On November 16, Charis Books and More will be virtually hosting a conversation between licensed midwife and owner of MAIA Midwifery and Fertility Services Liam Kali and Atlanta-based full-spectrum doula and reproductive justice organizer Yemi Combahee on Kali’s book “Queer Conception: The Complete Fertility Guide for Queer and Trans Parents-To-Be.”
Ahead of their conversation, Kali and Combahee talked with Georgia Voice about the book, what the audience can expect from their conversation, and trans inclusion and body positivity in the world of conception.
Quotes have been edited for clarity.
Talk to me about “Queer Conception.”
LK: The book is a midwife in paperback. It is designed so that anyone who is considering pregnancy as a queer or trans person who, specifically, may need assisted conception but it also speaks to those of us who sometimes don’t need assisted conception to conceive, all the way through from laying out a timeline, making initial decision making, to donor selection, lab work, preconception health, insemination methods and timing, coping with cycles of trying to conceive. There’s a chapter on IVF, one on surrogacy, and the last chapter of the book, I did want to include some information on early pregnancy because a lot of times once folks conceive so intentionally, the two months you have to wait to see a care provider can feel like forever. So, I address some early pregnancy stuff as well as lactation induction, because for folks who are going to be inducing lactation and not carrying pregnancies, that process stars pretty early.
YC: I’ll say that I connected with Liam when they were still writing the book and was able to do an early what they called “inclusivity read” of the book. That was a really great process of reading through to make sure it touched on different people’s circumstances, that it was inclusive of Black and Brown folks, folks living in the South, especially in a state like Georgia where resources are not as plentiful as in a place like Seattle. I think this book is super helpful for folks who might not feel like they have access to a community midwife or someone they know in their life who has been through a queer conception process. This is a book they can order, they can get from their local bookstore, and really have a lot of the information both that you would get from a really compassionate care provider but also from a queer friend that you would look to to ask, “Hey, what can I expect from this process?” For a lot of queer folks, they might be isolated, or they might be the first in their group of friends or community to go through this process. I think that this is a really great starting point for those folks.
To shift to your upcoming conversation, what topics are y’all going to cover?
LK: Yemi and I are very passionate about the communities we serve. When we prepped for the book event, as we were talking about what we wanted to cover, we just ended up having this very lively and vibrant conversation because of the passion behind the work that each of us does. It was like, “Okay, well let’s just have this conversation for an audience.” It’s mostly getting a message out to a population of people who can sometimes feel really isolated; even if you do have a friend or two who has gone through the conception process, the process they went through [may have been] way too medicalized because the only process that was available to them was an infertility model that doesn’t apply to healthy people who simply need donor sperm to conceive, or they [maybe] fell prey to the companies to just see us as a good opportunity to turn some cash selling products that are gimmicky or don’t work. The content [in the book] is filling this big gap. Our people are important, and we deserve really good health care. If the medical system hasn’t seen fit to provide that for us, then we make it happen in a community-based model.
YC: I definitely envision us talking a lot about what community-based birth work looks like in the queer community – communities, plural – and how that is universal in some ways in the work both of us do, but also how they differ and how we have to adjust for the different communities we serve. I’m hoping the folks that attend can see themselves in the experiences that we’re going to talk about.
You both mentioned this concept of inclusivity. The book is lauded as the first fertility guide to be trans-inclusive. Can you talk about how trans people are included in this guide and what trans-specific barriers, issues, or topics regarding fertility are addressed?
LK: Number one, it’s written with inclusive language. The whole book is written in a way that is inclusive and affirming of gender, regardless of what a person’s gender is. That in itself is pretty revolutionary. Trans people aren’t going to have to wade through an endless sea of misgendering in order to get the information that’s needed. I do include information about how hormonal transition can impact your fertility and what can be expected if you’re trying to regain your fertile function after hormonal transition. Additionally, I included in the lactation induction section lactation for every body. I have instructions if your body has ovaries and you carried a pregnancy, if your body has ovaries and you did not carry a pregnancy, if your body does not have ovaries or pregnancy, and how lactation can be induced in each of those scenarios. There are other things that are woven through, like gendered experiences during pregnancy.
I want to give people information that is evidence based and clinically accurate for their actual situation while affirming gender identity, family structure, and the very personal decision making that goes into this process. You can’t really separate those parts of yourself out.
YC: Liam, you do such a great job at being gender inclusive not just for the sake of gender inclusivity but also honoring the lived experiences of queer folks at large. Even when you talk about nutrition and how to feed your body to prepare for a pregnancy, you’re sensitive to the fact that a lot of us live in storied bodies that have been marked by fatphobia and eating disorders. You’re sensitive to the fact that this journey does not have to be at the expense of your mental health and your recovery. It’s not just about if you take hormones or not, it’s about your relationship to your body and your relationship to your community.
Speaking of body positivity, can you discuss the importance of body positivity – or rather the lack of body positivity in traditional medical spaces?
LK: BMI is a thing that is very easy to measure, so it gets included in a lot of studies related to health because it’s so easy to track, and therefore makes such an easy scapegoat. What that leaves out is the wholeness of who a person is. To simply tell somebody, “Oh, if you lose ten percent of your body weight, your chances for pregnancy go up.” Yep, that’s a study that was produced, I probably even name that in that book. I’m not trying to say none of that matters; yeah, there’s a study that says that, AND you’re a whole person. When we look at that kind of information from a health at every size approach, just to utilize that phrase, to me health means whole person health. Regardless of the size of one’s body, you look at what practices are going to add up to the health parameters you’re looking for. It’s like telling somebody, “Don’t stress.” How much good does that do? There’s a lot more to it.
YC: That in and of itself is revolutionary in a conception book, and it’s also why I think folks who might not identify as queer can also benefit from this viewpoint. If more pregnant people, queer or not, saw themselves and were able to see themselves through their pregnancies as whole people deserving of physical, mental, and communal health, and we as a society supported that, imagine what our reproductive system could look like.
Absolutely. To talk more about trans conception, I’m interested in discussing pregnancy and gender dysphoria and how you help people navigate that in a healthy way in your work.
LK: There are many ways that I approach that issue. One is, again, just to state things in ways that aren’t going to misgendering somebody so an individual can start to see themselves reflected in the language that I’m using. Because there’s this cultural overlay of, “There are two genders!” refuting that and talking to a person outside of those terms means that they get the opportunity to show up and be seen within the context of receiving health care. What keeps coming to mind in relation to this question as well as your last is if you look at these sorts of issue from a colonization perspective, we know that when colonization happens, one group is coming in and saying, “Our way of life is the best way of life, so we’re going to oppress everyone else so that they assimilate and become more like us.” The same happens around pregnancy and birth; here’s this epitome of the way you should [be “successfully” pregnant], and that is also a colonization approach. Because of the broader cultural mindset that upholds the validity of white, cisgender, heterosexual couples having babies, anybody who doesn’t fit into that is made to feel like they’re less than. If you don’t fit into that model, you either have to hate yourself and assimilate or reject that model and love yourself. Rejecting that model is how we become so isolated. It’s for our own self-preservation that we have to get the toxicity out of our lives, and it’s really hard to do that when you’re in an area where you don’t have access to health care providers who are going to celebrate who you are, let alone give you care that applies to you and is appropriate for you and your body.
What advice would you give to people who are hesitant to embrace parenthood because of all the systemic barriers that may be in their way?
LK: You are beautiful, you are valid. The more you step into yourself and everything that you are, the more that you have to give to your child. Your decision to have a child and become a parent is totally human and something you get to choose, too. Don’t let anybody tell you otherwise. Oftentimes the ways we are made to feel bad about ourselves or who we are, that’s just the toxic sludge that keeps us down and traumatizes us over and over again. You still have to live in the world, but you have to become our own filter and parent ourselves in order to be able to go forth and live our lives. Make sure you’re talking to yourself the same way you would talk to a child. You get to have this. You get to have a good life, regardless of what anyone else says. Step into your power, step into your fullness.
YC: You’re not the first, you won’t be the last, and you are part of a legacy of queer families that has existed always. That’s really empowering to know that queer folks have been making babies since people were on this planet. Just because we have these systems that try to box us in, that are effective at traumatizing us and making us feel less than, it’s the systems that are invalid, not us.