Reproductive aspects of transgenders

Abstract

Objectives:The reproductive function of transgender (trans) men and women may be compromised after the implementation of gender-affirming therapy (GAT) and gender-affirming surgeries (GAS). Trans men recover their reproductive capacity months after discontinuing testosterone; however, estrogen therapy can permanently compromise the reproductive function of trans women. The aim of the present study was to discuss the reproductive aspects of transgender people, especially those who seek GAT and/or GAS to adapt their bodies to the gender with which they identify. Methods: original articles, case series, case reports, and review articles published in English and indexed in the PubMed, Google Scholar, and Embase databases were taken into consideration. Two authors selected the articles to be included, and a third author judged when there was disagreement between the former two. Results: Our search retrieved 1,628 articles. After removing duplicates, 1,426 titles were screened, 112 were considered potential, and 63 were included in this review. Conclusions: there are changes in the gonads of trans people caused by estrogen and androgen that can promote infertility in this population, perhaps temporarily or not. Thus, it is necessary to carry out reproductive counseling for this population before starting GAHT and during all medical follow-ups, especially with individuals who will undergo GAS.