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Are Transgender Youth Considering Fertility Preservation?

What type of questions should transgender youth be considering when it comes to their fertility?

November 22, 2019
Bridget Houlihan

When you’re young, fertility preservation isn’t the first thing on your mind. In fact, unless you have a condition that might affect your fertility, you might not even consider that fertility preservation could be an option. It is also something that transgender youth might be interested in, however, as this study shows, they might not be getting all the information they need. There are very few transgendered youth who actually opt to participate in fertility preservation prior to their medical transition, but who still would consider becoming parents in the future.


 In this article we’re going to examine:


  • Types of fertility preservation available for transgender youth
  • What are some of the barriers facing transgender youth when it comes to fertility preservation


sperm and egg
There are a couple of options for transgendered individuals who might consider parenthood in the future.

Types of Transgender Fertility Preservation Available

Transgender individuals should be counseled on their options

There are a couple of different options to transgender individuals who are interested in fertility preservation before they undergo their medical transition. Medical transitions typically consist of hormone therapy and might also include physical alteration of genitals through reassignment surgery. If an individual is considering this, their doctor should also make them aware of their options regarding fertility preservation for the future. These types of procedures might affect fertility and chances at conception in the future, which is why it is so important for a transgender individual to have an informed discussion with their doctor.

Female to male preservation

One method of fertility preservation is oocyte preservation for transgender males. This process involves the removal of eggs in order for them to be frozen and allow for fertilization in the future. If a transgender man decides to under go this process, they will first have to receive hormones that cause the ovaries to produce eggs. After about 10-12 days of this, the unfertilized eggs will then be removed and stored in cryostorage. These eggs can be dethawed in the future and fertilized during and IVF procedure.

Male to female preservation

Sperm preservation is an option for transgender women, and can be done in a clinic or at home. This method freezes the sperm for an indefinite amount of time and allows the transgender woman the freedom to choose when she wants to have biological children. When she is ready, the sperm will be dethawed and used to fertilize her partner’s egg or a donated one.

Embryo freezing

Another option for transgender couples is to have an embryo frozen before they begin their medical transition. This process would involve a fertilized embryo that is from either or both partners. This embryo would then be frozen and could be dethawed in the future after the gender reassignment process is complete.

scientist working with bloodwork
Having all the information you need regarding fertility preservation can help transgendered individuals make the right decision for themselves.

Barriers to Transgender Fertility Preservation

Few transgender youth elect to undergo fertility preservation

While there are options out there for transgender individuals to ensure their fertility preservation, according to reports, not many decide to complete this process. According to the study done by the Ann and Robert Lurie Children’s Hospital of Chicago, only 12% of those opting to pursue hormone therapy decided to see a fertility specialist. Of that 12%, less than 5% of that group decided to start and complete fertility preservation.


The researchers were able to identify the major barriers facing transgendered individuals when it comes to fertility preservation. The major issues were the invasiveness of the procedure, the cost, and their reluctance to delay their hormone therapy. The invasiveness of the procedure was especially an issue for transgender men, who experience high levels of body dysphoria that can be amplified by the preservation process. The fertility preservation process for transgender men requires 10-14 days of hormone injections and trans-vaginal monitoring that culminates in the removal of unfertilized eggs. This particular study looked at 105 transgender people, and found that only 13 met with a fertility specialist and five individuals underwent a fertility preservation procedure. 


The team also noted that once the individuals had begun their hormone therapy and were starting to feel more comfortable in their bodies, they tended to consider the possibility of becoming parents in the future. The researchers want to dig deeper into this concern, and understand why transgendered youth just are not considering fertility preservation when perhaps they should be. It may be an education issue, as some individuals are not prepared to speak at length about this very personal process with a professional. On the other hand, it might be a lack of sensitivity when it comes to doctors discussing these issues with their transgendered patients. 


Although it might seem like a far way off, once these individuals are armed with the right information, as well as knowledge of all the options out there, transgender youth should consider their reproductive future. It is important for them to understand that their biological options might not always be available, so to ensure it is, a method of fertility preservation might be a good course of action.


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