Fertility Preservation in Transgender and Gender Non-conforming Adults [21A

Abstract

INTRODUCTION: Obstetricians and gynecologists play an important role in providing care to all persons who desire parenthood. However, there are limited studies assessing the preferences of transgender adults in achieving parenthood. We aimed to examine the importance of parenthood and preferred means to achieve it in a transgender adult population. METHODS: A cross-sectional survey of patients aged ≥ 18 years and who self-identified as a gender minority at an urban academic medical center and outpatient primary care center specializing in LGBTQ health. RESULTS: Sixty-two people completed the survey, of which 7 (11.3%) were born male and 55 (88.7%) were born female. The average age of participants was 28.2. Only 2 (3.2%) participants had children, although 52 (88%) reported desiring parenthood. Of those who desired parenthood, 14 (29%) preferred to achieve this using their own gametes, 12 (24%) preferred adoption and 14 (29%) preferred to use a gestational carrier without using their gametes. Only 34 (56%) reported that a healthcare provider discussed oocyte cryopreservation prior to transition. The largest barriers identified to oocyte cryopreservation were desire (33%), cost (58%), and stopping cross-sex hormones (25%). 10 (16.4%) believed their ability to have children was decided without their consent. CONCLUSION: In this survey of adult transgender patients, the majority are desiring parenthood. Barriers previously identified in the literature such as physical examination and provocation of periods/penile tumescence were not viewed to be as significant as cost and stopping cross-sex hormones. This knowledge can improve clinical discussions and identify the barriers that transgender patients experience in achieving parenthood.