Low Fertility Preservation Utilization Among Transgender Youth

Abstract

Utilization rates of FP are low among transgender adolescents. More research is needed to understand parenthood goals among transgender youth at different ages and developmental stages and to explore the impact of gender dysphoria on decision-making about FP and parenthood. Discussions about infertility risk, FP, and other family building options should be prioritized in this vulnerable adolescent population.

Research Review: Gender identity in youth: treatment paradigms and controversies

“…Though there has been recent success with this technique (Demeestere et al., ), it remains experimental. Notably, the majority of transgender adolescents (~97%) attending endocrine gender clinics who are counseled on fertility preservation options choose not to undergo these measures (Nahata, Tishelman, Caltabellotta, & Quinn, ). Major barriers include lack of insurance coverage and the need to proceed through puberty to undergo fertility preservation via standard techniques (most of these patients are attending endocrine clinics for the very purpose of halting puberty; Nahata et al., ).…”

“…Notably, the majority of transgender adolescents (~97%) attending endocrine gender clinics who are counseled on fertility preservation options choose not to undergo these measures (Nahata, Tishelman, Caltabellotta, & Quinn, ). Major barriers include lack of insurance coverage and the need to proceed through puberty to undergo fertility preservation via standard techniques (most of these patients are attending endocrine clinics for the very purpose of halting puberty; Nahata et al., ). Notably, though the vast majority of adolescents attending gender identity clinics do not desire fertility preservation, up to 38% of transgender adults report that they would have cryopreserved gametes, if such an option were available when they transitioned (Wierckx et al., ).…”

Fertility desires and reproductive needs of transgender people: Challenges and considerations for clinical practice

“…In another study by Nahata et al, nearly half of the participants reported no desire to have biological children. A recent online survey conducted on a sample of 156 (age range 14‐17 years) gender nonconforming adolescents revealed that 36% of these individuals want to have biological children.…”

Management of gender dysphoria in adolescents in primary care

“…However, even with current ages of medication administration, a recent study found that very few youth with gender dysphoria opted for fertility preservation procedures such as sperm or egg harvesting. 48,49 More research is required to understand why this is the case. Although it may be important to delay medical therapy temporarily to allow for fertility preservation, decisions regarding future fertility should not preclude care to address gender dysphoria.…”