Reproductive Considerations in the Transgender and Gender Diverse Population: A Review

Abstract

Many transgender and gender diverse (TGD) individuals will be considering gender-affirming treatments during their reproductive lifespan. These medically necessary treatments have a negative impact on reproductive potential. All TGD individuals should be counseled regarding fertility. Options for fertility preservation for individuals who have undergone puberty include mature oocyte, embryo, and sperm cryopreservation. In prepubertal individuals, ovarian tissue cryopreservation may be considered, but testicular tissue cryopreservation remains experimental only. While there have been advances in the technology and standardization of reproductive health care for this population, many gaps remain in our knowledge which require further research.

Keywords: Adolescents; Contraception; Cryopreservation; Fertility; Fertility preservation; Gender-affirming hormone therapy (GAHT); Transgender; Transgender and gender diverse (TGD).