Abstract
Transgender and gender diverse (TGD) individuals experience significantly greater all-cause mortality and mental health disparities compared to their cisgender peers. Gender-affirming hormone therapy (GAHT) is a safe and effective treatment option for gender dysphoria that dramatically improves psychosocial health outcomes but may adversely impact fertility. Guidelines recommend medical fertility preservation (FP) counseling for TGD individuals and pre-fertility treatment psychoeducational implications consultation from qualified reproductive mental health professionals (MHPs) for TGD individuals pursuing FP or third-party reproductive treatment. However, sparce literature exists specific to the structure of mental health psychoeducational consultation for TGD individuals pursuing FP. This narrative review highlights aspects of mental health implications pre-fertility treatment consultation for the provision of supportive counseling. Results indicate that implications counseling should be conducted by an MHP with specialized training in reproductive mental health with TGD populations to reduce risk of harm and promote successful emotional navigation of fertility treatment. Such counseling should be psychoeducational and not gatekeeping in nature and may include consideration of the psychosocial (e.g., emotional, relational, ethical, spiritual, social) risks and benefits of various family building options. During these consultations, TGD individuals can explore their hopes and fears related to fertility and future family building plans and discuss realistic treatment expectations, individual strengths, coping and communications strategies, and identify key support network members which may aid in navigating the fertility treatment process. MHPs can provide referrals to appropriate resources if necessary to help TGD individuals navigate treatment while coping with psychological symptoms and promote behavior change.
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