Fertility Resources

Research shows that trans folx want families at the same rate as our cis peers. Families can be built in so many ways. We want you to have the resources you need to help support your desires.

Queer Family Building Resources

• Family Equality– Creating a world where everyone can experience family. Founded in 1979 at the National March on Washington for Lesbian and Gay Rights, Family Equality has spent more than 40 years ensuring that everyone has the freedom to find, form, and sustain their families by advancing equality for the LGBTQ+ community.
  • Trans Family Building Resources– From planning for fertility before transition to advocating for yourself in the fertility doctor’s office to supporting your family once you form it.
• Gay Parents To Be– A little binary in their approach, but they do have a trans family building page.
• Just a Baby– Similar to a dating app where you can find sperm and egg donors, surrogates, partners or coparents.

Birthing and Parenting Support

• Birthing and Breast or Chestfeeding Transpeople and Allies
• QueerDoc has supported several adults seeking to establish milk supply. If you are an LGBTQ+ identified person who would like to produce milk with your body, no matter your sex assigned a birth, no matter the size or shape of your chest, we can help. Our work in developing milk supply is informed by the work of:
  • Newman-Goldfarb Protocols
  • Reisman T, Goldstein Z. Case Report: Induced Lactation in a Transgender Woman. Transgend Health. 2018 Jan 1;3(1):24-26. doi: 10.1089/trgh.2017.0044. PMID: 29372185; PMCID: PMC5779241.

Adoption Resources

• HRC’s Adoption Resource
• All Children All Families– a map of LGBT friendly adoption and foster agencies that worked with HRC for inclusive training
• Adoptions Together– a LGBT friendly adoption agency

Mail Order Sperm Preservation Resources

• CryoChoice
• Give Legacy
• ReproTech
• Sppare
• Another at home option with a non-affirming name (Dadi)

A note about fertility preservation: fertility preservation is best attempted prior to starting most medications we use to support gender care. Most of the medical interventions used in gender care affect fertility immediatly. So if you took even one dose of medication prior to freezing sperm or eggs, the sample frozen would be lower quality. For folx who have achieved reproductive maturity (completed their endogenous puberty) and have testicles, research and information about return to fertility after gender affirming medical interventions is limited. Spermatogenosis is a 74 day process. Which seems to have lead to conventional wisdom of return to fertility for people with testicles at about two months off of estradiol, progesterone, AND anti-androgens (spirolactone, finasteride/dutasteride, bicalutamide). In clinical practice, our patients have never had viable samples at two months off of gender care meds. It seems more likely that 3-6 months will be required. Studies have also found that gender diverse people whose bodies make sperm are more likely to have issues with those sperm even prior to medical transition then their cis peers. With such limited published literature, we feel less confident in counseling patients with testicles that fertility can be accessed after starting gender affirming medications.

For folx who have achieved reproductive maturity (completed their endogenous puberty) and have ovaries, we have several examples and published literature of people being able to achieve pregnancy or access fertility both off and on testosterone. We feel more confident in counseling patients with ovaries that they will be able to access fertility after starting gender afffirming testosterone if desired.

Financial Support

Unfortunately, most insurance plans do not cover reproductive medicine. Assitive reproductive technologies and adoption can be quite costly. Family equality has created a list of funding sources that might be helpful in building your family.

References:

1. Neblett MF, Hipp HS. Fertility considerations in transgender persons. Endocrinol Metab Clin North Am 2019; 48:391–402.[Context Link]Review discussing logistics behind fertility preservation in transwomen and transmen.
2. Martinez F, Andersen CY, Barri PN, et al. Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives. Fertil Steril 2017; 108:407.e11–415.e11.[Context Link]
3. Light A, Wang LF, Zeymo A, Gomez-Lobo V. Family planning and contraception use in transgender men. Contraception 2018; 98:266–269.[Context Link]Article shows the desire for fertility and children in transmen.
4. Wierckx K, Van Caenegem E, Pennings G, et al. Reproductive wish in transsexual men. Hum Reprod 2012; 27:483–487.[Context Link]
5. Tornello SL, Bos H. Parenting intentions among transgender individuals. LGBT Health 2017; 4:115–120.[Context Link]
6. The Williams Institute, Stotzer RL, Herman JL, Hasenbush A. Transgender parenting: a review of existing research. 2014; Available from: https://williamsinstitute.law.ucla.edu/wp-content/uploads/transgender-parenting-oct-2014.pdf [cited December 1, 2019].[Context Link]
7. De Sutter P, Verschoor A, Hotimsky A, Kira K. The desire to have children and the preservation of fertility in transsexual women: a survey. Int J Transgenderism 2002; 6:97–103.[Context Link]
8. Sermondade N, Benaloun E, Berthaut I, Moreau E, Prades M, Béranger A, Chabbert-Buffet N, Johnson N, Lévy R, Dupont C. Reproductive functions and fertility preservation in transgender women: a French case series. Reprod Biomed Online. 2021 Aug;43(2):339-345. doi: 10.1016/j.rbmo.2021.04.016. Epub 2021 Apr 30. PMID: 34144898.
9. Rodriguez-Wallberg KA, Häljestig J, Arver S, Johansson ALV, Lundberg FE. Sperm quality in transgender women before or after gender affirming hormone therapy-A prospective cohort study. Andrology. 2021 Nov;9(6):1773-1780. doi: 10.1111/andr.12999. Epub 2021 Mar 23. PMID: 33683832.
10. Hamada A, Kingsberg S, Wierckx K, T’Sjoen G, De Sutter P, Knudson G, Agarwal A. Semen characteristics of transwomen referred for sperm banking before sex transition: a case series. Andrologia. 2015 Sep;47(7):832-8. doi: 10.1111/and.12330. Epub 2014 Oct 1. PMID: 25269748.
11. Li K, Rodriguez D, Gabrielsen JS, Centola GM, Tanrikut C. Sperm cryopreservation of transgender individuals: trends and findings in the past decade. Andrology. 2018 Nov;6(6):860-864. doi: 10.1111/andr.12527. Epub 2018 Aug 9. PMID: 30094956; PMCID: PMC6301129.
12. A. Light, L.F. Wang, A. Zeymo, V. Gomez-LoboFamily planning and contraception use in transgender menContraception, 98 (4) (2018), pp. 266-269
13. R.L. Taub, S.A. Ellis, G. Neal-Perry, A.S. Magaret, S.W. Prager, E.A. MicksThe effect of testosterone on ovulatory function in transmasculine individualsAm J Obstet Gynecol, 223 (2) (2020), pp. 229.e1-229.e8
14. C. Krempasky, M. Harris, L. Abern, F. GrimstadContraception across the transmasculine spectrumAm J Obstet Gynecol, 222 (2) (2020), pp. 134-143
15. A. Bonnington, S. Dianat, J. Kerns, et al.Society of Family Planning clinical recommendations: contraceptive counseling for transgender and gender diverse people who were female sex assigned at birthContraception, 102 (2) (2020), pp. 70-82
16. Moravek MB, Dixon M, Pena SM, Obedin-Maliver J. Management of testosterone around ovarian stimulation in transmasculine patients: challenging common practices to meet patient needs-2 case reports. Hum Reprod. 2023 Mar 1;38(3):482-488. doi: 10.1093/humrep/dead003. PMID: 36644915; PMCID: PMC9977120.