The morning after Cypress was released from the hospital, I waited until about 11:15 before texting Liam to see how the family’s first night at home went.
I imagined a scene like in the movies: a restless night with two brand-new, exhausted parents taking turns leaving their bed to feed the baby or change a diaper.
But I got a text back around noon. In typical Liam humor it said, “I don’t know who sleeps more: Duane or Cypress lol.” Cypress had slept five hours through the night and woke them up briefly at 5 a.m., before going back down for a two-hour nap.
“Lucky to have such a good non-fussy baby,” Liam wrote.
In those first few weeks after the hospital, Cypress went to the pediatrician and received a positive health report. Dr. Laura Levin, with Atrium Health Levine Children’s Piedmont Pediatrics, told Liam and Duane their baby made good progress despite being born almost two months early.
Levin’s office, in Concord, is more than 25 miles away and Liam and Duane drive past nearly a dozen other pediatric doctors to get there. They chose Levin’s practice for a reason: Four years ago, Levin announced to her employees, patients and the public that she was transitioning male-to-female.
Liam picked Levin not only because she is transgender but also because her practice is accustomed to serving trans families, including both trans parents and youth patients who are transitioning. Her staff has been trained, Levin says, in “how to be open and affirming toward LGTBQ populations.”
“To have a pediatrician for Cypress who knew first hand trans-sensitivity and not even have to educate her. That one little thing is a big weight lifted off our shoulders,” Liam says.
When Levin’s office started taking on an increased number of gay, lesbian and transgender patient families, and especially after transitioning herself, some employees quit, Levin says. But most are supportive.
“We have a fairly large LGBTQ population coming through my office,” she said. “And you can’t always tell someone’s gender identity based on how they’re presenting (or appearance).”
Employee training at Levin’s office includes avoiding the use of words like “sir” or “girl” in favor of gender-neutral words like “parent” or “child.” Cypress is her first patient to be raised gender-neutral, where Liam and Duane, as parents, aren’t disclosing their child’s birth sex to anyone.
While pediatric research on gender-neutral child-rearing is limited, Levin says she’s found most children do not form their own gender identity until around 4. In her office, it’s OK for parents to write “N/A” for gender, as Liam and Duane did.
At home, Liam and Duane quickly fell into the rhythms of fatherhood. Most days, Duane tends to the baby for about two hours before he goes to work and Liam stays home with Cypress. If Liam needs to pick up a shift at work, his mother, Rosalyn, helps care for the baby.
After about a month of having Cypress home, the birth experience seemed “like a blur” in his memory, Liam said.
He waited around 11 weeks after birth before he restarted testosterone injections. “I’m excited to get back to feeling normal within myself and within my body,” Liam said. “Just get back to feeling like myself.”
But,Cypress’ two-month stay in the neonatal unit at Levine Children’s Hospital stuck with Liam.
“It’s kind of surreal,” he said in October. “Last night when I went to pick them up, I was thinking there was still wires attached.”
Research has shown both people who give birth and non-birthing parents often experience post-traumatic stress disorder during and after their child is in the NICU. Anxiety, nightmares and constant worrying about their child’s health after a prolonged hospital stay are some of the most-common symptoms.
Levine Children’s Hospital NICU tries to mitigate these difficulties for families as much as possible, through support programs, special gatherings and meetings with social workers on staff, says Dr. David Fisher, medical director of neonatology at Levine.
“When babies come to us in the ICU, they’re sick. Life-threatening illness effectively,” Fisher said.
Most of those babies — more than 1,000 newborns each year — are admitted with breathing issues, infections or genetic conditions. In the month Cypress was born, the hospital broke its own record for the highest number of babies admitted: 115 infants in the NICU in July 2018.
By the time Cypress came home, doctors believed the infant was essentially eating, sleeping and otherwise experiencing as good as health as would be the case for a baby the same age.
It’s a relief, Liam says. He still worries others will jump to the conclusion that his pregnancy complications or Cypress’ premature birth were caused because he is transgender.
“When really, me being trans had nothing to do with it,” he said.
He was also nervous to register on breast milk-sharing sites as he and Duane looked for a donor and hoped they’d be able to avoid using formula. Once, they drove as far as Virginia to pick up several hundred ounces of donated breast milk to feed Cypress. Other times, they met with women in Charlotte who produce more milk than needed to nurse their own babies.
Each time, Liam was happily surprised the donors were unfazed he’s trans and gave birth. And he and Duane say they’re grateful to the many people who donated milk to Cypress.
Still, they expect some reaction will be negative once their story is shared publicly.
Trans people, Liam says, continue to face discrimination and marginalization in society even amid incremental legal and political wins for LGBTQ people. It’s that reality that led Liam to begin trans equality activism more than three years ago, when North Carolina lawmakers passed HB2, a law that restricted access to public restrooms for transgender people who had transitioned but had not changed the sex listed on their birth certificate.
Back then, Liam was featured in a Charlotte Observer article alongside a portrait of him standing arms-crossed, defiant in front of a row of restroom stalls. “I’m 100 percent human and deserve 100 percent equality,” Liam said in 2016. “When our community’s lives are under attack, we stand up and fight back.” HB2 was later partially repealed.
In many ways, Liam says, the fight today is harder than ever.
But lately, he’s spending less time attending protests and more time changing diapers.
The short-term plan is for Liam to stay home with Cypress while Duane’s started a new nursing job, working second shift. And Liam wants to renew his paramedic training so he can work full-time again.
They dream of a future for Cypress where transgender families are treated equally and hospitals — and the rest of the world — are ready to receive them.
I remember Liam telling me that the first day we met.
As we sat down in February 2018, in a coffee shop in Charlotte’s Plaza Midwood neighborhood, he said he wanted to share his story for one main reason: so other trans men would have more information about what it’s like to give birth.
“There aren’t a lot of stories about trans and queer families and their experiences about growing their families or reproductive issues,” he says. “We couldn’t find anything that we could connect with to help us with information and give us hope that we could have a family…
“We knew we couldn’t be the only ones out there doing this, so we decided to share our story so people could have something to identify with.”
For much of Liam’s life, pronouns — and whether people were using the right ones — could make him feel wholly understood, or downright alone.
Now, at home with Duane and Cypress, Liam’s family has a brand new pronoun to go by: “Us.”
BEHIND OUR REPORTING
Reporter Anna Douglas and videographer Diedra Laird spent more than a year chronicling the lives of Liam Johns and husband Duane Danielson through Liam’s pregnancy and the birth of their child.
Almost all of the conversations and details in #TeamPregnantDad were personally witnessed by Douglas or Laird. In story scenes containing flashbacks or details the journalists did not witness, the Observer has reconstructed that information following extensive interviews with Liam, Duane, their healthcare providers, friends and family.
Liam had previously been featured in 2016 in an Observer profile called “Becoming Liam,” which was published around the time North Carolina lawmakers passed HB2. The law (which was later repealed) restricted access to public restrooms for transgender people who had transitioned but had not changed the sex listed on their birth certificate.