Fertility Preservation in Transgender Youth Undergoing Feminizing Therapy

Gender-affirming therapy for adolescents assigned male at birth (i.e., feminizing therapy) consists of exogenous administration of estradiol. Many patients also receive blockade of puberty, sex steroids, or both from leuprolide acetate or other agents. These treatment regimens may damage testicular germ cells irreversibly. Fertility preservation counseling is recommended by many professional groups, but the uptake is highly variable.

Researchers retrospectively examined fertility preservation outcomes in 10 transgender youth assigned male at birth who were undergoing semen cryopreservation. All completed at least one semen collection. Eight patients cryopreserved semen before receiving gender-affirming therapy (gonadotropin-releasing hormone…