Trans Peoples' Interest in Reproduction and Fertility Preservation: a Cross-Sectional, Descriptive study into Barriers to Reproductive Care.

Abstract

Introduction: Trans folks comprise a growing, vulnerable population. Historically, gender-affirming care was synonymous with the loss of reproductive options. Trans and fertility care have been evolving, as such, inquiry into current reproductive interest and barriers to reproduction is warranted.

Objective: To ascertain trans peoples' interest in reproductive choices. Our secondary objective was to understand barriers to meeting their reproductive goals.

Methods: We conducted a descriptive cross-sectional study using a one-time anonymous survey. Analysis was conducted using descriptive statistics and a thematic analysis by means of inductive coding.

Results: Analysis of trans participants' responses revealed 82% (N = 169) of participants are interested in pursuing reproductive options (biologically related children, donor gametes, gestational carriers, or fertility preservation). Sixty eight percent (N = 172) of participants are taking gender affirming hormone therapy or plan to start. Forty nine percent (N = 124) have had, or plan to have, gender-affirming surgery that affects fertility. Trans folks experience many barriers when accessing fertility care; cost, and trans-specific barriers were the most common and insurmountable barriers.

Conclusions: Our study highlights that trans folks are interested in reproductive options. However, many trans folks experience significant barriers to meeting their reproductive goals and the impact is significant to quality of life. With most of our survey population identifying as trans at an age, during the window of peak fertility, we highlight the importance of early assessment and treatment to achieve fertility goals.