Fertility preservation in transgender men and the need for uniform, comprehensive counseling

Park, Selena U.; Sachdev, Devika; Dolitsky, Shelley; Bridgeman, Matthew; Sauer, Mark V.; Bachmann, Gloria; Hutchinson-Colas, Juana

doi:10.1016/j.xfre.2022.07.006

Cited by 4 publications

(5 citation statements)

References 25 publications

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“… 15 By creating an inclusive clinic environment, providing gender neutral bathrooms, and ensuring proper pronoun use in documentation and during the process of FP counseling, this barrier can be mitigated. 16 Implementation of routine and high-quality counseling regarding FP is an area for improvement in gender affirming care.…”

Section: Counseling Regarding Fpmentioning

confidence: 99%

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Barriers to fertility preservation access in transgender and gender diverse adolescents: a narrative review

Nadgauda,

Butts

2024

Clin Med�Insights�Reprod�Health

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Fertility preservation (FP) involves the cryopreservation of gametes, embryos, and/or gonadal tissue oocytes, for future use in family building. FP as part of a comprehensive approach to care of transgender and gender diverse (TGD) individuals is an understudied topic. Current evidence indicates that gender affirming therapies may increase the risk for infertility. As a result, TGD individuals, including adolescents, should receive counseling regarding FP prior to beginning gender affirming treatment. Many barriers exist to TGD adolescents receiving FP counseling and undergoing FP if desired. The objective of this narrative review is to summarize the literature regarding the desire for FP in TGD adolescents, the barriers to TGD adolescents in accessing of FP, and to discuss potential interventions for alleviation of such barriers. A literature search using the following Medical Subject Headings search terms: ‘transgender persons’ and ‘fertility preservation’ and ‘adolescents’ was conducted via searching PubMed. Additional articles were located via reference review. Included articles consist of qualitative and quantitative research and society guidelines. Articles from inception to 1st July 2023 were included. The results of the literature search have been summarized into the format of a narrative review. Key barriers to FP for TGD adolescents include inconsistencies in form and timing of counseling, potential worsening of gender dysphoria with FP treatment, high cost of treatment, limited research on FP outcomes, and legal barriers. Intersectionality between gender identity and other forms of minority status can compound these barriers to FP and healthcare in general. Barriers to TGD adolescents accessing FP are significant. Increased research is needed upon methods to mitigate these barriers. Solutions include increasing uniformity and timing of FP counseling by varying health care providers, advocacy efforts to mitigate legal and financial barriers, increased research efforts in FP outcomes, and increased cultural competency in clinics offering FP care to TGD adolescents.

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Section: Counseling Regarding Fpmentioning

confidence: 99%

“… 17 Sperm cryopreservation via masturbation costs $388 on average, and $555 on average annually for storage. 16 According to ReproTech, a cryogenic storage company, the average cumulative cost of sperm storage or oocyte storage alone surpasses $2500 over 10 years. 19…”

Section: Barrier: Costmentioning

confidence: 99%

Barriers to fertility preservation access in transgender and gender diverse adolescents: a narrative review

Nadgauda,

Butts

2024

Clin Med�Insights�Reprod�Health

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“…Similarly, the embryos eventually collected can be cryopreserved, or freshly transferred into a gestational carrier, in the uterus of the individual if not removed surgically, or in the uterus of the female partner, depending on the sex of the partner. Ovarian or embryo cryopreservation are standardized treatments widely used in the field of Assisted Reproductive Technology (ART) and, thus, currently represent the treatments of choice for FP in transgender patients [ 9 , 10 , 15 ]. Despite this, both techniques could cause discomfort to the subjects, mainly due to the following side effects: the need to suspend HT in order to start COS; the process of COS itself can bring both physical changes and psychological distress; and frequent vaginal ultrasound monitoring may not be easy to bear for these patients [ 16 ].…”

Section: Fertility Preservation Options For Transgender Menmentioning

confidence: 99%

“…The possible advantages of this technique are represented by the possibility of not stopping the hormonal therapy for the patients; it could be performed at the same time as the GAS. Additionally, the eventual ovarian stimulation could be postponed until a later or further usage [ 15 ]. Furthermore, it constitutes the only viable option for FP in patients of prepuberal age.…”

Section: Fertility Preservation Options For Transgender Menmentioning

confidence: 99%

“…For these reasons, efforts should be made in all the stages of counseling to relieve the feeling of anxiety and worry [ 8 ]. This includes creating an appropriate and welcoming office environment, setting an inclusive and gender neutral doctor–patient relationship, and establishing a nondiscriminatory policy, including the use of proper pronouns and the supply of gender-free bathrooms and documentation [ 15 , 31 ].…”

Section: Psychological and Emotional Impact Of Fp On Transgender Men ...mentioning

confidence: 99%

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“Lights and Shades” of Fertility Preservation in Transgender Men Patients: A Clinical and Pathological Review

D’Amato

Cascardi

Etrusco

et al. 2023

Life

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Fertility preservation (FP) is becoming a critical issue in transgender men who desire biological offspring in the future. The prevalence of transgender individuals in the United States is increasing, and as a result, the demand for gender-affirming surgeries (GAS) and associated FP techniques is rising. Despite the growing demand, there is currently no personalized approach to FP for transgender men, and the available techniques have limitations that require further investigation. In the present review we carefully examine the existing literature on this topic to highlight the shortcomings of current methods and areas where additional research is needed to advance the field. Hormonal therapy (HT), which is an integral part of gender transition in transgender men, can have a significant impact on fertility and may increase the risk of various diseases. Moreover, GAS usually leads to permanent sterility in these patients. Therefore, it is essential to provide patients with accurate information about the benefits and potential risks of different FP techniques, taking into account the patient’s reproductive goals. This review underscores the complex and multifaceted nature of FP in transgender men and emphasizes the need for further research to develop more effective and personalized approaches to FP for this population.

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Clinical management of transgender and non-binary patients in the fertility preservation service: Current evidence

Tsonis,

Kopeika

2023

International Journal of Transgender Health

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Fertility preservation in transgender men and the need for uniform, comprehensive counseling

Cited by 4 publications

References 25 publications

Barriers to fertility preservation access in transgender and gender diverse adolescents: a narrative review

Barriers to fertility preservation access in transgender and gender diverse adolescents: a narrative review

“Lights and Shades” of Fertility Preservation in Transgender Men Patients: A Clinical and Pathological Review

Clinical management of transgender and non-binary patients in the fertility preservation service: Current evidence

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