Walker Zachary W, McDilda Katelin, Lanes Andrea, Goldman Randi, Ginsburg Elizabeth S, Insogna Iris
Center for Infertility and Reproductive Surgery, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA (Walker, Mcdilda, Lanes, and Ginsburg).
Harvard Medical School, Boston, MA (Walker, Mcdilda, Lanes, and Ginsburg).
AJOG Glob Rep. 2024 Sep 18;4(4):100398. doi: 10.1016/j.xagr.2024.100398. eCollection 2024 Nov.
When considering the significant prevalence of transgender and gender nonconforming individuals, it is imperative that physicians work to understand the unique needs of this population including paths to family building and fertility preservation.
To understand the thoughts and opinions about fertility preservation and family building within the transgender community.
Survey-based study and qualitative study at a single, large hospital-affiliated fertility center. A 16-question survey followed by a 30-minute virtual interview was utilized. Forty-three participants completed the survey and were used for quantitative analysis, and 40 audio files were used for qualitative analysis.
The average age of participants was 27.0±7.3 years old. The majority of participants were assigned female at birth (70.7%); however, most participants' gender identities were transgender (54.8%) or nonbinary (47.6%). The average age at which participants realized they were transgender and disclosed their identity to a friend, or partner, was 16.2±7.0 (range 3-30) and 20.1±5.6 (range 11-33), respectively. The average age that participants disclosed their gender identity to their parents, siblings, or other family was 22.4±5.9 (range 12-35). Five categories were utilized to summarize the experiences and opinions of the participants: family building and parenthood goals, influences of family background/partner on parenthood goals, awareness and knowledge about fertility preservation, barrier to family building, and recommended healthcare provider communication and education. Sixteen participants (40.0%, /=16/40) were interested in having children in the future, 18 (45.0%, /=18/40) were unsure/dependent on their partner, and 6 (15.0%, /=6/40) were not interested in having children. Of those interested in having children (/=16/40), the majority wished to utilize adoption to build their family (68.8%, /=11/16). Nine participants (22.5%, /=9/40) reported that fertility preservation was never discussed. Most participants agreed that gender dysphoria, cost, inadequate counseling, and improvements in healthcare knowledge about transgender individuals were key influences on their opinions about pursuing fertility preservation or parenthood.
Transgender individuals want to build families, and the majority consider adoption the preferred method. There are still transgender individuals who are not counseled about fertility preservation. It is imperative the healthcare system continues to improve the education of healthcare providers about management and care of transgender individuals to provide the best care for this vulnerable population.
鉴于跨性别者和性别不一致者的显著患病率，医生必须努力了解这一人群的独特需求，包括生育和家庭构建途径。
了解跨性别群体对生育和家庭构建的想法和观点。
在一家大型医院附属的生育中心进行基于调查的研究和定性研究。采用了一份包含16个问题的调查问卷，随后进行30分钟的虚拟访谈。43名参与者完成了调查问卷并用于定量分析，40个音频文件用于定性分析。
参与者的平均年龄为27.0±7.3岁。大多数参与者出生时被指定为女性（70.7%）；然而，大多数参与者的性别认同为跨性别者（54.8%）或非二元性别者（47.6%）。参与者意识到自己是跨性别者并向朋友或伴侣披露身份的平均年龄分别为16.2±7.0岁（范围3 - 30岁）和20.1±5.6岁（范围11 - 33岁）。参与者向父母、兄弟姐妹或其他家人披露其性别认同的平均年龄为22.4±5.9岁（范围12 - 35岁）。使用五个类别来总结参与者的经历和观点：生育和育儿目标、家庭背景/伴侣对育儿目标的影响、对生育保存的认识和知识、生育障碍以及推荐的医疗保健提供者沟通和教育。16名参与者（40.0%，/=16/40）对未来生育感兴趣，18名（45.0%，/=18/40）不确定/取决于其伴侣，6名（15.0%，/=6/40）对生育不感兴趣。在对生育感兴趣的参与者中（/=16/40），大多数希望通过收养来组建家庭（68.8%，/=11/16）。9名参与者（22.5%，/=9/40）报告从未讨论过生育保存问题。大多数参与者同意性别焦虑、成本、咨询不足以及关于跨性别者的医疗保健知识的改善是影响他们对寻求生育保存或育儿看法的关键因素。
跨性别者希望组建家庭，大多数人认为收养是首选方式。仍有一些跨性别者未得到关于生育保存的咨询。医疗保健系统必须继续加强对医疗保健提供者关于跨性别者管理和护理的教育，以便为这一弱势群体提供最佳护理。
