Ten years of fertility treatment experience and reproductive options in transgender men

Abstract

Background

Up to 2018, the Belgian law stated that transgender people who wanted to change their legal sex had to undergo physical gender affirming treatment. This included gonadectomy to a medically possible and justified extent, which entailed that they had to accept the fact that they could no longer reproduce. However, research has shown that many transgender people desire to have children.

Aims

(1) to describe a cohort of transgender men and their respective cisgender female partners, to share our experiences with their request for donor conception, and to evaluate their disclosure intentions to the child, (2) to explore how the couples approach current and future reproductive options.

Methods

This mixed method study presents data from a retrospective analysis of patient records and from a qualitative interview study. The couples were selected from the group of transgender men who – together with their respective cisgender female partners – applied for sperm donation at Ghent University Hospital between 2002 and 2012.

Results

Forty-seven transgender men with a cisgender female partner requested treatment with anonymous donor sperm for a first child as a couple. Forty-one requests were accepted for treatment. We found that most couples requesting treatment intended to disclose the use of donor sperm to their future child (n = 34) while 24 couples were planning to inform the child about the parent’s transgender identity. The six couples we interviewed saw donor conception as the preferred route to become parents. Adoption was seen as less obvious. The couples’ attitudes toward stem cell-derived gametes reflected the significance of the genetic link with the child for both parents.

Discussion

Not all participants in our study were aware of their reproductive options. To be able to make a well-informed decision, transgender people should be counseled about all options at the time of transition.

Keywords:

• Fertility
• disclosure
• donor conception
• reproductive options
• transgender men
• counseling

Acknowledgements

We acknowledge all staff members at the Department of Reproductive Medicine of Ghent University Hospital (Belgium). We also thank all the couples for participating in the interview study. All the other members of the qualitative research team are acknowledged for their efforts in interviewing, transcribing and team discussions: Hanna Van Parys, An Ravelingien, and Inez Raes.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The qualitative part was supported by the Special Research Fund of Ghent University, Belgium under Grant number 01G00111. Sara Somers holds a Special PhD Fellowship of the Flanders Research Foundation (1900820N).