Abstract
Medical advances in assisted reproductive technology have created new ways for transgender persons to become parents outside the context of adoption. The limited empirical data does not support the idea that trans-parenthood negatively impacts children's development. However, the question has led to lively societal debates making the need for evidence-based studies urgent. We aimed to compare cognitive development, mental health, gender identity, quality of life and family dynamics using standardized instruments and experimental protocols in 32 children who were conceived by donor sperm insemination (DSI) in French couples with a cisgender woman and a transgender man, the transition occurring before conception. We constituted two control groups matched for age, gender and family status. We found no significant difference between groups regarding cognitive development, mental health, and gender identity, meaning that neither the transgender fatherhood nor the use of DSI had any impact on these characteristics. The results of the descriptive analysis showed positive psycho-emotional development. Additionally, when we asked raters to differentiate the family drawings of the group of children of trans-fathers from those who were naturally conceived, no rater was able to differentiate the groups above chance levels, meaning that what children expressed through family drawing did not indicate cues related to trans-fatherhood. However, when we assessed mothers and fathers with the Five-Minute Speech Sample, we found that the emotions expressed by transgender fathers were higher than those of cisgender fathers who conceived by sex or by DSI. We conclude that the first empirical data regarding child development in the context of trans-parenthood are reassuring. We believe that this research will also improve transgender couple care and that of their children in a society where access to care remains difficult in this population. However, further research is needed with adolescents and young adults.
Highlights
Individuals and couples with fertility issues have been able to conceive thanks to biomedical technology advances [1]
We aimed to compare cognitive development, mental health, gender identity, quality of life and family dynamics in children from transgender fathers conceived by donor sperm insemination (Trans-DSI group) and in two control groups matched for age, gender and family status: naturally conceived (NC group) children conceived by sex from cisgender parents and children from cisgender parents conceived by conventional DSI (Cis-DSI group)
There was no significant difference between the Trans-DSI and the NC group or between the Cis-DSI group and the NC group
Summary
Individuals and couples with fertility issues have been able to conceive thanks to biomedical technology advances [1]. These medical advances in assisted reproductive technology (ART) have created new ways for transgender persons to become parents outside the context of adoption [2]. It remains technically impossible to develop the capacity to procreate after gender affirming surgery that involves removal of gonads, but it is possible to help trans people use their own gametes with assisted reproductive technology (ART). The World Professional Association for Transgender Health (WPATH) recommends discussing fertility options with patients before any treatment or medical and/or surgical interventions [3]
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