An Italian who was transitioning to become a man was found to be five-months pregnant after undergoing a mastectomy.
The individual, who had assumed the male name Marco, was at an advanced stage of the sex-change process having had his breasts removed.
He had been due to have a hysterectomy to remove his uterus before the pregnancy was discovered by doctors at a hospital in Rome.
Thought to be the first case of its kind in Italy, the surprise discovery has raised concerns about the welfare of the baby and whether the foetus has been affected by the procedures that Marco has undergone to date.
“Once the pregnancy is discovered, the first thing to do is to immediately suspend the hormone therapy,” said Giulia Senofonte, an endocrinologist and expert on gender therapy.
“If the halting of the therapy is not immediate, there could be consequences, especially in the first trimester of pregnancy, which is an important time for the development of the baby’s organs.
“It’s difficult to talk about it in abstract terms but it all depends on the timing of the suspension of the dosages of testosterone that the person is taking.”
Doctors are also worried about the impact on Marco, who has begun to exhibit male physical characteristics, including additional body hair growth and the ability to grow a beard.
Some experts believe high levels of both male and female hormones in a person’s body can pose a cardiological risk, heightening the prospect of heart attacks and strokes, although there is a lack of conclusive research on the subject.
Marco is now expected to go through with the pregnancy and give birth to the baby.
Under Italian law, an abortion after 90 days is only allowed if the pregnancy seriously endangers the health of the mother or if there are significant problems with the foetus.
Marco will be the baby’s biological mother but will be registered legally as its father.
The unusual case makes him a member of a tiny category of people known as “seahorse dads” – transgender men who carry babies. The term is derived from the fact that among seahorses, it is the male which carries and gives birth to young.
Marco had never felt comfortable as a woman and had decided some years ago to change gender.
“Hormonal therapy blocks the menstrual cycle but is not a contraceptive,” Dr Senofonte told the La Repubblica newspaper, which first revealed the case.
“The person can continue to ovulate and as a result, run the risk of getting pregnant. Experts who oversee these transitions normally recommend contraceptive pills that can be taken during the therapy.”
The president of Pro Vita e Famiglia, a conservative Catholic foundation, said he hoped Marco would decide to halt his therapy permanently.
“The gender fluidity theory is total madness,” said Toni Brandi. “It’s against science and against nature. This case is a challenge for gender theories because it shows a woman is a woman.”