Fertility preservation discussions, referral and follow-up in male-to-female and female-to-male adolescent transgender patients

Allison S. Komorowski, Andrew R. Fisher, Emily Jungheim, Christopher S. Lewis, Kenan R. Omurtag

Research output: Contribution to journalArticlepeer-review

Abstract

The number of patients seeking transgender healthcare is growing, and there is a potential impact of gender-affirming therapies on fertility. The use of fertility preservation (FP), particularly among transgender adolescents, has been limited. We aimed to examine differences in FP counselling, referral and utilisation between male-to-female (MtF) and female-to-male (FtM) transgender adolescents. A retrospective review of the medical records of patients ages 12–17 seen at an academic medical centre between 2012 and 2017 with a diagnosis of gender dysphoria was conducted. A total of 22 MtF and 45 FtM adolescents were included. The counselling on the potential fertility impact of gender-affirming therapy was documented in 55%, and of those counselled, 73% were counselled before receiving medication. There was no significant difference between the timing of counselling for MtF versus FtM adolescents. Of patients with documented reproductive wishes, 77% reported either desire for adopted children or no desire for biological children. Among patients offered FP referral, 2 (22.2%) MtF and 3 (12.5%) FtM patients accepted; both MtF patients cryopreserved sperm. While most adolescents were counselled on the fertility impact of gender-affirming therapy, there is room for improvement as 45% of patients had no documented counselling. The rate of transgender adolescents pursuing FP consultation and gamete cryopreservation was low, consistent with prior studies in this population.

Original languageEnglish
JournalHuman Fertility
DOIs
StateAccepted/In press - 2021

Keywords

  • adolescent
  • fertility preservation
  • gamete cryopreservation
  • gender-affirming treatment
  • hormonal therapy
  • Transgender

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