Fertility Options for Transgender Patients: How Can Physicians Provide More Inclusive Care?

Abstract

Family planning is critical to the sexual and reproductive health of all patients. For transgender individuals, using gender-preferred modalities for conception and prevention can minimize gender incongruence and dysphoria. Currently, the literature describes several pregnancy options including natural conception, gamete cryopreservation, in vitro fertilization, and uterine transplantation. Prevention methods remain similar to those for cisgender patients such as oral contraception, intrauterine devices, condoms, and various surgical procedures. However, great emphasis lies on choosing a method that best supports the chosen gender identity of the patient. This review supports oocyte and sperm cryopreservation as the preferred method for pregnancy and finds consensus with the literature that there is no best method for prevention. As such, physicians should prioritize early discussions with patients and work closely to use modalities that fit each patient’s needs and expectations. As the body of literature on LGBTQ+ health continues to grow, this review will help to expand the knowledge around family planning for transgender patients.