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Many transgender adults would opt to preserve fertility
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ORLANDO, Fla. — Almost one-quarter of transgender adults surveyed in Toronto reported valuing their fertility, and many expressed willingness to delay or temporarily halt hormonal transition to regain that fertility, according to a presenter at the Endocrine Society Annual Meeting.
“Many transgender individuals consider fertility to be important, but are lacking knowledge regarding their reproductive options,” Adam C. Millar, MD, MScCH, assistant professor at the University of Toronto and an endocrinologist at Mount Sinai Hospital, Toronto, told Endocrine Today. “This can result in patient regret after undergoing hormonal transition. This may represent a failure of health care providers to address the issue of fertility preservation prior to initiation of hormone therapy.”
Millar and colleagues administered a semi-structured questionnaire to transgender adults (median interquartile range age 27 years; 108 assigned male at birth) attending routine appointments at endocrinology and psychiatry clinics in Toronto; 213 questionnaires were included in the study.
Among the respondents, 78% (n=166) had undergone hormonal therapies, transition-related surgeries, or both. More of those assigned male at birth (18%) had children vs. those assigned female at birth (5%; P < .05); of those without children, 21% expressed a desire to have children in the future. Although 24% of all respondents rated their fertility as somewhat to very important, 61% reported that they lacked knowledge of options for preserving fertility. Regret about failing to bank sperm or eggs prior to hormonal therapy was reported by 8% of those who said they were aware of the options vs. 43% of those who expressed ignorance of fertility preservation options (P < .01); 77% said they had never discussed or did not remember discussing fertility options with a health care provider.
Prior to beginning therapy, 3% of respondents had fertility preservation; 72% of those remaining said they would not do anything differently, while 18% said they would be willing to temporarily suspend hormone therapy and 15% to delay therapy. Some (7%) said they would be willing to do “all it took” to regain their fertility. Cost (44%), lack of awareness of fertility options (22%) and treatment delay (20%) were commonly reported barriers to fertility preservation,
“The clinical implication is that early discussions with health care professionals about fertility preservation prior to initiating gender transition-related therapies may improve awareness of and access to available reproductive options,” Millar said. – by Jill Rollet
Reference:
Millar A, et al. SUN-110. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2017; Orlando, Fla.
Disclosures: Millar reports no relevant financial disclosures.