Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-20T06:54:25.913Z Has data issue: false hasContentIssue false

Chapter 24 - Fertility Counseling for Transgender and Nonbinary People

from Section E - Fertility and Reproduction

Published online by Cambridge University Press:  22 December 2022

By
Diane Chen  and
Leena Nahata
Edited by
Mick van Trotsenburg ,
Rixt A. C. Luikenaar  and
Maria Cristina Meriggiola
Mick van Trotsenburg
Affiliation:
Sigmund Freud PrivatUniversität, Wien
Rixt A. C. Luikenaar
Affiliation:
Rebirth Health Center, Utah
Maria Cristina Meriggiola
Affiliation:
Università di Bologna
Get access

Summary

This chapter provides an overview of the hormonal and surgical interventions available to transgender and nonbinary (TNB) people, what is known about how these interventions affect fertility, fertility preservation options at different stages of pubertal development, TNB individuals’ attitudes toward family building and experiences with fertility counseling and fertility preservation, barriers to fertility counseling, and recommendations for best practice for fertility counseling for TNB people based on the known literature to date.

Keywords

transgendertransgender and nonbinary individualsgender-affirming medical caregender-affirming hormonesGnRHatestosteroneestrogenfertility preservationfertility counselingoocyte cryopreservationsperm cryopreservationembryo cryopreservation
Type
Chapter
Information
Context, Principles and Practice of TransGynecology
Managing Transgender Patients in ObGyn Practice
 , pp. 183 - 189
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Gorman, JR, Su, HI, Roberts, SC, et al. Experiencing reproductive concerns as a female cancer survivor is associated with depression. Cancer 2015;121(6):935–942.CrossRefGoogle ScholarPubMed
Armuand, GM, Wettergren, L, Rodriguez-Wallberg, KA, et al. Desire for children, difficulties achieving a pregnancy, and infertility distress 3 to 7 years after cancer diagnosis. Support Care Cancer 2014;22(10):2805–12.CrossRefGoogle ScholarPubMed
Tornello, SL, Bos, H. Parenting intentions among transgender individuals. LGBT Health 2017;4(2):115–120.Google Scholar
Riggs, DW, Power, J, von Doussa, H. Parenting and Australian trans and gender diverse people: an exploratory survey. Int J Transgend 2016;17(2):59–65.Google Scholar
Thoreson, RR. Yogyakarta principles. In Naples, N. A. and Hoogland, R. C. (Eds.), The Wiley Blackwell Encyclopedia of Gender and Sexuality Studies. Oxford: Wiley-Blackwell, 2016, pp. 1–2.Google Scholar
Ethics Committee of the American Society for Reproductive Medicine. Access to fertility services by transgender persons: an Ethics Committee opinion. Fertil Steril 2015;104(5):1111–1115.CrossRefGoogle Scholar
Coleman, E, Bockting, W, Botzer, M, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, Version 7. Int J Transgend 2012;13:165–232.CrossRefGoogle Scholar
Hembree, WC, Cohen-Kettenis, PT, Gooren, L, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2017;102(11):3869–3903.CrossRefGoogle ScholarPubMed
Finlayson, C, Johnson, EK, Chen, D, et al. Proceedings of the Working Group Session on Fertility Preservation for Individuals with Gender and Sex Diversity. Transgend Health 2016;1(1):99–107.CrossRefGoogle Scholar
Ikeda, K, Baba, T, Noguchi, H, et al. Excessive androgen exposure in female-to-male transsexual persons of reproductive age induces hyperplasia of the ovarian cortex and stroma but not polycystic ovary morphology. Hum Reprod 2013;28(2):453–461.CrossRefGoogle Scholar
De Roo, C, Lierman, S, Tilleman, K, et al. Ovarian tissue cryopreservation in female-to-male transgender people: insights into ovarian histology and physiology after prolonged androgen treatment. Reprod Biomed Online 2017;34(6):557–566.Google Scholar
Spinder, T, Spijkstra, JJ, Gooren, LJ, et al. The effects of long-term testosterone administration on pulsatile luteinizing hormone secretion and on ovarian histology in eugonadal female to male transsexual subjects. J Clin Endocrinol Metab 1989;69(1):151–157.Google Scholar
Leung, A, Sakkas, D, Pang, S, et al. Assisted reproductive technology outcomes in female-to-male transgender patients compared with cisgender patients: a new frontier in reproductive medicine. Fertil Steril 2019;112(5):858–865.Google Scholar
Light, A, Wang, L-F, Zeymo, A, et al. Family planning and contraception use in transgender men. Contraception 2018;98(4):266–269.Google Scholar
Light, AD, Obedin-Maliver, J, Sevelius, JM, et al. Transgender men who experienced pregnancy after female-to-male gender transitioning. Obstet Gynecol 2014;124(6):1120–1127.Google Scholar
Lai, TC, McDougall, R, Feldman, D, et al. Fertility counseling for transgender adolescents: a review. J Adolesc Health 2020;66(6):658–665.Google Scholar
Nahata, L, Chen, D, Moravek, MB, et al. Understudied and under-reported: fertility issues in transgender youth—a narrative review. J Pediatr 2019;205:265–271.Google Scholar
de Nie, I, Meißner, A, Kosteli, EH, et al. Impaired semen quality in trans women: prevalence and determinants. Hum Reprod 2020;35(7):1529–1536.Google Scholar
Marsh, C, McCracken, M, Gray, M, et al. Low total motile sperm in transgender women seeking hormone therapy. J Assist Reprod Genet 2019;36(8):1639–1648.Google Scholar
Barnard, EP, Dhar, CP, Rothenberg, SS, et al. Fertility preservation outcomes in adolescent and young adult feminizing transgender patients. Pediatrics 2019;144(3):e20183520.Google Scholar
Leavy, M, Trottmann, M, Liedl, B, et al. Effects of elevated beta-estradiol levels on the functional morphology of the testis: new insights. Sci Rep 2017;7:39931.Google Scholar
Jiang, DD, Swenson, E, Mason, M, et al. Effects of estrogen on spermatogenesis in transgender women. Urology 2019;132:117–122.Google Scholar
Brik, T, Vrouenraets, LJJ, de Vries, MC, et al. Trajectories of adolescents treated with gonadotropin-releasing hormone analogues for gender dysphoria. Arch Sex Behav 2020;49(7):2611–2618.Google Scholar
Johnson, EK, Finlayson, C. Preservation of fertility potential for gender and sex diverse individuals. Transgend Health 2016;1(1):41–44.Google Scholar
Kolbuck, VD, Sajwani, A, Chen, D, et al. Formative development of a fertility decision aid for transgender adolescents and young adults: a multidisciplinary Delphi consensus study. J Assist Reprod Genet 2020 (online). https://doi.org/10.1007/s10815-020-01947-8Google Scholar
Practice Committee of the American Society for Reproductive Medicine. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril 2019;112(6):1022–1033.Google Scholar
Nahata, L, Woodruff, TK, Quinn, GP, et al. Ovarian tissue cryopreservation as standard of care: what does this mean for pediatric populations? J Assist Reprod Genet 2020;37(6):1323–1326.CrossRefGoogle ScholarPubMed
Albert, M, Hurrelmann, K, Quenzel, G. 17th Shell Jugendstudie: Jugend 2015. Frankfurt: S. Fischer Verlag, 2015.Google Scholar
Auer, MK, Fuss, J, Nieder, TO, et al. Desire to have children among transgender people in Germany: a cross-sectional multi-center study. J Sex Med 2018;15(5):757–767.Google Scholar
Wierckx, K, Van Caenegem, E, Pennings, G, et al. Reproductive wish in transsexual men. Hum Reprod 2012;27(2):483–487.Google Scholar
De Sutter, P, Kira, K, Verschoor, A, et al. The desire to have children and the preservation of fertility in transsexual women: a survey. Int J Transgend 2002;6(3):215–221.Google Scholar
Wierckx, K, Wierckx, K, Stuyver, I, et al. Sperm freezing in transsexual women. Arch Sex Behav 2012;41(5):1069–1071.CrossRefGoogle ScholarPubMed
Amir, H, Yaish, I, Oren, A, et al. Fertility preservation rates among transgender women compared with transgender men receiving comprehensive fertility counselling. Reprod Biomed Online 2020;41(3):546–554.Google Scholar
Chen, D, Matson, M, Macapagal, K, et al. Attitudes toward fertility and reproductive health among transgender and gender-nonconforming adolescents. J Adolesc Health 2018;63(1):62–68.Google Scholar
Strang, JF, Jarin, J, Call, D, et al. Transgender youth fertility attitudes questionnaire: measure development in nonautistic and autistic transgender youth and their parents. J Adolesc Health 2018;62(2):128–135.Google Scholar
Persky, RW, Gruschow, SM, Ninet Sinaii, MPH, et al. Attitudes toward fertility preservation among transgender youth and their parents. J Adolesc Health 2020;67(4):583–589.CrossRefGoogle ScholarPubMed
Chen, D, Simons, L, Johnson, EK, et al. Fertility preservation for transgender adolescents. J Adolesc Health 2017;61(1):120–123.CrossRefGoogle ScholarPubMed
Nahata, L, Tishelman, AC, Caltabellotta, NM, et al. Low fertility preservation utilization among transgender youth. J Adolesc Health 2017;61(1):40–44.Google Scholar
Wakefield, BW, Boguszewski, KE, Cheney, D, et al. Patterns of fertility discussions and referrals for youth at an interdisciplinary gender clinic. LGBT Health 2019;6(8):417–421.Google Scholar
Brik, T, Vrouenraets, LJJJ, Schagen, SEE, et al. Use of fertility preservation among a cohort of transgirls in the Netherlands. J Adolesc Health 2019;64(5):589–593.Google Scholar
Segev-Becker, A, Israeli, G, Oren, A, et al. Children and adolescents with gender dysphoria in Israel: increasing referral and fertility preservation rates. Endocr Pract 2020;26(4):423–428.CrossRefGoogle ScholarPubMed
Armuand, G, Dhejne, C, Olofsson, JI, et al. Transgender men’s experiences of fertility preservation: a qualitative study. Hum Reprod 2017;32(2):383–390.Google Scholar
Chen, D, Kyweluk, MA, Sajwani, A, et al. Factors affecting fertility decision-making among transgender adolescents and young adults. LGBT Health 2019;6(3):107–115.CrossRefGoogle ScholarPubMed
Chen, D, Simons, LJC. Ethical considerations in fertility preservation for transgender youth: a case illustration. Clin Pract Pediatr Psychol 2018;6(1):93.Google Scholar
Hudson, J, Nahata, L, Dietz, E, et al. Fertility counseling for transgender AYAs. Clin Pract Pediatr Psychol 2018;6(1):84–92.Google ScholarPubMed
Tishelman, A.C., Sutter, ME, Chen, D, et al. Health care provider perceptions of fertility preservation barriers and challenges with transgender patients and families: qualitative responses to an international survey. J Assist Reprod Genet 2019;36(3):579–588.Google Scholar
Nahata, L, Morgan, TL, Ferrante, AC, et al. Congruence of reproductive goals and fertility-related attitudes of adolescent and young adult males and their parents after cancer treatment. J Adolesc Young Adult Oncol 2019;8(3):335–341.Google Scholar
Morrison, A, Olezeski, C, Cron, J, et al. A pilot study to assess attitudes toward future fertility and parenthood in transgender and gender expansive adolescents. Transgend Health 2020;5(2):129–137.Google Scholar
Campo-Engelstein, L, Chen, D. Ethical issues in pediatric and adolescent fertility preservation. In Woodruff, TK and Gosiengfiao, YC, Eds. Pediatric and Adolescent Oncofertility. Cham: Springer, 2016.Google Scholar
Chen, D, Kolbuck, VD, Sutter, ME, et al. Knowledge, practice behaviors, and perceived barriers to fertility care among providers of transgender healthcare. J Adolesc Health 2019;64(2):226–234.Google Scholar
Klosky, JL, Anderson, LE, Russell, KM, et al. Provider influences on sperm banking outcomes among adolescent males newly diagnosed with cancer. J Adolesc Health 2017;60(3):277–283.Google Scholar
Quinn, GP, Bowman Curci, M, Reich, RR, et al. Impact of a web-based reproductive health training program: ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare). Psychooncology 2019;28(5):1096–1101.Google Scholar
Kyweluk, MA, Reinecke, J, Chen, D. Fertility preservation legislation in the United States: potential implications for transgender individuals. LGBT Health 2019;6(7):331–334.CrossRefGoogle ScholarPubMed
Quain, KM, Kyweluk, MA, Sajwani, A, et al. Timing and delivery of fertility preservation information to transgender adolescents, young adults, and their parents. J Adolesc Health 2020;68(3):619–622.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×