The fertility of transgender youths in Texas was thrust into the spotlight recently after state leaders issued a directive designating gender-affirming care as child abuse that infringed on a person’s “fundamental right to procreation.”
Medical interventions for transgender adolescents can have an impact on a person’s short and long-term fertility.
But trans health experts say it’s a nuanced issue: New research into the preservation of fertility is opening doors for trans patients who may want to have their own biological children in the future.
State leaders have gone too far by prioritizing future fertility over the current health concerns caused by gender dysphoria, said Renee Baker, a professional counselor in Dallas who specializes in LGBT-specific care.
“It’s almost like you’re saying the life of an unborn possibility is more important than the existing life [of a transgender adolescent],” she said.
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Consideration of a trans adolescent’s ability to have children in the future has been a critical part of proper trans health care, medical experts say. Scientists are still researching the potential impact of gender-affirming medical care on fertility, and they say more data is needed to fully understand its implications.
“It is essential that a thorough discussion of fertility preservation and the options available are provided. Not to do that would be malpractice,” said Dr. Stephen Rosenthal, medical director of the child and adolescent gender center for the University of California, San Francisco Benioff Children’s Hospitals.
Patients and their families have to give informed consent, meaning that they’ve been given information about all the potential risks and benefits of a treatment before deciding whether or not to pursue it, Baker said.
Gender-affirming medical treatments can alter a person’s fertility, depending on when the treatments are initiated and whether they are continued. Such treatments are not started until a person has begun puberty. Puberty varies by person, but it can start as early as age 8 for people assigned female at birth and age 9 for people assigned male at birth, according to the Cleveland Clinic.
Most parents don’t anticipate discussing fertility preservation with their teenager. Most parents also don’t anticipate having to balance a transgender adolescent’s need for gender-affirming care with any potential risks to their future fertility.
“If you say that, ‘I’m not going to let you have access to pubertal blockers until you’re older, until you’ve gone through full puberty,’ well then [the adolescent] would experience all of these irreversible physical changes that can increase their risk for severe mental health problems, including suicide attempts,” Rosenthal said.
There are some options for transgender adolescents who want the opportunity to have their own biological kids down the road, although those options look different for each individual case.
I think SB8 and all of the anti-abortion bills that came before it expresses quite clearly the relative value of existing people versus theoretical ones. It’s all part of a consistent Republican philosophy. Local control is great because government closest to the people is best, except when they do things we don’t like. Parents should be fully free to make whatever decisions they want about how to raise their children, except when we don’t agree with those choices. Businesses should be free of the yoke of government regulation, except when they adopt “too woke” policies. It all makes sense, if you understand that underlying philosophy.