Will I definitely become infertile?

There is no evidence to suggest that puberty blockers negatively impact fertility. Cross-sex hormone therapy may negatively impact fertility, although this is not guaranteed. If you wish to have biological children you should consider fertility preservation treatments before starting cross-sex hormone therapy. Some surgical procedures involving the reproductive organs, like hysterectomy (removal of the uterus) or orchiectomy (removal of the testes) will result in irreversible infertility.

Who can I talk to for help around fertility?

You can talk to a member of our team or one of our gender specialists, your doctor may be able to advise you on your fertility options, and if they don’t know they may be able to refer you to a specialist service for a consultation. If you have been referred to a Gender Identity Clinic (GIC) you can discuss fertility preservation options with them. Lots of information about fertility in general, and the treatments associated with it, is available via the Human Fertilisation and Embryology Author...

How can I store my genetic material?

For people with a uterus The process for egg storage is similar to IVF (In Vitro Fertilisation). You will be prescribed hormones to stimulate egg production, then attend a clinic where the mature eggs will be extracted under general anaesthetic or sedation. Because the extraction process is transvaginal it can be a source of dysphoria, and your clinician should be made aware so that they can ensure you are as comfortable as possible. Once the eggs are extracted they are frozen until they are ne...

What if thinking/talking about fertility gives me gender dysphoria?

Even if you want to start a family, some of the processes involved in reproduction or fertility preservation may cause gender dysphoria. This will be different for all trans people, but examples include people with ovaries who feel dysphoria at the idea of pregnancy, or people with testes who feel dysphoria at the idea of ejaculation. Even if fertility options cause gender dysphoria, this does not mean you cannot start a family. For instance, people with ovaries might be able to consider IVF ...

What options would be available to me if I wanted to start a family of my own?

Besides fertility preservation options, such as freezing reproductive material, there are many options for starting families, including co-parenting, adoption, surrogacy, and chosen families. You can read about the latest research on fertility options on our website (https://www.gendergp.com/latest-thinking-fertility-transgender-non-binary-youth/).

I want the possibility of having children in future and am concerned about my fertility. What are my options?

Fertility is important to consider, as it can be affected by hormone replacement therapy (HRT). More information on your options and how we can assist is available here (https://www.gendergp.com/help-centre/fertility-considerations-for-trans-people/).

Can I still have a happy family?

Yes, absolutely. There is no single ‘right’ way to have a family, and regardless of your gender identity or what your transition journey looks like there will be a way that you can do it. The most important thing is that you get the support you need right now, so that you can give that same support to your family in future.

How might surgery affect my fertility?

If you have a hysterectomy or vaginectomy (removal or alteration of the uterus or vagina, respectively) or an orchiectomy (removal of the testes), you will be unable to have biological children unless you preserve genetic material beforehand. Top surgery will not affect your fertility.

How might hormone therapy affect my fertility?

Hormone replacement therapy may negatively impact your fertility (for instance, in people with testes it can reduce sperm count and motility) but it doesn’t necessarily make you infertile. Post-pubertal trans people may be able to come off cross-sex hormones to enable sperm/egg production to resume. However, to mitigate the possible impact on future fertility post-pubescent trans people will typically be offered fertility preservation before starting hormones in the form of freezing sperm or egg...

How might puberty blockers affect my fertility?

If you use puberty blockers to prevent the progression of puberty, it will mean that you have fewer immediate fertility options (although it’s important to note that no one, regardless of gender identity, has guaranteed fertility options). This is because blocking puberty prevents the sperm and eggs from maturing. However, this doesn’t mean puberty blockers cause infertility or that you cannot have a family. Both people with testes and people with ovaries have fertility preservation options. In ...