Nov. 14, 2008 -- Is Thomas Beatie the first legal pregnant man? That's a question that can't be answered with absolute certainty.
Stephanie Brill, director of Maia Midwifery & Preconception Services and founder of Gender Spectrum, told ABC's Barbara Walters that Beatie was "by no means" the first pregnant man.
"He is the first man to go public with his pregnancy on such a widespread level," Brill said.
But how does one define who is a pregnant man? For one thing, there is a bewildering array of requirements for legally changing sex and these vary from state to state, making it difficult to say who is legally male and who isn't.
Also, the few transgender men who have become pregnant do not make their pregnancies public, so it's unclear how many have gotten pregnant before Beatie, and whether they were legally male at the time of their pregnancy.
The Village Voice reported on one pregnant man several years ago. Matt Rice, a female-to-male transsexual, conceived using artificial insemination and gave birth to a baby boy in 1999.
And then there is the case of Daniel Burghammer. Christened and raised as male, Burghammer became a blacksmith, husband and Italian soldier more than 400 years ago. But in 1601, he scandalized his regiment when he gave birth to a baby girl.
According to biologist Anne Fausto-Sterling, who discussed this story in her book, "Sexing the Body," Burghammer was a hermaphrodite, meaning he had both male and female reproductive organs. That made his pregnancy, and even breastfeeding, possible.
Several Approaches to Parenthood
Brill, who is also a midwife and founder of the educational group Gender Spectrum, first delivered the baby of a transgender man more than eight years ago. She now knows of as many as 40 men who have gotten pregnant. In the coming years, Brill expects that number to rise significantly.
"Most transgender men will choose another path to parenthood, but some will choose this path," Brill said.
According to Brill, Beatie's case is significant because of what it says about dramatic societal shifts now under way.
"I think that what it's helping us to do is understand that the face of family is changing," Brill said. "It's been changing for a long time.
"Each time that something pushes the edge of that family, our society at first tends to think it's wrong," Brill added, "whether that was people having interracial babies, or whether that was single mothers by choice, [or] whether that was gay or lesbian families. The same is true for transgender families."
No longer living on the fringes of society, transgender families are quietly raising their children in towns and neighborhoods across the country.
Take the case of Andey and Leaf Nunes, and their son Antonio. Even in San Francisco, where the two men live, their relationship raises eyebrows and the questions of, "What is a woman? What is a man?"
"We're a gay male couple that got to have a child the old-fashioned way," said Andey, a transgender man. "I am Antonio's biological mother on his birth certificate."
How is that possible? Leaf is biologically male, while Andey was born female.
When the two of them married, Andey was still Angie. But by then, she was already struggling with the feeling that she was really a man. Angie delayed her transition in order to get pregnant.
"It was sometimes funny to me to look in the mirror and see this pregnant person," said Andey, "because I just didn't see myself that way."
Broadening Ideas About Family
About a year after Antonio was born, with Leaf's support, Angie became Andey. He began taking testosterone and had his breasts surgically removed. Antonio, now 4 years old, refers to Leaf as daddy, and Andey as his papa.
"Antonio has seen pictures of us together with him as an infant, before my medical transition, and he recognizes me," said Andey. "So, he just sees me. He doesn't see the gender."
The couple hopes its example will broaden our notions of what constitutes a family.
"I don't think there are parenting issues or family issues that are different because one of us has transitioned genders," said Leaf. "How do you feel with finances? And how do you deal with providing education for your child? Those are the central issues to keeping a family together."
"We've been seen as freaks over the years," said Jennifer Finney Boylan, an English professor at Colby College. "Now we've made all this progress in which we're starting to be seen as peoples' neighbors and as familiar people."
Boylan, who was born male, married a woman and fathered two young boys. The marriage survived Boylan's transition from male to female.
"You can say she's crazy," Boylan said of her wife. "But she decided in the long run that her life is better with me in it than without [me in] it."
Boylan, the author of the memoirs, "I'm Looking Through You" and, "She's Not There," about her transgender experience, added, "There are so many different ways of being a family."
Using In Vitro Fertilization
Often, transgender people are becoming parents and creating families with the help of reproductive technology.
One married couple told ABC News of their complicated path to making a baby. The husband is a transgender man. Before he transitioned from a woman into a man, "she" had "her" eggs harvested and fertilized with donor sperm.
Later, the embryo was implanted into his wife, who is now pregnant with their baby. They declined to go on camera because they were afraid of the public's reaction.
Tiffany and Bridgette Woods, a married lesbian couple in California, also relied on in-vitro fertilization to become parents. In their case, Tiffany was born biologically male and Bridgette is biologically female.
When Tiffany transitioned into a woman, however, she chose not to have vaginal surgery so that the couple could conceive children "the old-fashioned way." But they were thwarted by infertility issues that were unrelated to Tiffany's transition.
Through donor sperm and several attempts at IVF, Bridgette eventually became pregnant. The couple has had three children using this method.
"After all of this, being a trans parent seems so much an afterthought to us," Tiffany told ABC News.
"Altogether, our family cost us somewhere over $40,000, and more tears, stress, and heartache than one can imagine. So now we are trying to just be a family, one that does not take each other for granted and truly knows all about the miracle of birth."
"Thomas Beatie is only one face of transgender families," said Brill. "There are so many ways for transgender people to make families."
Added Boylan, "For the most part, if you look at our family, what do you see? You see a group of people that love each other."