Transgender Youth Not Willing to Delay Hormone Therapy for Fertility Preservation

Transgender symbol
Transgender symbol
Transgender and gender nonconforming youth should be counseled regarding fertility preservation before undergoing hormone therapy.

Having biological children was not an important issue for the majority of transgender youth and their parents, and they would not be willing to delay initiation of hormone therapy to pursue fertility preservation options, according to new findings presented during the Pediatric Academic Societies (PAS) 2018 Meeting. However, some parents did express concern about the uncertainty of the effect on biologic fertility, and that was associated with willingness to delay treatment.

To gain a better understanding of attitudes of transgender and gender nonconforming youth and their families about fertility preservation, the authors surveyed 66 youth and 52 parents who were receiving gender-affirming medical care at Children’s Hospital of Philadelphia’s Gender and Sexuality Development Clinic. The average age of the youth participating in the study was 16 years, and 63% were assigned female sex at birth.

Of this group, 20% of youth and 11.5% of parents found it important to have biologic offspring. Among the youth, the importance of having biologic children was associated with a perception that it was important to their parents (odds ratio [OR], 6.07).

Only 4.5% reported that they would be willing to delay hormone treatment to undergo fertility preservation, but that was the most important predictor for those who delay hormone treatment (OR 6.76). Parent willingness to delay treatment for fertility preservation was a result of lack of information about whether hormone therapy prevents biologic preservation (OR 24.57).

“More qualitative research is needed to understand youth and parent decisions regarding [fertility preservation],” conclude the authors.


Persky R, Gruschow S, Carlson C, Ginsberg J, Dowshen N. Attitudes towards fertility preservation among transgender youth and their parents. Presented at: Pediatric Academic Societies (PAS) 2018 Meeting; May 5-8, 2018; Toronto, Canada.