Conceptions of transgender parenthood in fertility care and family planning in Sweden: from reproductive rights to concrete practices

Abstract

It is an oft-repeated trope that the recent medical advances in the field of assisted reproduction have radically transformed the ways in which we can achieve, practice and imagine parenthood. This development has enabled new forms of non-heterosexual family constellations, including same-sex nuclear families and solo-parents by choice, and as a result an increasing number of groups are mobilising politically for access to fertility treatments. Swedish transgender patients are one of these groups; after many years of political mobilisation, they are no longer required by law to go through sterilisation as a compulsory part of gender corrective surgery, and instead today, all transgender patients are offered fertility preservation through gamete freezing. This, in turn, has meant not only that Swedish fertility clinics have faced an entirely new patient group-the transgender fertility patient-but also that the cultural imagination of who can become a parent and what a family might look like is becoming further destabilised. Building on interviews with medical staff, LGBTQ-advocates and complementing qualitative data, this paper seeks to shed light on the very process by which these new rights are translated in the practical context of the fertility clinic, and also what it means, more generally, for cultural imaginations of parenting when a group whose reproductive futures were previously considered either impossible or undesirable are now 'anticipating infertility' and engaging in 'family planning' as central parts of their lifecourse and medical engagements.

Fertility preservation and fertility treatment in transgender adolescents and adults in a Swedish region, 2013–2018

“…This law required a person to be unmarried and sterilized in order to complete the legal gender change. However, this requirement was abandoned according to the new amended Swedish law dated 1 July 2013 ( Swedish Law (2013 :405); Payne and Erbenius, 2018 ).…”

A qualitative study examining transgender people’s attitudes towards having biological children and pursuing fertility treatments in Greece

“…However, within the recently changing legal framework that greatly strengthened transgender rights by allowing citizens to choose to legally change their gender identity, more transgender people are expected to use fertility clinics. If this is the case, fertility clinics will face an entirely new patient group (transgender people) 'whose reproductive futures were previously considered either impossible or undesirable [and] are now "anticipating infertility" and engaging in "family planning" as central parts of their lifecourse and medical engagements', as Payne and Erbenius (2018) wrote with respect to Sweden [22].…”

Ethical issues involving fertility preservation for transgender youth

“…Transgender youth might not avail themselves of fertility preservation for many reasons. These include distress over the use and effects of assigned gender hormones during the preservation process; production of gametes of the assigned gender; dysphoria with the anatomic area involved or the procedures; the patients' immature decision-making or inability to consider the future; cost or lack of insurance coverage; invasiveness of gamete retrieval; lack of knowledge about how to access FP services; potential delay in gender affirming treatment; and mood disorders affecting decision-making [24,[26][27][28][29][30][31][32]. One study found that most transgender youth want children; however, only a quarter want genetically related children [33].…”