Whose Concern Is It? Navigating Fertility for Trans Youth
As we progress toward greater understanding and acceptance of gender diversity, more transgender youth are able to seek and receive gender-affirming care to align their physical appearance with their gender identity. For parents of transgender children, this journey can be both empowering and challenging. A common concern shared by parents and caregivers is worry about how medical interventions, such as puberty blockers or hormones, will impact their child's fertility and ability to have biological children of their own. In this blog we will explore the subject, addressing common concerns and providing information to help parents support their child's well-being through this process.
Understanding Puberty Blockers and Hormones
Before delving into concerns around fertility, it's essential to understand gender-affirming care options like puberty blockers and hormones. Puberty blockers are medications that can temporarily pause the physical changes associated with puberty, giving the child more time to explore their gender identity and providing an opportunity to affirm their identity without irreversible changes taking place. Puberty blockers are safe, well-researched, and fully reversible. Hormone therapy involves administering hormones (such as estrogen or testosterone) to induce the development of secondary sex characteristics that align with the individual's gender identity.
Fertility Concerns
One of the most common parental concerns is fertility preservation. Puberty blockers, when administered for an extended period, can delay the maturation of the reproductive system, potentially affecting future fertility. However, it is essential to note that puberty blockers are reversible, and their effects are temporary. Once the individual stops taking puberty blockers, their body resumes puberty. Some individuals begin taking blockers after their body has gone through the “wrong” puberty in order to halt their body’s production of hormones that do not align with their gender identity; in these cases there is the opportunity for fertility preservation prior to starting blockers if desired.
For transgender adolescents considering hormone therapy, there are different considerations. For example, estrogen has been shown to impact fertility (namely, production of sperm) and so some transfeminine individuals may choose to engage in fertility preservation prior to starting hormones. For transmasculine individuals, there is no data to show that testosterone has a long-term impact on fertility and several studies have found that egg quality and quantity (in addition to other variables around pregnancy and egg harvesting) were the same between transgender men and cisgender women.
Fertility Preservation Options
Open and honest communication between parents and their transgender child is crucial throughout the gender-affirming care journey. Creating a safe space for the child to share their feelings and concerns is essential. It allows parents to understand their child's perspective better and offer appropriate support. Parents and caregivers should explore fertility preservation options with their child and healthcare provider before starting gender-affirming care if needed. Various methods, such as sperm or egg freezing, may allow transgender youth to have biological children in the future. While fertility preservation can be expensive, discussing it early in the process can help families make informed decisions about their child's care. Healthcare providers should explore with patients and families the desire or importance of an individual having biological children in the future. The topic of future parenting is not something on the mind of every pre-teen or adolescent and your child may not be sure about being a parent when they are older - and that’s okay! In fact, there are many different ways to have a family, and some wonderful books that address this for children of all ages.
Focusing on the Child You Have
It's also essential for parents to focus on the child they have in the present, rather than dwelling solely on hypothetical future grandchildren. Placing undue emphasis on potential future generations can overshadow the immediate needs and well-being of their transgender child. Engaging in gender-affirming care can have profoundly positive outcomes for these children. Research consistently shows that when transgender youth receive the support and care that aligns with their gender identity, they experience improved mental health, self-esteem, and overall well-being. These positive effects not only benefit the child but can also lead to healthier family dynamics and relationships. By embracing and affirming their child's gender identity, parents can foster a strong sense of trust, acceptance, and love that lays the foundation for a happier and more fulfilling life for their child, regardless of whether they have biological children in the future. Nurturing a supportive and loving relationship with the child you have today should be the primary focus.
Conclusion
For parents of transgender children, supporting their journey through gender-affirming care can be filled with challenges and uncertainties, especially when it comes to concerns about fertility. However, with open communication, education, and professional guidance, parents can offer the vital support and understanding that their child needs. Remember that each transgender individual's experience is unique, and by standing by their side, parents can help them navigate this transformative period with love, acceptance, and empowerment.
Take Action Today!
Go to the Protect Trans Youth page for ways to take action, resources, and suggestions for where to donate your time and money.
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