Abstract
Purpose
While gender-affirming hormones (GAH) may impact the fertility of transgender and
gender diverse (TGGD) youth, few pursue fertility preservation (FP). The objective
of this study is to understand youth and parent attitudes toward FP decision-making.
Methods
This study is a cross-sectional survey of youth and parents in a pediatric, hospital-based
gender clinic from April to December 2017. Surveys were administered electronically,
containing 34 items for youth and 31 items for parents regarding desire for biological
children, willingness to delay GAH for FP, and factors influencing FP decisions.
Results
The mean age of youth (n = 64) was 16.8 years, and 64% assigned female at birth; 46
parents participated. Few youth (20%) and parents (13%) found it important to have
biological children or grandchildren, and 3% of youth and 33% of parents would be
willing to delay GAH for FP. The most common factor influencing youth FP decision-making
was discomfort with a body part they do not identify with (69%), and for the parents,
whether it was important to their child (61%). In paired analyses, youth and their
parents answered similarly regarding youth desire for biological children and willingness
to delay GAH for FP.
Conclusions
The majority of TGGD youth and parents did not find having biological offspring important
and were not willing to delay GAH for FP. Discomfort with reproductive anatomy was
a major influencing factor for youth FP decision-making and their child's wishes was
a major factor for parents. Future qualitative research is needed to understand TGGD
youth and parent attitudes toward FP and to develop shared decision-making tools.
Keywords
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Article info
Publication history
Published online: April 29, 2020
Accepted:
February 26,
2020
Received:
September 26,
2019
Footnotes
Conflicts of interest: The authors have no conflicts of interest relevant to this article to disclose.
Identification
Copyright
Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.
