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Perspectives on fertility preservation and parenthood among transgender youth and their parents
  1. Lyne Noelle Chiniara1,
  2. Christine Viner2,
  3. Mark Palmert1,3,
  4. Herbert Bonifacio4
  1. 1 Department of Pediatrics, Division of Endocrinology, Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2 Department of Pediatrics, Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
  3. 3 Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  4. 4 Department of Pediatrics, St-Michael’s Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Lyne Noelle Chiniara, Department of Pediatrics, Division of Endocrinology, Hospital for Sick Children, Toronto, ON H3T 1C5, Canada; lyne.chiniara.hsj{at}


Objective The aim of this study was to investigate the views of young people (YP) with gender dysphoria and their parents concerning fertility preservation and reproductive and life priorities.

Design A cross-sectional questionnaire-based study assessed knowledge of potential effects of treatments for gender dysphoria on fertility, current and future life priorities and preferences regarding future fertility/parenting options among YP and parents.

Results A total of 79 YP (81% assigned female at birth [AFAB], 19% assigned male at birth [AMAB], aged 12–18 years, 68% between ages 16 years and 18 years) and 73 parents participated. The top current life priority for YP among eight options was being in good health; the least important priority was having children. Anticipated life priorities 10 years from now were ranked similarly. Parents’ rankings paralleled the YP responses; however, parents ranked having children as a significantly higher priority for AFAB compared with AMAB YP in 10 years. The majority of YP (66% AFAB, 67% AMAB) want to be a parent in the future. However, most do not envision having a biological child. A large majority (72% AFAB, 80% AMAB) were open to adoption. None of the YP surveyed pursued fertility preservation.

Conclusion Fertility is a low current and future life priority for transgender YP. The majority of YP wish to become parents but are open to alternative strategies for building a family. These data may explain in part the reported low rates of fertility preservation among this population. Further studies are needed to assess if life priorities change over time.

  • transgender
  • gender variance
  • adolescent health
  • gender-affirming hormones
  • fertility preservation

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  • Contributors LNC designed the data collection instruments, collected data, carried out the initial analyses and drafted the initial manuscript. CV collected data and revised the manuscript. HB and MP conceptualised the study, coordinated and supervised the design of the study and questionnaires, assisted with analysis and interpretation of data and critically reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding No external funding; work supported by a Creative Professional Activity grant from the Department of Pediatrics, Hospital for Sick Children, Toronto, Canada.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at This study has been presented as a poster at the International Meeting of Pediatric Endocrinology in Washington in September 2017.

  • Patient consent for publication Obtained.

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