Addressing fertility in gender-affirming care and its mental health implications: a cross-sectional study from Turkey

Abstract

Background: Transgender and non-binary (TNB) people may seek gender-affirming treatments and these treatments have well-known effects on fertility. Aims: The goal of this study was to identify TNB people’s desire for parenthood, perspectives on fertility preservation, and how possible involuntary childlessness in the future might negatively impact mental health. Methods: We conducted a cross-sectional questionnaire study. Participants self-reported their demographics and perspectives on parenthood and fertility preservation. In addition, they filled out scales for conceptual future parent grief (CFPG), perceived social support, perceived discrimination, satisfaction with life and depressive symptoms. Results: A total of 67 participants were included in the study. 58.2% wanted to have children and among them 56.4% preferred genetic parenthood. Of the participants using gender-affirming treatments, 35.1% were not informed about the adverse effects on fertility. 40.3% would utilize fertility preservation if given the opportunity. Analyses suggest that CFPG accounts for 3% of the variation in depressive symptoms. Conclusion: Addressing fertility and CFPG might be important for promoting the psychological well-being of TNB people. This study also highlights the need for revisiting fertility related legal and healthcare aspects of gender affirmation in Turkey.