Abstract
Purpose:
In this pilot study, we sought to characterize the knowledge about fertility and attitudes about future parenthood in a sample of transgender and gender expansive (TGE) youth attending an academic, university-affiliated adolescent gender program.
Methods:
A 22-item cross-sectional survey assessing knowledge of fertility issues and attitudes toward future parenthood was administered to 23 transgender adolescents, 12–22 years of age, who reported gender identity incongruent with birth-assigned sex, and who were seen at our university-affiliated clinic during an 11-month period between October 2016 and August 2017. Knowledge scores and ranked responses on selected topics in fertility and reproduction were evaluated.
Results:
Participants were well informed overall about fertility topics related to their gender care (mean score of 3.8±0.8 out of 5), but over half of participants lacked specific knowledge regarding basic fertility principles and overestimated the ability of physicians to predict the effects of gender-affirming hormone therapy on fertility. The majority of participants (15/23) preferred nonbiological parenthood in the form of adoption. Participants who ranked future parenthood as unimportant had the greatest concern about becoming a parent (p<0.05), and over one-third were also concerned about interrupting their gender-affirming hormone therapy to preserve fertility.
Conclusion:
TGE youth would benefit from fertility-related counseling that both assesses baseline understanding of reproduction and also acknowledges the limitations of current data on gender-affirming hormones and future fertility. Counseling should also be comprehensive and explore both biological and nonbiological forms of parenthood.
Get full access to this article
View all access options for this article.