Department of Obstetrics and Gynaecology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Centre of Expertise on Gender Dysphoria, Amsterdam UMC, Amsterdam, The Netherlands.
Hum Reprod. 2024 Sep 1;39(9):2032-2042. doi: 10.1093/humrep/deae155.
How do adult transgender and gender diverse (TGD) people, who are infertile due to prior gender-affirming treatment, view their current infertility and their reproductive decisions made in the past?
In a time where sterilization was mandatory, transgender adolescents prioritized gender-affirming treatment over their future fertility and would make the same choice today despite emotional challenges related to infertility experienced by some.
Under transgender law in the Netherlands, sterilization was required for legal gender recognition until 2014, resulting in permanent infertility. The long-term consequences of this iatrogenic infertility in transgender adolescents who have now reached adulthood remain underexplored.
STUDY DESIGN, SIZE, DURATION: Qualitative study design based on 21 in-depth one-on-one semi-structured interviews.
PARTICIPANTS/MATERIALS, SETTING, METHODS: TGD people in a stage of life where family planning may be a current topic were eligible for participation. They all received gender-affirming treatment in adolescence prior to the legislation change in 2014. A purposeful sampling technique was used from participants of another ongoing study. Eleven people assigned female at birth and ten people assigned male at birth were included. Interview transcripts were thematically analysed using a modified version of Braun and Clarke's six steps theory.
Six main themes were generated: (i) personal considerations regarding fertility and fertility preservation in the past; (ii) external considerations regarding fertility and fertility preservation in the past; (iii) current vision on past considerations and decisions; (iv) Current experiences and coping with infertility; (v) future family building; (vi) advice regarding fertility and fertility preservation decision-making.
LIMITATIONS, REASONS FOR CAUTION: Selection, recall, and choice supportive bias may play a role in interpreting our results.
This study highlights the importance of tailored counselling and comprehensive information on fertility preservation for transgender individuals, especially adolescents, undergoing gender-affirming treatment.
STUDY FUNDING/COMPETING INTEREST(S): N/A.
N/A.
由于先前的性别肯定治疗而导致不育的成年跨性别和性别多样化（TGD）人群如何看待他们目前的不育状况以及他们过去的生育决策？
在强制性绝育的时代，跨性别青少年优先考虑性别肯定治疗，而不顾一些人所经历的与不育相关的情感挑战，他们今天仍会做出同样的选择。
根据荷兰的跨性别法律，直到 2014 年，进行合法的性别认同需要绝育，这导致了永久性不育。在已经成年的接受过性别肯定治疗的青春期跨性别青少年中，这种医源性不育的长期后果仍未得到充分探索。
研究设计、规模和持续时间：基于 21 次深入的一对一半结构化访谈的定性研究设计。
参与者/材料、设置、方法：有生育计划可能是当前话题的 TGD 人群有资格参与。他们在 2014 年立法变更之前的青春期都接受了性别肯定治疗。采用另一个正在进行的研究的参与者的目的性抽样技术。共纳入 11 名出生时被指定为女性和 10 名出生时被指定为男性的参与者。使用修改后的 Braun 和 Clarke 的六步理论对访谈记录进行主题分析。
生成了六个主要主题：（i）过去对生育和生育保存的个人考虑；（ii）过去对生育和生育保存的外部考虑；（iii）当前对过去考虑和决策的看法；（iv）当前的不孕经历和应对方式；（v）未来的家庭建设；（vi）关于生育和生育保存决策的建议。
局限性、谨慎的原因：选择、回忆和选择支持性偏见可能会影响我们对结果的解释。
本研究强调了为接受性别肯定治疗的跨性别个体，特别是青少年，提供量身定制的咨询和全面的生育保存信息的重要性。
研究资金/利益冲突：无。
无。
