Trans persons' ideas and concerns about fertility and fertility preservation: a population-based survey
Defreyne, J1; Motmans, J1; Tillemans, K1; T'Sjoen, G1
1: Ghent University Hospital, Belgium
Objectives: Although theoretically options for trans persons to fulfill their child wish are nowadays extensive, fertility preservation utilization rates remain low. The ideas and concerns of trans persons regarding fertility preservation and child wish have never been reported on a large, non-clinical sample.
Materials and Methods: A web-based anonymous survey on fertility and parenthood was conducted in Belgium in 2017. All self-identified trans persons aged 16 years or older were invited to participate, including gender non binary (GNB+) persons, previously ignored in studies on fertility.
Results: The questionnaire was filled out by 426 participants (116 trans men (TM), 196 trans women (TW), 100 GNB+ persons and 14 transvestites). One hundred sixteen (27.2%) respondents had a current/future child wish. Child wish was already fulfilled in 95 (22.3%) and inexistent in 152 persons (35.7%), other categories accounted for 14.8%. GNB+ persons (21; 22.8%) less frequently reported a future/current child wish, compared to TM (43; 39.1%, ; P=0.013), (TW 51; 26.0%). Eighty-two persons (19.3%) considered the loss of fertility due to the transitioning process as undesirable. More GNB+ persons (26; 44.8%) indicated that the loss of fertility was undesirable, compared to TW (32; 23.7%, P=0.003) or TM (23; 19.8%). A majority (62.4%) did not wish for fertility preservation, and GNB+ (2; 2.0%) were less likely to proceed with fertility preservation (which could be explained by the fact that they were less likely to search for medical help), compared to TM (4; 3.4%, P=0.032) and TW (12; 6.1%, P=0.011). Barriers encountered for fulfilling the child wish included: the adoption procedure (70; 16.4%), fear of discrimination against the child (68; 16.0%) and the price for using own oocytes in TM and birth-assigned female GNB+ (43; 10.1%).
Conclusion: Fertility preservation utilization in our trans population is lower than in previous research on clinical samples, although child wish is comparable. GNB+ persons have different needs for gender affirming treatment and subsequently, for fertility preservation. Fertility preservation utilization rates are similar in TM and TW, although theoretically, the procedure is more straightforward in TW. This could be explained by the significantly older age of TW in our sample. These low utilization rates reflect the barriers trans persons face when considering fertility options.
This work is supported by Fonds voor Wetenschappelijk Onderzoek (FWO) TBM T001816N.
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