?Much concern focused on the possible effect of testosterone on the foetus. Lisa Masterson, a Los Angeles obstetrician, told ABC TV it was "really important" that he did not take any testosterone during the pregnancy as this could "cause male-type characteristics in the female baby". Concerns were also raised about the confusion the child may later experience due to the baby having a legally male mother. Beatie has said that he will be the child's father while his wife Nancy will be her mother. But psychologists said this raised concern that the child will face psychological problems after discovering that daddy is actually mummy. "There is going to be an extra degree of complication or confusion about 'where am I from?'" said Robert Withers, a psychoanalyst who has treated transgender patients.

Were there any complications?It would appear not. Beatie's obstetrician Dr Kimberly James claimed the pregnancy was uncomplicated. She told Oprah when Beatie and his wife went on her chatshow earlier this year: "This baby is totally healthy. This is what I consider a normal pregnancy." The new family was discharged from the St Charles Medical Centre in Bend, Oregon, yesterday.

Is this case unprecedented?No. Another American trans-man Matt Rice gave birth to a baby boy in 1999, and his trans-man partner, Patrick Califia, later told the Village Voice newspaper about his toddler son who "shrieks with delight at the sight of the tortoiseshell cat". In the UK, businessman Sam More, 39, gave birth in his early 20s after falling in love with another man with whom he wanted a baby. More was told that he had not been taking male hormones long enough to affect a pregnancy and eventually he conceived.