Fertility Preservation in the Transgender and Nonbinary Population: A Survey Study [ID 2683653

Abstract

INTRODUCTION: To date, there are little data discussing fertility preservation desires of transgender and nonbinary adults. This study seeks to examine the demographic characteristics of transgender and nonbinary adults interested in or who have pursued fertility preservation as well as assess the barriers these adults face when interested in fertility preservation. METHODS: An online survey was designed by a team of researchers at an academic medical center. It was assessed for readability by an expert in survey design and reviewed for relevance by members of the transgender and nonbinary communities. It was distributed to an international audience. Participants were 18+, English-speaking, identified as non-cisgender, and had interest or previous experience in completing fertility preservation. The survey was distributed online from November 2022 to May 2023. Results were analyzed using REDCap Stats & Charts software. RESULTS: In total, 102 participants initiated the survey. Fifty-three participants met inclusion criteria for analysis. The majority of participants identified either as transgender woman (43.3%; 23) or nonbinary (32.1%; 17), with 18.9% (10) identifying as transgender man. 17 (32.1%) participants had previously preserved eggs, sperm, or embryos, and 36 (67.9%) were interested in, but had not yet pursued, fertility preservation. Of participants who had completed preservation, 94.1% (16) were assigned male at birth. Of those interested in fertility preservation, 61.8% (21) were assigned female at birth. In terms of barriers to preservation, 63.8% (23) quoted cost as a barrier, despite 91.4% (32) having insurance. CONCLUSION: This survey demonstrates that transgender and nonbinary adults are both interested in and have pursued fertility preservation. In our study sample, only transgender women had been able to complete fertility preservation, which may be illustrative of the more arduous and costly process of preserving oocytes versus sperm. Our results demonstrate, as anticipated, cost continues to be the most common barrier to fertility preservation.