Transgenderism and reproduction

Abstract

Fertility is possible for both trans men and women, but it requires timely cryopreservation of gametes or stopping cross-sex hormones and possible fertility treatments which are costly and may be unpleasant. Centers should elucidate their policy and inform trans persons on the possibilities and limitations.

Oestrogen and anti-androgen therapy for transgender women

“…Many transgender women desire the opportunity to have their own biological children in the future, and seek cryopreservation of their sperm. 92 Results of a case series of 29 transgender women showed a high rate of abnormalities in sperm characteristics, even before the initiation of oestrogen therapy, including oligo-azoospermia (27%, eight of 29), teratozoospermia (31%, nine of 29), and asthenozoospermia (31%, nine of 29). 93 Why sperm characteristics are altered in transgender women even before initiation of hormone therapy is not clear.…”

Transfusion support for transgender men of childbearing age

“…These social or physical transitions are a personal choice, and there is not a standard set or sequence of medical or surgical interventions . Since many transgender people desire to have children, it is standard practice to discuss reproductive options and fertility issues before starting medical transition . Although the frequency of pregnancy in transgender men is not known, there are at least 40 cases described in the literature of transgender men who became pregnant after transitioning …”

“…For donors, sex identification is important to test for the presence of HLA alloantibodies, usually formed after a sensitization event such as pregnancy, for transfusion‐related acute lung injury risk mitigation . Collection facilities vary nationally in their testing algorithms for these antibodies, but to our knowledge, all strategies rely on donor identification as “female” before proceeding.…”

“…3 Since many transgender people desire to have children, it is standard practice to discuss reproductive options and fertility issues before starting medical transition. 4 Although the frequency of pregnancy in transgender men is not known, there are at least 40 cases described in the literature of transgender men who became pregnant after transitioning. 5 The World Professional Association for Transgender Health's Standards of Care provides multidisciplinary guidelines to support transgender people and health professionals during sex/gender transition.…”

“…7 For donors, sex identification is important to test for the presence of HLA alloantibodies, usually formed after a sensitization event such as pregnancy, for transfusionrelated acute lung injury risk mitigation. 4 Collection facilities vary nationally in their testing algorithms for these antibodies, but to our knowledge, all strategies rely on donor identification as "female" before proceeding. Additionally, sexual orientation is used as a risk prevention strategy: men who have sex with men in the previous year are considered higher risk for transfusiontransmitted HIV and are deferred from donation.…”