Conversations about sex are stressful for young people, especially when it concerns themselves. Trans youth are likely to already feel confused and alienated with regards to their bodies, and trying to make them think too much about physiological factors like sex and pregnancy could pressure them into making an uninformed decision. Talking clearly about their options in terms of reproduction rather than sex will produce a better narrative, and emphasise that fertility options are about future family rather than personal sexual behaviour. Many trans youth will be having these conversations with their parents or family, which can make the matter more complicated or introduce additional pressures. For instance, even supportive parents may long to have biological grandchildren. You can emphasise the importance of an affirming journey to both trans young people and their families, and be clear that future fertility should not outweigh the merits of early intervention (e.g. there is a 41% incidence of suicidality in transgender people that could be addressed by avoiding gender dysphoria through use of puberty blockers).