Fertility Considerations in Parental Decision-Making about Pubertal Suppression Treatment for Their Transgender and Gender-Diverse Children

Abstract

Transgender and gender diverse (TGD) youth receiving pubertal suppression treatment may be at risk for future infertility if they progress on to gender-affirming hormones. Little is known about whether and how parents of TGD youth consider fertility-related implications when making medical decisions about pubertal suppression treatment. We conducted interviews with 13 parents of 11 TGD youth about fertility-related considerations in the context of treatment decision-making. Three major themes were identified: (1) current fertility knowledge and counseling experiences, (2) barriers to parent–child discussions around fertility, and (3) importance of fertility in treatment decision-making. Findings highlight the complex nature of fertility considerations in this population.

Keywords:

• Fertility preservation
• gender dysphoria
• medical decision-making
• qualitative research
• reproductive health
• transgender

Acknowledgements

We thank all the participants for their thoughtful contributions in the interviews. We also thank Robert Garofalo, MD, MPH for his leadership within the Gender & Sex Development Program that made this research possible; Teresa K. Woodruff, PhD, for her ongoing support of our work to expand Oncofertility to other patient populations at risk for infertility; Marco Hidalgo, PhD, Jennifer Jensen, APRN, Ellie Kim, MD, Ginny Scheffler, RN, Lisa Simons, MD, and D. Javier Thompson, LCSW for assistance recruiting study participants; and Ilina Rosoklija, MPH and Anthony D’Oro, BA for feedback on our interview guide.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

This work was supported by the 2016–2017 Research Excellence Award by the Chairman from the Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine (PI: Chen); the 2017 Targeted Research Grant from the Society of Pediatric Psychology (PI: Chen); and the 2017 Sexualities Project at Northwestern Summer Grant Award (PI: Kyweluk). Drs. Chen, Gordon, and Finlayson’s effort also were supported, in part, by R21HD097459 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Study sponsors had no role in (a) study design, (b) collection, analysis, and interpretation of data, (c) writing of the report, or (d) the decision to submit the article for publication.