The Code: Professional standards of practice and behaviour for nurses and midwives.London: NMC; 2018

Will this be the first baby in Britain not to have a mother?. 2019. (accessed 26 February 2019)

Mothers and fathers: what's in a name?

02 March 2019
Volume 27 · Issue 3

In February 2019, The Telegraph reported the case of a child, known for legal reasons as YY, who could become ‘the first baby in Britain to not to have a mother’ (Stanford, 2019). The case is being brought to the High Court by ‘TT’, who gave birth to the child but seeks to be recognised on YY's birth certificate as the father, better reflecting his identity as a transgender man. This—and TT's proposed compromise of being registered as the ‘parent’ or ‘gestational parent’—has been rejected.

This debate has arisen from ‘two competing truths’ (Stanford, 2019). TT was granted a Gender Recognition Certificate (GRC) before becoming pregnant and is therefore legally recognised as male. Although GRCs require applicants to meet a number of criteria—such as a diagnosis of gender dysphoria, the consent of a spouse (if married), and proof of having lived in the ‘acquired gender’ for two years with an intention to do so until death—surgery is not one of them. Therefore, TT was legally able to both give birth and identify as a man.

To some, the debate is clear cut: the Human Fertilisation and Embryology Act (2008) rules that the person who bears the child is to be ‘treated as the mother’ (a decision introduced to clarify surrogacy laws). Therefore, some may say, YY's birth certificate should reflect that TT was born biologically female. The more cynical may also argue that the birth certificate is incidental, as in practice, YY is likely to grow up seeing TT as the father, not the mother. Most children rarely see their birth certificate anyway, so what difference does a piece of paper make?

For the transgender community, the difference is significant. Many parents have no need to show their child a birth certificate, because, other than being an interesting document, it merely confirms what the child has known all along. In TT's case, registering him as the mother may force him into a choice between concealing the document to avoid hurt and confusion, or informing YY that their birth certificate does not reflect their experience—that it is, essentially, false. Ruling in TT's favour would change little for most parents, but could enable the estimated 200 000–500 000 people identifying as transgender (Stanford, 2019) to feel respected and accurately identified. TT no more wants to be ‘mum’ than any other dad.

What does this mean for midwives? The Human Fertilisation and Embryology Act (2008) states that the mother is the ‘woman’ who carries the child, but with more and more routes to parenthood, is it time to stop emphasising that etymology of the word ‘midwife’ is ‘with woman’? It's a small sacrifice to help people feel respected, and would, after all, still uphold midwives' duty to ‘make [service users’] care and safety their main concern and make sure that their dignity is preserved and their needs are recognised, assessed and responded to’ (Nursing and Midwifery Council, 2018:5). The priority for the courts, the family and health professionals should be that YY is healthy and well cared for. While know very little about YY, one thing that is certain is that YY has a parent who is willing to fight—potentially all the way to the Supreme Court—to procure a birth certificate that is as accurate as any other. As we await the trial, the one thing that can be proved from this story is that YY is a child who is very much loved.