Gender affirming treatment for transgender and non-binary adolescents has been shown to decrease depression and suicidality, increase confidence, and reduce anxiety. In this way, gender affirming hormones can be viewed as life-saving medications, but treatments have medical and social risks. For example, hormone treatment for gender dysphoria may impact patients' future fertility and child bearing capabilities. In this study, we interviewed transgender and gender nonconforming (TGNC) adolescents and solicited their thoughts on parenting, biological children, and family. We completed 23 interviews with TGNC adolescents aged 13-19 who had previously been seen at the Seattle Children’s Gender Clinic. Research associates recruited TGNC adolescents between ages 13 and 21 to participate in a one on one semi-structured interview. We sought out a diverse sample of interviewees, with attempts to enroll transfeminine, transmasculine, and gender non-conforming/non-binary patients. Interviews lasted between 15 minutes and an hour and included a number of questions on fertility. Interviews were recorded, transcribed, and uploaded unto Dedoose version 8.0.42, a web application that allows for collaborative transcript review. Two research associates analyzed and coded the interviews according to the theory of thematic analysis. TGNC adolescents have myriad views on fertility, family, and the importance of having one’s own biological children. Of 23 participants 11 identified as transfeminine, 9 as transmasculine, and 3 as gender non-conforming. Eighteen of 23 participants expressed interest in having their own families one day, but only half expressed interest in those families including biological children. Participants identified a number of barriers to future fertility including the cost of fertility treatment as well as the fear that reproductive sparing procedures would slow or complicate one’s social or medical transition. Many interviewees described feeling as though they had to come to terms with infertility as part of the transition process. Participants rarely described discussing this topic with care providers. Participants also described feeling a sense of discord at having to make fertility decisions earlier than their peers, and a few discussed the hope that future medical advances could allow them to have biological children. The TGNC youth we interviewed expressed a wide range of views on fertility, influenced by both first-hand experience and personal preferences. Given the diverse expectations and goals of this patient population, further study is needed to create a care paradigm that can guide affirming, developmentally-appropriate fertility consultations for adolescents seeking gender care.