Conception describes both the material “act of conceiving in the womb” and, symbolically, the ability to comprehend. As such, the term is apt for attending to how trans and intersex reproduction “engender a reimagining of the dominant epistemological and ontological understandings of sex, gender, and pregnancy, and their relationship to one another”. This chapter provides an overview of topics pertinent to the reproductive experiences of those who are trans and gender expansive (TGE) or intersex. In doing so, it seeks to underscore the ways in which cisnormativity forecloses the consideration of trans and intersex reproductive possibilities insofar as it relies on exclusionary and reductivist conceptions of embodiment. Biogenetically and otherwise, TGE people have long engaged in family building; however, these kinship formations have remained legally and socially unintelligible when mediated by what Butler refers to as the heterosexual matrix.