Background: 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.

Objective: To understand the thoughts and opinions about fertility preservation and family building within the transgender community.

Study design: 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.

Results: 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%, n/N=16/40) were interested in having children in the future, 18 (45.0%, n/N=18/40) were unsure/dependent on their partner, and 6 (15.0%, n/N=6/40) were not interested in having children. Of those interested in having children (n/N=16/40), the majority wished to utilize adoption to build their family (68.8%, n/N=11/16). Nine participants (22.5%, n/N=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.

Conclusion: 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.

Keywords: counseling; education; family building; fertility preservation; transgender.

© 2024 The Authors.

背景：考虑到跨性别和性别不一致个体的高流行率，医生有必要了解这一人群的独特需求，包括家庭建设及生育力保存的途径。

目的：为了理解跨性别社区对于生育力保存和家庭建设的想法与意见。

研究设计：一项基于问卷的研究和质性研究，在一家大型医院附属的生殖中心进行。使用了包含16个问题的调查问卷，随后进行了30分钟的虚拟访谈。43名参与者完成了问卷，并用于定量分析；40份音频文件被用于定性分析。

结果：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（占70.7%），然而，大部分参与者的性别认同是跨性别者（54.8%）或非二元性别的个体（47.6%）。参与者意识到自己是跨性别并告知朋友或伴侣的平均年龄为16.2±7.0岁（范围从3岁到30岁），而向父母、兄弟姐妹或其他家庭成员披露性别认同的平均年龄为22.4±5.9岁（范围从12岁到35岁）。研究使用了五个类别来总结参与者的经历和意见：家庭建设及育儿目标，家庭背景/伴侣对育儿目标的影响，生育力保存的意识与知识，家庭建设障碍，以及推荐给医疗保健提供者的沟通方式和教育。共有十六名参与者（占40.0%，n/N=16/40）表示有兴趣在未来拥有孩子，十八人（占45.0%，n/N=18/40）尚不确定或取决于其伴侣的意见，六名参与者（占15.0%，n/N=6/40）表示没有兴趣拥有孩子。在那些有兴趣拥有孩子的参与者中（n/N=16/40），大多数希望采用领养的方式来组建家庭（占68.8%，n/N=11/16）。九名参与者（占22.5%，n/N=9/40）报告称从未讨论过生育力保存的问题。大多数参与者同意性别不安、成本、咨询不充分以及医疗保健知识的改进是影响他们对追求生育力保存或育儿意见的关键因素。

结论：跨性别个体希望组建家庭，而大多数人更倾向于通过领养的方式实现这一目标。仍然有一些跨性别者没有接受过关于生育力保存的咨询。因此，医疗保健系统必须继续改善医疗提供者的教育，以更好地管理和服务于这一脆弱的人群。

关键词：咨询；教育；家庭建设；生育力保存；跨性别。

© 2024 The Authors.