SAT408 Assessment Of Family Planning Readiness In Transgender Youth

Abstract

Abstract Disclosure: R.S. Conard: None. L.J. Folsom: None. Background: Transgender individuals identify with a gender incongruent with the sex assigned at birth. Some seek medical care in the form of gender affirming hormone therapy (GAHT) or gender affirming surgery (GAS). GAHT initiated in adolescence may include GnRH analogues and cross-sex hormones. Barriers to family planning in this population include low utilization of cryopreservation and decisional regret. There is a paucity of data on the risk of infertility with GAHT, and on to what degree transgender adolescents feel informed about fertility and family planning options. Objective: To assess knowledge regarding options for family planning and fertility preservation in transgender adolescents treated with GAHT in a pediatric endocrinology gender clinic. The goal is to enhance patient education about potential effects of GAHT on fertility and options for family planning. Methods: 41 adolescent patients aged 10 years and older treated with GAHT in an urban outpatient pediatric endocrinology clinic were surveyed from January to June 2022. Survey questions were multiple choice, Likert scale, and open-ended. To be included participants were at least 10 years of age, actively followed in the clinic, and receiving GAHT at time of enrollment. Results: 41 participants completed the survey. Four (10%) expressed interest in discussing family planning with their provider at the time of survey completion. 18 (45%) were open to discussion in the future; 16 (39%) were not interested at all. 13 (32.5%) participants were planning for future parenthood, and 16 (40%) participants were undecided. Of those interested in parenthood 7 (53.8%) planned to adopt or foster. Barriers to family planning expressed included financial concerns, potential need to pause GAHT, and social stigma of transgender parenthood. 20 (50%) participants reported prior family planning discussion with their endocrinologist. Conclusion: Despite routine family planning discussions documented during visits, these may not be optimally impactful given that 50% of participants did not recall the conversations. Family planning appears to be of lower priority in this population as most desired to postpone discussions with their provider despite undergoing treatment that could influence fertility. Our findings indicate it is essential to actively identify methods to engage transgender youth in discussions related to family planning during GAHT. Presentation: Saturday, June 17, 2023