Rebecca W Persky1, Siobhan M Gruschow2, Ninet Sinaii3, Claire Carlson4, Jill P Ginsberg5, Nadia L Dowshen6. 1. Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: rebecca.persky@nih.gov. 2. Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 3. Department of Biostatistics and Clinical Epidemiology, Clinical Center, National Institutes of Health, Bethesda, Maryland. 4. Cancer Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 5. Cancer Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 6. Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract
PURPOSE: While gender-affirming hormones (GAH) may impact the fertility of transgender and gender diverse (TGGD) youth, few pursue fertility preservation (FP). The objective of this study is to understand youth and parent attitudes toward FP decision-making. METHODS: This study is a cross-sectional survey of youth and parents in a pediatric, hospital-based gender clinic from April to December 2017. Surveys were administered electronically, containing 34 items for youth and 31 items for parents regarding desire for biological children, willingness to delay GAH for FP, and factors influencing FP decisions. RESULTS: The mean age of youth (n = 64) was 16.8 years, and 64% assigned female at birth; 46 parents participated. Few youth (20%) and parents (13%) found it important to have biological children or grandchildren, and 3% of youth and 33% of parents would be willing to delay GAH for FP. The most common factor influencing youth FP decision-making was discomfort with a body part they do not identify with (69%), and for the parents, whether it was important to their child (61%). In paired analyses, youth and their parents answered similarly regarding youth desire for biological children and willingness to delay GAH for FP. CONCLUSIONS: The majority of TGGD youth and parents did not find having biological offspring important and were not willing to delay GAH for FP. Discomfort with reproductive anatomy was a major influencing factor for youth FP decision-making and their child's wishes was a major factor for parents. Future qualitative research is needed to understand TGGD youth and parent attitudes toward FP and to develop shared decision-making tools. Published by Elsevier Inc.
PURPOSE: While gender-affirming hormones (GAH) may impact the fertility of transgender and gender diverse (TGGD) youth, few pursue fertility preservation (FP). The objective of this study is to understand youth and parent attitudes toward FP decision-making. METHODS: This study is a cross-sectional survey of youth and parents in a pediatric, hospital-based gender clinic from April to December 2017. Surveys were administered electronically, containing 34 items for youth and 31 items for parents regarding desire for biological children, willingness to delay GAH for FP, and factors influencing FP decisions. RESULTS: The mean age of youth (n = 64) was 16.8 years, and 64% assigned female at birth; 46 parents participated. Few youth (20%) and parents (13%) found it important to have biological children or grandchildren, and 3% of youth and 33% of parents would be willing to delay GAH for FP. The most common factor influencing youth FP decision-making was discomfort with a body part they do not identify with (69%), and for the parents, whether it was important to their child (61%). In paired analyses, youth and their parents answered similarly regarding youth desire for biological children and willingness to delay GAH for FP. CONCLUSIONS: The majority of TGGD youth and parents did not find having biological offspring important and were not willing to delay GAH for FP. Discomfort with reproductive anatomy was a major influencing factor for youth FP decision-making and their child's wishes was a major factor for parents. Future qualitative research is needed to understand TGGD youth and parent attitudes toward FP and to develop shared decision-making tools. Published by Elsevier Inc.
Entities:
Keywords:
Fertility counseling; Fertility preservation; Gender dysphoria; Gender-affirming hormones; Survey; Transgender adolescents and young adults; Transgender medicine; Transgender youth
Authors: Timothy Chwan Lai; Cristyn Davies; Kerry Robinson; Debi Feldman; Charlotte Victoria Elder; Charlie Cooper; Ken C Pang; Rosalind McDougall Journal: BMJ Open Date: 2021-05-19 Impact factor: 2.692
Authors: Selena U Park; Devika Sachdev; Shelley Dolitsky; Matthew Bridgeman; Mark V Sauer; Gloria Bachmann; Juana Hutchinson-Colas Journal: F S Rep Date: 2022-07-19