Perspectives of Transgender and Gender Diverse People on Fertility Preservation and Future Biological Family Building: A European Network for the Investigation of Gender Incongruence Study
Restricted accessResearch articleFirst published online 2026
Perspectives of Transgender and Gender Diverse People on Fertility Preservation and Future Biological Family Building: A European Network for the Investigation of Gender Incongruence Study
This study examined the perspectives of transgender and gender diverse (TGD) people on fertility preservation and future biological family building at the initiation of gender-affirming hormone therapy (GAHT), aiming to enhance counseling practices and support informed decision-making.
Method:
This international multicenter questionnaire study was conducted as part of the European Network for the Investigation of Gender Incongruence across four outpatient clinics in four countries. Participants completed a fertility questionnaire at the initiation of GAHT from January 2017 to June 2023.
Results:
Of 661 participants, 58% were assigned female at birth (AFAB) and 42% assigned male at birth (AMAB). Most received information on GAHT’s effects on fertility (78%), with 36% expressing a (future) desire for parenthood, biologically or otherwise. Cryopreservation rates for people AFAB were 7% and 24% for people AMAB. The most common reason for not freezing gametes was not finding it necessary, in both people AFAB and AMAB.
Conclusions:
Our study shows that many TGD individuals desire to parent children. However, they do not always consider a biological relation a necessity. This partly explains the low uptake of fertility preservation.
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