Fertility preservation

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Fertility preservation, in the context of the trans and nonbinary community, means any steps taken by individuals to retain the option of having children who are biologically related to them. There is often an assumption that all trans people are unable to have or do not want to have biological children, but this is untrue.^[1]

Some types of hormone therapy or surgery will reduce or eliminate fertility either reversibly or irreversibly. Physicians often do not inform their patients about this, especially younger patients, although discussing it is recommended to be always done.^[2]^[1]

Some countries and states require transgender people to be sterilized (have their ovaries or testicles removed) in order to be legally recognised as their self-identified gender.

In some cases, individuals who take puberty blockers and then seamlessly move to taking adult hormone therapy may not have their bodies develop sufficient "reproductive material", leaving them permanently infertile.^[2]

Fertility preservation for people who were assigned female at birth

Masculinizing hormone therapy decreases ovulation and stops menstrual bleeding. However, people on masculinizing HRT may still become pregnant.^[3]

In patients who have at least begun puberty and who still have their ovaries, oocytes (egg cells) can be cryopreserved for use at a later time. This process can take two or three weeks and requires a doctor to give the patient synthetic hormones which induce oocyte production.^[2]

Fertility preservation for people who were assigned male at birth

In patients who have at least begun puberty and who still have their testicles, sperm can be cryopreserved for use at a later time. The sperm can be collected manually or can be extracted by a doctor. The process only takes a day.^[2]

Cost

Insurance companies generally consider fertility preservation as "not medically necessary", and thus do not cover these procedures, even when covering other transition-related healthcare.^[2]

References

↑ ^1.0 ^1.1 Rafferty, Jason (2019). "Fertility Preservation Outcomes and Considerations in Transgender and Gender-Diverse Youth". Pediatrics. 144 (3): e20192000. doi:10.1542/peds.2019-2000. ISSN 0031-4005.
↑ ^2.0 ^2.1 ^2.2 ^2.3 ^2.4 Smith, Allison (2019). "Preserving the Possibility of a Future Biological Family: State-Mandated Insurance Coverage of Fertility Preservation for Youth Patients When Primary Treatment Causes Sterility". Dukeminier Awards: Best Sexual Orientation Law Review Articles. 18 (1): 267–294.
↑ Krempasky C, Harris M, Abern L, Grimstad F (2020). "Contraception across the transmasculine spectrum". The American Journal of Obstetrics and Gynecology. 222 (2): 134–143. doi:10.1016/j.ajog.2019.07.043. PMID 31394072.CS1 maint: multiple names: authors list (link)

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[Rafferty2019-1] 1.0 ^1.1 Rafferty, Jason (2019). "Fertility Preservation Outcomes and Considerations in Transgender and Gender-Diverse Youth". Pediatrics. 144 (3): e20192000. doi:10.1542/peds.2019-2000. ISSN 0031-4005.

[Smith2019-2] 2.0 ^2.1 ^2.2 ^2.3 ^2.4 Smith, Allison (2019). "Preserving the Possibility of a Future Biological Family: State-Mandated Insurance Coverage of Fertility Preservation for Youth Patients When Primary Treatment Causes Sterility". Dukeminier Awards: Best Sexual Orientation Law Review Articles. 18 (1): 267–294.

[3] Krempasky C, Harris M, Abern L, Grimstad F (2020). "Contraception across the transmasculine spectrum". The American Journal of Obstetrics and Gynecology. 222 (2): 134–143. doi:10.1016/j.ajog.2019.07.043. PMID 31394072.CS1 maint: multiple names: authors list (link)

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