Fertility Preservation in Transgender Individuals

The importance of fertility preservation arose alongside improvements in cancer treatment, permitting people to retain the ability to become parents in addition to defeating cancer itself. For transgender individuals pursuing reassignment procedures, those who wish to maintain the ability to reproduce biologically may also wish to understand their options for fertility preservation.

However, given the rich and varied nature of gender identification, fertility preservation for transgender patients carries complications well beyond what other people face. The procedures and outcomes of fertility preservation are stressful enough, but while the harvesting and storage of gametes for future in vitro reproduction is a standard and reliable procedure, there are aspects that you, as a transgender individual, should consider in your decision to maintain reproductive capability.

Transition choices

Every person who identifies with a gender that isn’t their biological assignment may have unique feelings about how to reconcile identity with biology. It’s important to understand that there’s no “correct” way to transition. There may be no need to transition at all if that’s the right decision for you. This is part of the personal battle each transgender person faces, and as with other aspects of the human experience, everyone faces these hurdles their own way.

So, if you’re considering fertility preservation as a reproductive hedge against a transition procedure decision, it’s important to keep in mind that there is no preset way for you to proceed with your gender identification, other than what is right for you.

Identity discords

Retaining reproductive ability introduces some harsh realities that may affect your gender dysphoria. For example, if you’re a transgender woman who needs to retrieve sperm for insemination purposes, the thought of masturbating to ejaculation may be distressing, and this distress could prevent success.

Similarly, undergoing ultrasound-guided egg retrieval may be traumatic for a transgender man, as would enduring a pregnancy. Some people can take these identity discords in stride, but it’s not unusual to be further confused by retained body functions that are at odds with your gender identification.

Discussing these potentially upsetting conflicts with me is key to successfully navigating fertility preservation. At Innovation Fertility Preservation and IVF, we may be able to provide alternate procedures, such as surgical sperm retrieval or ultrasounds performed under sedation, for example. These may spare you the harshest effects of discordant biology.

Biological parent identity

Another aspect of identity discord that sometimes arises is the effect of being “held back” by fertility preservation. Some transgender people feel that part of their biological origin is preserved when gametes are frozen, and they have difficulty feeling they can obtain an identity goal while these gametes exist. This isn’t a common concern, and many feel that fertility preservation should be freely presented as an option prior to reassignment procedures.

Another thinking point may be feelings of conflict surrounding your identity as a parent of a child born through your decision to preserve fertility. A transgender woman would biologically be a father and a transgender man would be a mother. While parenting identity has many aspects other than biology, it is something to consider when making a fertility preservation decision.

There is much to consider as you take steps toward fulfilling your gender identification goals. You can approach me or any of the staff at Innovation Fertility Preservation and IVF to discuss your concerns and options. Call the office or request an appointment online today.