Reproductive life planning and interest in fertility preservation among transgender and gender non-binary individuals

Professional organizations agree that all transgender persons should be counseled on the effects of their transition on their fertility as well as options for fertility preservation and reproduction prior to transition. The UCLA Gender Health Program (GHP) is a multidisciplinary medical, surgical and behavioral health team that supports transgender and gender non-binary individuals in their transition. We sought to identify characteristics of individuals who desired fertility preservation at intake to the GHP. Cross-sectional study. When individuals establish care at the GHP, a Care Coordinator performs a telephone intake to ascertain which referrals and services they require. We obtained IRB exemption to examine this intake data for all those in the Gender Health Program from January 2018 – March 2019. The data were coded and de-identified. Descriptive statistics were then performed. A total of 397 intake surveys were included in the data analysis. The average age of individuals who established care at the GHP was 29 years (SD 12.4). Forty-seven (11.8%) individuals stated they had reproductive life planning goals. Twelve (3%) had previously undergone fertility preservation, with eleven of those assigned male at birth. Forty-seven (11.8%) stated they desired fertility preservation. Of the 397, only eight (2%) endorsed presenting to the GHP for fertility preservation as their primary goal. Eleven (2.9%) stated they were interested in referral for hysterectomy with oophorectomy. None of these eleven patients who desired surgical sterilization were also interested in referral for fertility preservation (see Table 1). Neither gender identity, nor race/ethnicity was predictive of interest in fertility preservation. Access to reproductive health services is desired by many transgender and gender non-binary individuals. Although forty-seven (11.8%) of individuals stated they had reproductive goals, only twelve (3%) had undergone any fertility preservation and a majority of those had sex documented as male at birth. Given the low reported rate of fertility preservation and apparent level of interest, future research should focus on barriers to receiving fertility counseling or referrals for transgender and gender non-binary individuals.Table 1Sex Documented at BirthAverage AgeSDFemaleMaleIntersexReferral to GHP specifically for fertility preservation53025.15.3Those with reproductive life planning goals2025227.110.1Those who have undergone fertility preservation111026.46.8Those who desire fertility preservation2620127.210.3 Open table in a new tab