Few Transgender Teens Opt for Fertility Preservation

By Anne Harding

February 10, 2017

NEW YORK (Reuters Health) - Just a fraction of transgender adolescents who are counseled about infertility risks associated with their treatment will opt for fertility preservation (FP) measures, new research shows.

"More research needs to be done to understand parenthood goals and barriers to fertility-preservation utilization specific to this transgender population," lead author Dr. Leena Nahata of Nationwide Children's Hospital, The Ohio State University College of Medicine, in Columbus, told Reuters Health by phone.

The findings were published online February 1 in the Journal of Adolescent Health.

Most research to date on FP has focused on young patients undergoing cancer treatment, Dr. Nahata noted. However, she and her colleagues point out, there are many other medical situations where a discussion of FP could be warranted, including for transgender individuals undergoing gender-affirming hormone therapy.

Current guidelines and ethics committee statements recommend that transgender patients receive fertility counseling and be offered FP before they begin hormone treatment. They also suggest that transgender individuals have the same desire for biological children as other populations, Dr. Nahata noted.

The researchers looked retrospectively at 73 adolescent patients treated at their center (50 transgender males and 23 transgender females), all but one of whom received fertility counseling. Of the 72 patients who received counseling, only two, both transgender females, opted for FP.

About three-quarters of the study participants had a documented reason for refusing FP, with 45% saying that they were considering or planning to adopt, 22% saying they never want to have children, and 8% saying they thought FP would be too expensive.

By comparison, the authors note, about 25% of pubertal males diagnosed with cancer will bank their sperm, while pubertal females may be less likely to choose FP.

"Our findings suggest that parenthood goals among transgender individuals may not be the same as they are in other populations," Dr. Nahata noted.

Dysphoria about one's body, urgency to start treatments, developmental factors and mental health concerns, could also make these patients less likely to use FP, she and her colleagues note.

"Many of the adolescents in this study said 'I don't ever want to have kids,' or 'I want to adopt,' and we don't know if that attitude persists into adulthood for these kids," Dr. Nahata said. "We intend to pursue prospective work in those areas to examine if and how parenting goals may change over time, and what the perceived benefits and barriers to FP are in this population at different ages and developmental stages."

SOURCE: http://bit.ly/2lutMN9

J Adolesc Health 2017.