Many transgender individuals lack knowledge and access to fertility options, survey finds

Nearly one-fourth of transgender individuals in Toronto, Canada, regard their own fertility as important, but most lack knowledge regarding and access to reproductive options, a new survey finds. Results of the survey will be presented Sunday at the Endocrine Society's 99th annual meeting in Orlando, Fla.

"Modern techniques allow people of transgender experience to have biological children by freezing their sperm or eggs before hormone treatment," said the study's senior investigator, Adam Millar, M.D., an assistant professor at the University of Toronto and an endocrinologist at Mount Sinai Hospital, Toronto. "This option was not offered to transgender people in the past, but our study shows that 97 percent of transgender individuals feel that the option to freeze sperm or eggs should be offered to them prior to treatment that may affect their fertility."

Millar said it is important to study transgender people because they have traditionally been excluded from population health and sexuality research. He and his co-workers surveyed transgender patients attending routine medical visits at three medical centers in Toronto about their knowledge and beliefs regarding fertility.

A total of 213 adults, ages 17 to 69, completed the written questionnaire: 108 who were assigned male at birth and 103 assigned female. Most participants (78 percent) had already undergone hormone therapy or gender transition surgery, according to the study abstract.

Reported survey findings included the following:

• Among the childless respondents, 21 percent (40 of 187) expressed the desire to have children in the future.
• Of the 64 respondents who said they lacked knowledge about their fertility options, 77 percent (49) said they never discussed this subject with their health care provider.
• Only 3 percent of participants (seven) had sperm or eggs banked before hormone treatment.
• The most commonly noted barriers to fertility preservation were cost (44.1 percent), lack of awareness of the option (21.6 percent) and not wanting to delay starting hormone therapy (19.7 percent).

"Early discussions with health care professionals about fertility preservation before commencing gender transition-related therapies may improve awareness of and access to available reproductive options," Millar said.