Preserving the reproductive potential of transgender and intersex people

Abstract

Background: The bodies of some transgender and intersex people have been mutilated and their minds subjected to immense distress. Their gender has often been determined by others. Loss of fertility used to be considered an inevitable consequence of treatment.

Objective: To review the issue of preserving the reproductive potential of transgender and intersex people.

Methods: A narrative review based on a wide-ranging search of the literature in multiple disciplines.

Results: Major technological advances have facilitated reproduction for transgender and intersex people in the last few years. A majority of trans-adults believe that fertility preservation should be offered to them. Deferment of surgery for intersex people is often best practice; gonadectomy in infancy closes off fertility options and determines a gender they may later regret.

Conclusions: Transgender and intersex people should be able to consent to or decline treatment, especially radical surgery, themselves. Preservation of reproductive potential and sexual function must be given a high priority. Treatment by multidisciplinary teams can provide a strong emphasis on mental health and well-being. Detailed information about options, an absence of any coercion and enough time are all needed in order to make complex, life-changing decisions.

摘要

背景：一些跨性别者和双性人的身体被肢解, 使他们的思想受到巨大的痛苦。他们的性别往往是由别人决定的。不育常被认为是治疗的必然后果。

目的：探讨跨性别者和双性人生殖潜能保护的问题。

方法：在广泛查阅了多学科文献的基础上进行了叙述性回顾

结果：近些年, 重大的技术进步促进了跨性别者和双性人的生育。大多数跨性别成年人认为应该为他们提供生育保护。对于双性人来说, 推迟手术通常是最好的做法；在幼年时期的性腺切除术无法进行生育选择, 并决定他们以后可能会后悔的性别。

结论：跨性别者和双性人应该能够同意或拒接接受治疗, 尤其是根治性手术。必须高度优先注意保护生殖潜能和性功能。多学科团队治疗可以提供对精神健康和福祉的强烈重视。为了做出复杂的、改变生活的决定, 需要提供关于选择的详细信息、没有强制要求及足够的时间。

Keywords:

• Transgender
• intersex
• gender reassignment
• gonadectomy
• consent
• reproduction

Disclosure statement

The authors report no conflicts of interest.