Abstract
Twelve providers (eight institutions) participating in a Gender and Sex Diversity Fertility Working Group completed a survey assessing their hospital's transgender, disorders/differences of sex development (DSD), and fertility healthcare teams. Participants also prioritized the development of a: (1) Provider Assessment Tool (questionnaire assessing knowledge/feelings about future fertility), or (2) decision aid (DA). Healthcare team presence by institution: transgender (6/8; 75%), DSD (75%), and fertility preservation (75%). Two-thirds of providers reported that the DA was most needed. Respondents recommended the DA to: help manage complex information, have a take-home reference, and provide neutral information. Other identified resource needs included: fertility specialists in clinic and financial resources.
Highlights
The term ‘‘gender and sex diversity’’ encompasses the following: (1) transgender individuals for whom gender identity is incongruent with phenotypic sex, and (2) individuals with disorders/differences of sex development (DSD), for whom chromosomal, gonadal, or anatomic sex development is atypical.[1]
Medical decisions impacting the future fertility of transgender and DSD patients are complex, and often must be made in childhood, yet no clinical tools or guidelines exist to guide discussions about future fertility and fertility preservation (FP) with the families of gender and sex diverse individuals
Clinical tool development preferences Nine providers (75%) expressed a preference for developing either a Provider Assessment Tool or a decision aid (DA)
Summary
The term ‘‘gender and sex diversity’’ encompasses the following: (1) transgender individuals for whom gender identity is incongruent with phenotypic sex, and (2) individuals with disorders/differences of sex development (DSD), for whom chromosomal, gonadal, or anatomic sex development is atypical.[1]. Many treatments (e.g., gender-affirming hormones, gonadectomy) currently offered to young transgender and DSD patients can affect future fertility.[2] Medical decisions impacting the future fertility of transgender and DSD patients are complex, and often must be made in childhood, yet no clinical tools or guidelines exist to guide discussions about future fertility and fertility preservation (FP) with the families of gender and sex diverse individuals. Similar to the parents of gender and sex diverse children, parents of pediatric cancer patients face decisions related to potentially preserving their children’s future fertility. Challenges in this setting include the following: (1) Necessity of parental proxy decision-making; (2) uncertainty regarding future assisted reproductive technologies, related to maturation of immature reproductive tissue into usable adult eggs or sperm; and (3) cost of long-term tissue storage. Clinical guidelines regarding FP,[3,4] and patient decision aids (DAs) are available to guide care.[5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
