ABSTRACT
Objective
To describe family planning and fertility counseling perspectives of reproductive-age
gender diverse adults and youth pursuing gender affirming hormone therapy.
Materials and Methods
This was a cross sectional survey study of gender diverse adults and youth pursuing
or receiving gender affirming hormone therapy. The primary outcomes of interest were
parental desire and priorities for fertility preservation.
Results
Fifty-seven individuals (46 adults and 11 youths) completed the survey; 51% were transgender
women, 35% were transgender men, and 14% identified as non-binary. 32 participants
expressed interest in (n = 15, 26%) or uncertainty about (n = 18, 32%) future parenthood.
48% of participants had considered gamete cryopreservation, but only 7% each previously
completed or planned to pursue this fertility option; 67% cited cost as a barrier.
Participants with interest in or uncertainty about future parenthood were more likely
to consider cryopreservation (P <.001) or stopping hormones for fertility preservation (P <.001). 58% of respondents reported discussing fertility preservation with a health
care provider with lower rates among youth participants (P = .017). From a family planning perspective, 58% of respondents described counseling
as adequate; 23% described it as inadequate and 19% reported not receiving any counseling.
Participants who endorsed strong or uncertain parental desire were more likely to
report inadequate counseling (P = .016).
Conclusion
Gender diverse individuals interested in or undecided about future parenthood were
more likely to consider cryopreservation and report inadequate family planning counseling.
Therefore, current counseling practices may be insufficient and referral to a fertility
specialist should be considered.
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Article info
Publication history
Published online: October 28, 2022
Accepted:
October 10,
2022
Received:
August 10,
2022
Footnotes
Financial Disclosure: The authors have no pertinent conflicts of interest to disclose.
Funding Support: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
