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Fertility Preservation in Patients with Gender Dysphoria

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Textbook of Oncofertility Research and Practice

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Abstract

The Endocrine Society began publishing clinical practice guidelines for care of transgender persons in 2009. Since that time, society and the medical community have experienced increased acceptance of gender transition in persons with gender dysphoria. The hormonal treatment of transgender individuals may render them infertile, and thus, the guidelines recommend that individuals starting gender-affirming hormones be counseled about their effects on fertility and possible fertility preservation options. In this chapter, we examine hormonal treatments for individuals with gender dysphoria, their effects on fertility, fertility preservation options, and attitudes toward/update of fertility preservation among transgender individuals.

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Notes

  1. 1.

    Intentionally grammatically incorrect to avoid using binary gender-based terminology.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Jason Jarin

  2. Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Emilie K. Johnson

  3. Department of Urology and Center for Healthcare Studies, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Emilie K. Johnson

  4. Department of Women and Infant Services, Department of Surgery, MedStar Washington Hospital Center, Children’s National Medical Center, Washington, DC, USA

    Veronica Gomez-Lobo

Authors
  1. Jason Jarin
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  2. Emilie K. Johnson
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  3. Veronica Gomez-Lobo
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Corresponding author

Correspondence to Emilie K. Johnson .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Northwestern University , Chicago, IL, USA

    Teresa K. Woodruff

  2. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA

    Divya K. Shah

  3. Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA

    Wendy S. Vitek

Review Questions and Answers

Review Questions and Answers

  1. Q1.

    What types of hormonal therapies cause subfertility in individuals with gender dysphoria?

  2. A1.

    Pubertal suppression and gender-affirming hormones (testosterone for trans-men and estrogen for trans-women) can both cause subfertility. Both are thought to be at least partially reversible once stopped.

  3. Q2.

    True or false: Trans-men who have used testosterone cannot carry a pregnancy.

  4. A2.

    False – Trans-men who have previously used testosterone can carry a pregnancy, although testosterone must be stopped before attempting pregnancy.

  5. Q3.

    Which fertility preservation options are not recommended for adolescents with gender dysphoria, according to WPATH?

  6. A3.

    Ovarian or testicular tissue cryopreservation is currently considered experimental and is not recommended for adolescents due to (1) the need to potentially perform irreversible procedures (gonadectomy), (2) lack of data regarding potential success of the procedures, and (3) unclear data regarding exact gonadotoxicity of gender-affirming hormones.

  7. Q4.

    Approximately what percentage of transgender adolescents attempt fertility preservation prior to the initiation of gender-affirming hormones?

  8. A4.

    Approximately 3–4%, with sperm banking being more commonly reported than oocyte cryopreservation.

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Jarin, J., Johnson, E.K., Gomez-Lobo, V. (2019). Fertility Preservation in Patients with Gender Dysphoria. In: Woodruff, T., Shah, D., Vitek, W. (eds) Textbook of Oncofertility Research and Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-02868-8_5

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  • DOI: https://doi.org/10.1007/978-3-030-02868-8_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-02867-1

  • Online ISBN: 978-3-030-02868-8

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