A Qualitative Study Examining Transgender People’s Attitudes Toward The Desire to Have Biological Children and Pursue Fertility Treatments in Greece

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background:</jats:bold> Biomedical technologies advances permit transgender individuals not only to achieve gender transition but also experience parenthood. Little is known about it in Greece, a traditionally conservative country, which however, is changing at legal level towards greater recognition of transgender people’s rights. This study aimed to investigate transgender people’s attitudes toward the desire to have biological children and pursue fertility treatments in Greece.<jats:bold>Methods: </jats:bold>This is a prospective study among adult individuals who identified as transgender men or transgender women between April 2019 and March 2020. Individual in-depth qualitative interviews were conducted with twelve participants. The interviews were conducted in person and were digitally recorded and transcribed verbatim. The authors performed an inductive analysis of data.<jats:bold>Results:</jats:bold> The inductive analysis of the study findings resulted in the following themes that represent key barriers to pursuing FP or ART: lack of fertility counseling, fears of discrimination and bullying, high costs, concerns related to the child’s welfare, less than perfect legal framework, and gender transition. Not all participants expressed strong desire to have offspring. A number of sub-themes were grouped under the base themes. Concerns related to the child’s welfare due to factors related to context or transgender people themselves. Fertility treatment may impact negatively the process of transition or the result of it. The strength of the desire for fertility treatment is crucial. Various reasons behind the transgender people’s desire for parenthood were identified. Transgender individuals (especially those in social transition) showed striking adherence to patterns of the dominant culture when it comes to having children.<jats:bold>Conclusion: </jats:bold>The results demonstrate the importance of a) contextual factors (stigma, economic instability, law), b) factors related to transgender people themselves (gender dysphoria, desire to become parents, self-trust), as well as c) the preferred type of gender transition (social or medical) in considering or pursuing fertility preservation or assisted reproductive technologies. Transgender people’s attitude towards having children is a complex topic in need for further investigation. We stress the need for training health professionals to establish a safe environment for transgender people who want to undergo fertility treatment, go through pregnancy and give birth.</jats:p>