Conard Ryan, Folsom Lisal
University of Louisville, School of Medicine Department of Pediatrics, affiliated with Norton Children's Medical Group, 571 S. Floyd Street, Ste. 432, Louisville, KY 40202, USA.
University of Louisville School of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, 571 S. Floyd Street, Ste. 128, Louisville, KY 40202, USA.
J Clin Transl Endocrinol. 2024 May 18;36:100353. doi: 10.1016/j.jcte.2024.100353. eCollection 2024 Jun.
Known barriers to family planning in the transgender population include low utilization of cryopreservation and decisional regret. There is growing data on the risk of infertility with GAHT, and on to what degree transgender adolescents feel informed about fertility and family planning options.
Assess preferences regarding options for family planning and fertility preservation in transgender adolescents treated with GAHT in a pediatric endocrinology gender clinic. The goal is to enhance patient education about potential effects of GAHT on fertility and options for family planning.
Forty one adolescents aged 10 years and older treated with GAHT in an urban outpatient pediatric endocrinology clinic were surveyed over a 6-month period from January to June 2022. Survey questions were multiple choice, Likert scale, and open-ended. Participants were at least 10 years of age, actively followed in the clinic, and receiving GAHT at time of enrollment.
Forty one participants completed the survey. Four (10 %) expressed interest in discussing family planning with their provider. Eighteen (45 %) were open to discussion in the future; 16 (39 %) were not interested at all. 12 (30 %) participants were planning for future parenthood, and 16 (40 %) participants were undecided. Of those interested in parenthood 7 (53.8 %) planned to adopt or foster. Barriers to family planning expressed included financial concerns, potential need to pause GAHT, and social stigma of transgender parenthood. Twenty (50 %) participants recalled prior family planning discussion with their endocrinologist.
Family planning discussions may not be optimally impactful given that 50 % of participants did not recall the conversations. Family planning is a lower priority in this population as most desired to postpone discussion with their provider despite choosing treatment that could influence fertility. It is essential to identify methods to engage transgender youth in discussions related to family planning during GAHT.
已知跨性别群体中计划生育的障碍包括冷冻保存利用率低和决策后悔。关于性别确认激素治疗（GAHT）导致不孕风险的数据越来越多，以及跨性别青少年对生育和计划生育选择的了解程度。
评估在儿科内分泌性别诊所接受GAHT治疗的跨性别青少年对计划生育和生育力保存选择的偏好。目标是加强患者对GAHT对生育力的潜在影响和计划生育选择的教育。
2022年1月至6月的6个月期间，对在城市门诊儿科内分泌诊所接受GAHT治疗的41名10岁及以上青少年进行了调查。调查问题包括多项选择、李克特量表和开放式问题。参与者年龄至少10岁，在诊所积极随访，入组时正在接受GAHT治疗。
41名参与者完成了调查。4人（10%）表示有兴趣与他们的医疗服务提供者讨论计划生育。18人（45%）愿意在未来进行讨论；16人（39%）完全不感兴趣。12名（30%）参与者计划未来生育，16名（40%）参与者尚未决定。在那些对生育感兴趣的人中，7人（53.8%）计划收养或领养。所表达的计划生育障碍包括经济担忧、可能需要暂停GAHT以及跨性别父母身份的社会耻辱感。20名（50%）参与者回忆起之前与他们的内分泌学家进行的计划生育讨论。
鉴于50%的参与者没有回忆起这些谈话，计划生育讨论可能没有达到最佳效果。在这个群体中，计划生育的优先级较低，因为尽管选择了可能影响生育力的治疗方法，但大多数人仍希望推迟与他们的医疗服务提供者的讨论。确定在GAHT期间让跨性别青年参与与计划生育相关讨论的方法至关重要。
