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Research Letter
April 13, 2020

Rates of Fertility Preservation Use Among Transgender Adolescents

Author Affiliations
  • 1Royal Children’s Hospital, Melbourne, Victoria, Australia
  • 2Murdoch Children’s Research Institute, Parkville, Victoria, Australia
  • 3Department of Obstetrics & Gynaecology, University of Melbourne, Royal Women’s Hospital Parkville, Victoria, Australia
JAMA Pediatr. 2020;174(9):890-891. doi:10.1001/jamapediatrics.2020.0264

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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