J D Asseler, I de Nie, F B van Rooij, T D Steensma, D Mosterd, M O Verhoeven, M Goddijn, J A F Huirne, N M van Mello
{"title":"变性人对以往生育决策和当前不孕症的看法：一项定性研究。","authors":"J D Asseler, I de Nie, F B van Rooij, T D Steensma, D Mosterd, M O Verhoeven, M Goddijn, J A F Huirne, N M van Mello","doi":"10.1093/humrep/deae155","DOIUrl":null,"url":null,"abstract":"<p><strong>Study question: </strong>How do adult transgender and gender diverse (TGD) people, who are infertile due to prior gender-affirming treatment, view their current infertility and their reproductive decisions made in the past?</p><p><strong>Summary answer: </strong>In a time where sterilization was mandatory, transgender adolescents prioritized gender-affirming treatment over their future fertility and would make the same choice today despite emotional challenges related to infertility experienced by some.</p><p><strong>What is known already: </strong>Under transgender law in the Netherlands, sterilization was required for legal gender recognition until 2014, resulting in permanent infertility. The long-term consequences of this iatrogenic infertility in transgender adolescents who have now reached adulthood remain underexplored.</p><p><strong>Study design, size, duration: </strong>Qualitative study design based on 21 in-depth one-on-one semi-structured interviews.</p><p><strong>Participants/materials, setting, methods: </strong>TGD people in a stage of life where family planning may be a current topic were eligible for participation. They all received gender-affirming treatment in adolescence prior to the legislation change in 2014. A purposeful sampling technique was used from participants of another ongoing study. Eleven people assigned female at birth and ten people assigned male at birth were included. Interview transcripts were thematically analysed using a modified version of Braun and Clarke's six steps theory.</p><p><strong>Main results and the role of chance: </strong>Six main themes were generated: (i) personal considerations regarding fertility and fertility preservation in the past; (ii) external considerations regarding fertility and fertility preservation in the past; (iii) current vision on past considerations and decisions; (iv) Current experiences and coping with infertility; (v) future family building; (vi) advice regarding fertility and fertility preservation decision-making.</p><p><strong>Limitations, reasons for caution: </strong>Selection, recall, and choice supportive bias may play a role in interpreting our results.</p><p><strong>Wider implications of the findings: </strong>This study highlights the importance of tailored counselling and comprehensive information on fertility preservation for transgender individuals, especially adolescents, undergoing gender-affirming treatment.</p><p><strong>Study funding/competing interest(s): </strong>N/A.</p><p><strong>Trial registration number: </strong>N/A.</p>","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"2032-2042"},"PeriodicalIF":6.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373325/pdf/","citationCount":"0","resultStr":"{\"title\":\"Transgender persons' view on previous fertility decision-making and current infertility: a qualitative study.\",\"authors\":\"J D Asseler, I de Nie, F B van Rooij, T D Steensma, D Mosterd, M O Verhoeven, M Goddijn, J A F Huirne, N M van Mello\",\"doi\":\"10.1093/humrep/deae155\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study question: </strong>How do adult transgender and gender diverse (TGD) people, who are infertile due to prior gender-affirming treatment, view their current infertility and their reproductive decisions made in the past?</p><p><strong>Summary answer: </strong>In a time where sterilization was mandatory, transgender adolescents prioritized gender-affirming treatment over their future fertility and would make the same choice today despite emotional challenges related to infertility experienced by some.</p><p><strong>What is known already: </strong>Under transgender law in the Netherlands, sterilization was required for legal gender recognition until 2014, resulting in permanent infertility. The long-term consequences of this iatrogenic infertility in transgender adolescents who have now reached adulthood remain underexplored.</p><p><strong>Study design, size, duration: </strong>Qualitative study design based on 21 in-depth one-on-one semi-structured interviews.</p><p><strong>Participants/materials, setting, methods: </strong>TGD people in a stage of life where family planning may be a current topic were eligible for participation. They all received gender-affirming treatment in adolescence prior to the legislation change in 2014. A purposeful sampling technique was used from participants of another ongoing study. Eleven people assigned female at birth and ten people assigned male at birth were included. Interview transcripts were thematically analysed using a modified version of Braun and Clarke's six steps theory.</p><p><strong>Main results and the role of chance: </strong>Six main themes were generated: (i) personal considerations regarding fertility and fertility preservation in the past; (ii) external considerations regarding fertility and fertility preservation in the past; (iii) current vision on past considerations and decisions; (iv) Current experiences and coping with infertility; (v) future family building; (vi) advice regarding fertility and fertility preservation decision-making.</p><p><strong>Limitations, reasons for caution: </strong>Selection, recall, and choice supportive bias may play a role in interpreting our results.</p><p><strong>Wider implications of the findings: </strong>This study highlights the importance of tailored counselling and comprehensive information on fertility preservation for transgender individuals, especially adolescents, undergoing gender-affirming treatment.</p><p><strong>Study funding/competing interest(s): </strong>N/A.</p><p><strong>Trial registration number: </strong>N/A.</p>\",\"PeriodicalId\":13003,\"journal\":{\"name\":\"Human reproduction\",\"volume\":\" \",\"pages\":\"2032-2042\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373325/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Human reproduction\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/humrep/deae155\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human reproduction","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/humrep/deae155","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Transgender persons' view on previous fertility decision-making and current infertility: a qualitative study.
Study question: How do adult transgender and gender diverse (TGD) people, who are infertile due to prior gender-affirming treatment, view their current infertility and their reproductive decisions made in the past?
Summary answer: In a time where sterilization was mandatory, transgender adolescents prioritized gender-affirming treatment over their future fertility and would make the same choice today despite emotional challenges related to infertility experienced by some.
What is known already: Under transgender law in the Netherlands, sterilization was required for legal gender recognition until 2014, resulting in permanent infertility. The long-term consequences of this iatrogenic infertility in transgender adolescents who have now reached adulthood remain underexplored.
Study design, size, duration: Qualitative study design based on 21 in-depth one-on-one semi-structured interviews.
Participants/materials, setting, methods: TGD people in a stage of life where family planning may be a current topic were eligible for participation. They all received gender-affirming treatment in adolescence prior to the legislation change in 2014. A purposeful sampling technique was used from participants of another ongoing study. Eleven people assigned female at birth and ten people assigned male at birth were included. Interview transcripts were thematically analysed using a modified version of Braun and Clarke's six steps theory.
Main results and the role of chance: Six main themes were generated: (i) personal considerations regarding fertility and fertility preservation in the past; (ii) external considerations regarding fertility and fertility preservation in the past; (iii) current vision on past considerations and decisions; (iv) Current experiences and coping with infertility; (v) future family building; (vi) advice regarding fertility and fertility preservation decision-making.
Limitations, reasons for caution: Selection, recall, and choice supportive bias may play a role in interpreting our results.
Wider implications of the findings: This study highlights the importance of tailored counselling and comprehensive information on fertility preservation for transgender individuals, especially adolescents, undergoing gender-affirming treatment.
期刊介绍：
Human Reproduction features full-length, peer-reviewed papers reporting original research, concise clinical case reports, as well as opinions and debates on topical issues.
Papers published cover the clinical science and medical aspects of reproductive physiology, pathology and endocrinology; including andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, early pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues.
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