Trans people have been having children long before there was any medical intervention to help them do so, but in recent years there have been more and more options available to make the process easier and safer.
Gender-affirming care and surgeries are common today for trans individuals. The advancements in medicine have helped them access safe and effective gender-affirming care. Similarly, advancements in reproductive medicine also have meant that transgender individuals have a good chance of getting pregnant and having a normal childbirth.
This blog will look at the various trans fertility-related issues and how RHWC can help trans parents conceive. Read on!
Transgender Patients and Pregnancy Myths
There are many myths and misconceptions about trans people and conception. One myth is that transgender individuals who have undergone gender-affirming hormone treatment cannot conceive. This is simply not true. Trans men and trans women can have biological children. People with uteruses can still get pregnant and people who can produce sperm can still do so unless they have undergone surgeries to remove their reproductive organs.
Another common misunderstanding is in relation to complications during pregnancy and normal childbirth. Several studies show that trans parents can have normal pregnancies and that prior hormone treatments do not affect the health of the child or increase complications in pregnancy.
Fertility Issues that Come up While Gender Transitioning
There are a number of fertility issues that can come up while transitioning. The first is that, due to the masculinizing effects of testosterone therapy, trans women may experience a decline in fertility. This decline may be temporary, or it may be permanent. Studies show that hormone replacement therapy affects sperm production even after the individual stops taking the hormones. The treatment is found to reduce the sperm count, motility, and overall quality of the sperm sample even after stopping hormone therapy.
Another issue that can arise is that some trans women may have difficulty conceiving because of previous surgery to remove their testicles (orchiectomy). This surgery can damage the reproductive organs and make it difficult to conceive. If you have had an orchiectomy, you may want to consider sperm freezing before surgery so that you have the option of conceiving later on.
In transgender men, there are issues that may arise from hormone therapy because medications like testosterone or estrogen blockers may damage their ovaries and reduce the health of the eggs. Testosterone stops menstruation in about 6 months in most cases. But in this case, this is not usually a permanent change. If the person stops testosterone treatment, the menstruation can restart, they can produce good-quality eggs, and in turn, become pregnant again.
In addition to the issues that arise from gender-affirming care, there are also other infertility issues that even cisgender people deal with that can affect trans individuals too. Problems like PCOS and endometriosis can affect trans men too. There may also be inherent infertility issues that trans women may suffer from which reduces sperm count or mobility. Issues like these can also disrupt the chances to conceive.
How Can Transgender Individuals Conceive?
There are several options that can help trans parents have children of their own. Here are some of the ways in which transgender women and trans men overcome infertility issues and build a family.
Fertility preservation is the best bet to deal with fertility issues that may arise with gender-affirming care. Sperm cryopreservation or sperm freezing before starting hormone treatment is preferred. The sperm samples are collected through normal ejaculation and stored at low temperatures in special freezers in this process. The sperm samples can be thawed and used at a later stage when you are looking to conceive. Sperm freezing does not affect the health of the sperm but you might need to collect a few samples since some sperm will not survive the freeze-thaw cycle.
Egg freezing is also a great option to consider before you undergo HRT. Eggs are harvested during ovulation and frozen and stored. These eggs can be thawed and used for fertility treatments later using donor sperm or sperm from your partner.
Conception Through Natural Means
Yes, trans parents can of course conceive through natural means. For this to happen, you will want to get help from healthcare providers and fertility specialists to assess your fertility. You will also need to help stop your hormone treatment temporarily while you are trying to conceive.
It may take 6 months for menstruation to return to a normal rhythm and for sperm production to go back to normal. The fertility assessment can tell you if your uterus is ready to accept the embryo and if there are issues that can prevent a normal conception. Analyzing the sperm sample will also help you understand if the quantity or quality is affected and if they can impregnate your partner naturally.
Assisted Reproductive Technology
Several assisted reproductive options are also available for trans parents to help them with family building. Options like IUI and IVF are commonly used to help trans and LGBTQ individuals conceive and have children.
Using their own sperm and eggs or using donor sperm and eggs, the partners can try for IUI and IVF treatments to get pregnant and have children. Studies show that both IUI and IVF have pretty good success rates and can help transgender individuals get pregnant.
ART is also useful, especially in the case of gay or lesbian couples with transgender individuals. A sperm or egg donor may be needed in case they want to consider pregnancy and ART can be of great help.
Gestational surrogacy is another option that trans parents can consider. In this case, a gestational carrier carries the pregnancy to term. The embryo is usually from the trans parents or a donor’s eggs and sperm. The child is thus biologically related to both or either one of the parents.
Since the gestational carrier is carrying the fetus, there is no risk of hormone therapy that trans parents undergo affecting the health of the child.
How Can RHWC Help?
If you or someone you know is a transgender parent who wants to conceive, Reproductive Health and Wellness Center (RHWC) can help. We offer a variety of services that can assist trans parents in achieving their reproductive goals, including
Fertility counseling: We can provide guidance and support as you navigate your fertility options.
Fertility preservation: We help our patients preserve their fertility by freezing their eggs or sperm before undergoing any gender-affirming treatment.
Assisted reproductive technologies (ART): We offer ART services such as in vitro fertilization (IVF) and intrauterine insemination (IUI), which can help trans parents conceive. Our reproductive endocrinologists and fertility specialists are experts in transgender health care and can help you get the best results.
Surrogacy: We also work with surrogacy agencies to find the best gestational carriers for you and help you go through the process of surrogacy using your own egg/sperm or finding the right donor egg/sperm.
Mental health and wellness: Just medicines can’t help. Gender dysphoria and issues with gender identity can create a lot of stress already. Fertility treatment can add to this and seriously affect the mental health of trans parents. Our programs also include mental and spiritual wellness along with physical exercise to help your holistic health.
No matter what your reproductive goals are, we can help you achieve them. Contact us today to learn more about our services or to schedule an appointment.
Trans Awareness Month is an important time for us to celebrate the progress we’ve made in supporting trans individuals. The advancements in medical science can help us understand transgender health much better and can provide the best care for trans individuals. Like cisgender people, trans parents also hope to build a family and we believe trans parents need access to the best reproductive healthcare.
At RHWC, we’re proud to offer a range of services that can help trans parents conceive and have healthy pregnancies. We hope that our work can help more trans people start families of their own and live happy, fulfilling lives. Get in touch with us today to know more!