Family Building and Transgender Fertility

If you are a Transgender, Gender-queer, or Nonbinary Individual, you may be wondering what pregnancy options and fertility services are available and whether you can still have your own babies. And if there are options, are there LGBT friendly fertility clinic(s) that can help you for pregnancy?

Although it’s important to discuss your options with your fertility doctor, educational resources about fertility are hard to come by. A 2019 survey found that 52 percent of non-cisgender people are uncomfortable discussing their fertility with their healthcare providers. In this article, we will close that information gap by demystifying the pregnancy options and family-building process using a fertility clinic and will explain the LGBT fertility services for transgender people.

How can medical transition affect fertility?

The hormone replacement therapy (HRT) usually starts in teenagers around the age of 16. Thus, young people who identify as non-binary or transgender need to decide about their fertility before they have even received their driver’s licenses. Understandably, this might feel like a lot of pressure for both the teenagers and their parents. However, with enough information about the impact of medical transition on fertility, people will be able to make the best decisions for them. Eventually, it will help them to make plans for kids in the future.

Puberty blockers (or gonadotropin-releasing hormone agonists)

It is possible that you are yet to reach puberty and too young to start hormone treatment (this often applies to transgender teens aged 12 to 16). In that case, your physician might place you on puberty blockers (gonadotropin-releasing hormone agonists). This is to prevent you from developing secondary sex traits associated with the sex you are assigned at birth. When you get older, you can start hormone replacement therapy (through estrogen or testosterone hormone therapy) in order to develop the secondary sex characteristics of the sex you identify with.

The question is, can ingesting puberty blockers impact future conception? Well, health experts don’t know for sure yet. Current studies say that the effects are reversible in adults. However, it is not for sure if taking blockers before puberty transition affects fertility in the long term or not. A study was published in the journal Translational Andrology and Urology to find the answers. Findings revealed that puberty blockers could shrink the testicles, which can make sperm production harder.

Testosterone

Available data indicates that testosterone (T), even when used for several years, doesn’t destroy ovary function in transgender men. Research shows that 80 percent of people will start to ovulate again within 6 months after coming off testosterone.

Although testosterone may have an impact on the ovaries, it is unsure whether there’s a long-term effect on the ovaries. Moreover, the effects may be reversible. Therefore, as an LGBT fertility clinic we recommend that you take proper care of yourself. Also, start on a prenatal vitamin in order to ensure the best outcomes for conception.

Of course, you can be on testosterone for several years and still conceive with your own eggs. But remember that each person’s experience is different. Another thing you need to keep in mind is that testosterone therapy stops you from ovulating. So, you will need to get off testosterone and start menstruating when you are trying to get pregnant. This can bring up undesirable experiences of gender dysphoria. If you worry about how stopping hormone replacement therapy could make you feel – seek additional support. Speaking to a friend, getting in touch with a community of people passing through the same thing, and consulting a therapist can be helpful during this time.

Estrogen

It is a fact that estrogen has an impact on sperm production. But the issue is that experts don’t know how reversible the effect of estrogen is. There may still be some long-term effects on sperm production, even after stopping estrogen. With that being said, transwomen can have difficulty using their own sperm to conceive after estrogen therapy.

If your medical transition journey involves estrogen therapy and you want to use your own sperm to have a baby, you should consider freezing your sperm via cryopreservation for future use.

Gender-affirming surgery (GAS)

There are various surgeries that may be involved in a person’s transition. However, “bottom” surgery (in which the reproductive organs of the transgender people are changed or removed) is the one that can have the most impact on fertility. Transgender people, as well as members of the LGBT community, who go with the hysterectomy option, may not have the ability to conceive and carry a pregnancy later on. On the other hand, people who undergo removal of their reproductive organs cannot use their gametes (sperm or eggs) to create a baby in the future.

So, if these sex-reassignment surgeries (gender-affirming surgeries) are a part of your medical transition, keep in mind, that with the help of an LGBT fertility clinic, there are several treatment options for having kids using your own sperm or egg.

For Transgender men (masculine individuals) 

• Embryo cryopreservation, or embryo freezing
• Oocyte cryopreservation, or egg freezing
• Ovarian tissue cryopreservation, or ovarian tissue freezing

For Transgender women (transfeminine individuals)

• Sperm cryopreservation, or sperm freezing

How can you find supportive healthcare or the LGBT fertility Clinic?

Even now, Transgender, nonbinary, and gender non-conforming people are often neglected in reproductive medicine. Thus, it’s hard to find healthcare providers that will assist them when trying to get pregnant.

In 2017, the Center for American Progress conducted a study on discrimination of LGBTQ people in healthcare. Data showed 29 percent of transgender individuals said that healthcare providers refused to help them because of their gender identity. It is no surprise that many people who identify as trans are not comfortable or afraid to talk about their fertility with their physician.

How to find support

Conception, pregnancy, and fertility are personal processes that may be filled with loads of emotions and hope. A lot of us have expectations regarding how we want out family-building journey to be. And so, it can be annoying to hit a snag. This is the reason why you need to have support and fertility resources you can count on during this journey. There are different avenues for finding support, including in your community. You can search for Facebook groups where you can connect with other gender-nonconforming people who are also trying to become parents.  

Conclusion

Coastal Fertility is an LGBT friendly fertility clinic located in Irvine, Orange County, CA. We believe that everyone deserves the support and affirmation when they are ready to start their journey into parenthood regardless of their race, gender, or sexual preference! If you want to learn more about the pregnancy and family building options for the Transgender persons and the LGBT community or if you have any other questions regarding your fertility, please contact us at (949) 726-0600 to schedule a consultation or visit us at www.CoastalFertility.com.