Perspectives on fertility preservation and parenthood among transgender youth and their parents

• Published in: Archives of disease in childhood 2019-08, Vol.104 (8), p.739-744
• Main Authors: Chiniara, Lyne Noelle, Viner, Christine, Palmert, Mark, Bonifacio, Herbert
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent health; Adolescent Health Services; Adolescents; Birth; Caregivers; Child; Child Health; Children; Cross-Sectional Studies; Family planning; Female; Females; Fertility; Fertility Preservation; Gender; Gender dysphoria; Gender Dysphoria - psychology; Gender identity; gender variance; Gender-affirming care; gender-affirming hormones; Health Knowledge, Attitudes, Practice; Hormones; Humans; Individual Characteristics; Infertility; Male; Medical Services; Mental Health; Ontario; Parent Surveys; Parents; Parents - psychology; Participant Characteristics; Pediatrics; Physical Characteristics; Physicians; Population studies; Preservation; Puberty; Questionnaires; Readability; Sexual Identity; Social Support Groups; Surveys and Questionnaires; Teenagers; Transgender persons; Transgender Persons - psychology; Young adults; Youth
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2018-316080

ObjectiveThe aim of this study was to investigate the views of young people (YP) with gender dysphoria and their parents concerning fertility preservation and reproductive and life priorities.DesignA cross-sectional questionnaire-based study assessed knowledge of potential effects of treatments for gender dysphoria on fertility, current and future life priorities and preferences regarding future fertility/parenting options among YP and parents.ResultsA total of 79 YP (81% assigned female at birth [AFAB], 19% assigned male at birth [AMAB], aged 12–18 years, 68% between ages 16 years and 18 years) and 73 parents participated. The top current life priority for YP among eight options was being in good health; the least important priority was having children. Anticipated life priorities 10 years from now were ranked similarly. Parents’ rankings paralleled the YP responses; however, parents ranked having children as a significantly higher priority for AFAB compared with AMAB YP in 10 years. The majority of YP (66% AFAB, 67% AMAB) want to be a parent in the future. However, most do not envision having a biological child. A large majority (72% AFAB, 80% AMAB) were open to adoption. None of the YP surveyed pursued fertility preservation.ConclusionFertility is a low current and future life priority for transgender YP. The majority of YP wish to become parents but are open to alternative strategies for building a family. These data may explain in part the reported low rates of fertility preservation among this population. Further studies are needed to assess if life priorities change over time.