In 2008, the world was stunned to learn that Thomas Beatie–by all accounts a man–had given birth.

Beatie–who was born a female–began sexual reassignment surgery back in 2002 but went on to carry and give birth to three children with his wife Nancy, who was unable to conceive after endometriosis necessitated a hysterectomy. Now the couple is separated after nine years.

Beatie says the two are going through a rough patch, like all couples do, and that he recently had his final surgery for gender reassignment, although Nancy hasn’t seen him since it was completed.

Thomas–who went by the name of Tracy back in his beauty queen days–told Oprah when he first became pregnant that he was afraid for the safety of his family after the announcement garnered so much attention, claiming people didn’t understand and that he and Nancy were refused help with pre-natal care. He wrote about it in The Advocate in 2008:

“In total, nine different doctors have been involved. This is why it took over one year to get access to a cryogenic sperm bank to purchase anonymous donor vials, and why Nancy and I eventually resorted to home insemination.”

He went on to say, “Wanting to have a biological child is neither a male nor female desire, but a human desire.”