Transgender adolescents are increasingly seeking hormonal intervention to achieve a body consistent with their gender identity. These treatments include gonadotropin-releasing hormone agonists (GnRHa) to suppress puberty and the gender-affirming hormones testosterone and estrogen. Given that these interventions affect reproductive function, current treatment guidelines recommend prior fertility counseling and access to fertility preservation (FP).1 However, despite a previous report that 36% of transgender adolescents want biological children in the future,2 3 recent North American studies3-5 identified that less than 5% of transgender adolescents accessed FP. Whether these low rates reflect service barriers (eg, cost and availability), unwillingness to delay hormonal treatment for FP, and/or an intrinsic lack of desire for FP is unclear.
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Pang KC, Peri AJS, Chung HE, et al. Rates of Fertility Preservation Use Among Transgender Adolescents. JAMA Pediatr. 2020;174(9):890–891. doi:10.1001/jamapediatrics.2020.0264
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