Fertility preservation discussions, referral and follow-up in male-to-female and female-to-male adolescent transgender patients

Komorowski, Allison S.; Fisher, Andrew R.; Jungheim, Emily S.; Lewis, Christopher S.; Omurtag, Kenan

doi:10.1080/14647273.2021.2015804

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…Pooled estimates for each stage of the care pathway must be interpreted with caution due to inadequate and/or unclear reporting of follow-up and studies not reporting data on the full care pathway, in particular not reporting the numbers referred. This review did not extract information about fertility care for adolescents, which was reported by few of the identified studies and has been examined in separate studies 64–67…”

Section: Discussionmentioning

confidence: 99%

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Care pathways of children and adolescents referred to specialist gender services: a systematic review

Taylor,

Hall,

Langton

et al. 2024

Arch Dis Child

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BackgroundIncreasing numbers of children and adolescents experiencing gender dysphoria/incongruence are being referred to specialist gender services. However, little is currently known about the proportions accessing different types of care and treatment following referral.AimThis systematic review examines the range of care pathways of children/adolescents (under 18) referred to specialist gender or endocrinology services.MethodsDatabase searches were performed (April 2022), with results assessed independently by two reviewers. Peer-reviewed articles providing data for numbers of children and/or adolescents at referral/assessment and their treatment pathways were included. A narrative approach to synthesis was used and where appropriate proportions were combined in a random-effects meta-analysis.Results23 studies across nine countries were included, representing 6133 children and/or adolescents with a median age at assessment of 14–16 and overall a higher percentage of birth-registered females. Of those assessed, 36% (95% CI 27% to 45%) received puberty suppression, 51% (95% CI 40% to 62%) received masculinising or feminising hormones, 68% (95% CI 57% to 77%) received puberty suppression and/or hormones and 16% (95% CI 10% to 24%) received surgery. No study systematically reported information about the full pathway or psychological care received by children/adolescents. Follow-up in many studies was insufficient or unclear. Reasons for discontinuation were rarely provided.ConclusionsProspective studies with long-term follow-up reporting information about the full range of pathways are needed to understand what happens to children and adolescents referred to specialist gender services. Information about provision of psychological care is needed considering high rates of psychosocial difficulties in this population.PROSPERO registration numberCRD42021289659.

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Section: Discussionmentioning

confidence: 99%

“…This review did not extract information about fertility care for adolescents, which was reported by few of the identified studies and has been examined in separate studies. [64][65][66][67] on June…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Care pathways of children and adolescents referred to specialist gender services: a systematic review

Taylor,

Hall,

Langton

et al. 2024

Arch Dis Child

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“…Several scientific societies have issued guidelines navigating health care to the transgender population, recommending that all transgender individuals should receive a consultation about potential fertility risks of gender-affirming treatments and preservation options before transition ( 43 , 253 , 262 ). However, no guideline specifies the optimal time to initiate discussion and counseling, leading to some situations where patients have their first discussion about fertility preservation after the initiation of gender-affirming therapy ( 263 , 264 ). Inadequate and belated information provision puts patients in a dilemma between fertility preservation and discontinuation/delay of gender-affirming therapy.…”

Section: Transgender Populationmentioning

confidence: 99%

Fertility preservation in pediatric healthcare: a review

2023

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Survival rates for children and adolescents diagnosed with malignancy have been steadily increasing due to advances in oncology treatments. These treatments can have a toxic effect on the gonads. Currently, oocyte and sperm cryopreservation are recognized as well-established and successful strategies for fertility preservation for pubertal patients, while the use of gonadotropin-releasing hormone agonists for ovarian protection is controversial. For prepubertal girls, ovarian tissue cryopreservation is the sole option. However, the endocrinological and reproductive outcomes after ovarian tissue transplantation are highly heterogeneous. On the other hand, immature testicular tissue cryopreservation remains the only alternative for prepubertal boys, yet it is still experimental. Although there are several published guidelines for navigating fertility preservation for pediatric and adolescent patients as well as transgender populations, it is still restricted in clinical practice. This review aims to discuss the indications and clinical outcomes of fertility preservation. We also discuss the probably effective and efficient workflow to facilitate fertility preservation.

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Desire for children and fertility preservation in transgender and gender-diverse people: A systematic review

Stolk¹,

Asseler²,

Huirne³

et al. 2023

Best Practice & Research Clinical Obstetrics & Gynaecol

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Fertility preservation discussions, referral and follow-up in male-to-female and female-to-male adolescent transgender patients

Cited by 4 publications

References 12 publications

Care pathways of children and adolescents referred to specialist gender services: a systematic review

Care pathways of children and adolescents referred to specialist gender services: a systematic review

Fertility preservation in pediatric healthcare: a review

Desire for children and fertility preservation in transgender and gender-diverse people: A systematic review

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