Transitioning your gender shouldn’t mean you have to give up on your dream of having a family. Here we’ll break down the basics of trans-fertility and share some helpful signposting to communities and charities that can help you on your journey.
Trans Healthcare and Fertility
If you are struggling with gender dysphoria there are treatments available to help you transition to the gender you feel more aligned with. Many of these treatments will impact your fertility.
One of the most common treatments for the initial stages of transition is hormone therapy. This will mean trans-women will take the female sex hormone oestrogen to help them transition from male to female and trans-men will take testosterone to help them transition from female to male.
Taking these hormones can have an impact on your ‘original’ sex hormones and suppress your fertility, over time it could lead to a complete loss of fertility. Generally speaking, the longer you are on hormone therapy the more likely it is to impact your fertility. Some people do find that if they stop taking hormones their fertility is restored – but that isn’t guaranteed.
If you think you would like biological children in the future, it is possible to preserve your eggs or sperm, or create frozen embryos to be used at a later date, before beginning hormone therapy.
Trans Fertility Preservation
If you have already gone through puberty, it’s possible to freeze your sperm or eggs and store them until you are ready to start your family.
Egg freezing involves an egg collection similar to the process that happens during IVF. It’s a pretty safe and simple procedure although the drugs involved can put you at risk of ovarian hyperstimulation. Freezing sperm is an even easier process! You would simply produce a sample into a cup at your clinic and they would store it for you until you wanted to use it.
If you were unable to produce a sample or felt uncomfortable doing so, there is also the option to have a small surgery known as a sperm extraction, which can take sperm cells directly from the testicles.
For those who haven’t gone through puberty, you will likely not be producing mature eggs or sperm cells, but there are still ways you can preserve your fertility. If you are thinking about starting puberty-suppressing medication or hormone therapy it’s possible for you to store your ovarian or testicular tissue. However, there is no guarantee this will work as fertility treatments using tissue rather than sperm or egg cells are still very experimental. (We’ll go into more detail about this later.)
Sadly, like many fertility treatments, fertility preservation for trans people is not always funded by the NHS. It all depends on where you live and the rules and regulations in the area’s CCG.
Once you are in a position where you want to try for children, there are a few different options – and they all depend on your unique situation.
If you are a trans-man who was born with a female reproductive system and has not undergone a hysterectomy, it is theoretically possible to conceive with your frozen eggs and donor sperm (or sperm of your partner) and even carry your baby yourself. This is what trans-activist Danny Wakefield did – his story is an inspiring one to follow!
As a trans-man who has had a hysterectomy, you would have to either use a surrogate or have a partner who was able to carry the baby – but you could still potentially use your frozen eggs so the baby would have a biological link to you!
If you are a trans-woman who froze sperm cells before transitioning then you can use those sperm cells in IVF with the eggs of either a donor or a partner and then either a surrogate or your partner could carry the baby.
Again, funding for IVF and assisted fertility treatments for trans people can differ greatly depending on where you live – as can the rules on surrogacy.
In Vitro Gametogenesis and Trans Fertility
In vitro gametogenesis or IVG is a developing technology that could add a whole new dimension to trans-fertility options.
Defining in vitro gametogenesis (IVG), it is the means of developing gametes—reproductive cells like sperm or eggs—outside of the body. In theory, doctors could take any cell from your blood, skin or hair, and manipulate it in a lab to become a gamete. This could then be used to create fertilised embryos that could be used in traditional IVF.
This process is yet to be tested on humans, but recent animal studies have indicated great promise in this medical development.
IVG could be a game changer for trans people and queer couples where both produce the same sex cells. It could mean that not only is it possible to create gametes after a transition has happened (and even potentially negate the need for fertility preservation) but it could also mean that children born from the couple could have both of their genetics! However, many scientists believe we are still 10-20 years away from the first IVG baby
Trans Support Resources
If you are looking for advice and support around your Trans Fertility Journey – here are some resources that might be helpful.