Attitudes Toward Fertility and Reproductive Health Among Transgender and Gender-Nonconforming Adolescents

J Adolesc Health. 2018 Jul;63(1):62-68. doi: 10.1016/j.jadohealth.2017.11.306. Epub 2018 Mar 2.


Purpose: Little is known about the reproductive desires of transgender and gender-nonconforming (TGNC) adolescents who may seek gender-affirming medical care that leads to infertility. The current study addressed this gap by examining attitudes toward fertility and family formation in a diverse sample of TGNC youth.

Method: An online survey about sexual/reproductive health in sexual and gender minority (SGM) adolescents ages 14-17 years was conducted from September to October 2016.

Results: A total of 156 TGNC adolescents (Mage = 16.1 years; 83.3% assigned female at birth; 58.3% youth of color) responded. Overall, 70.5% of TGNC adolescents were interested in adoption and 35.9% in biological parenthood; more gender-nonconforming youth (43.8%) than transgender youth (25.8%) expressed interest in biological fertility. Discussions with health-care providers about fertility and reproductive health were uncommon-only 20.5% of youth had discussed fertility in general and only 13.5% had discussed effects of hormones on fertility. However, 60.9% of respondents were interested in learning more about their fertility and family building options. Key themes emerging from qualitative comments included concerns related to fertility/reproductive health (e.g., stigma of SGM parenthood, effect of gender-affirming treatments on fertility), and the need for additional reproductive health information both tailored to their individual experience and for SGM individuals more generally.

Discussion: TGNC adolescents expressed interest in multiple family building options, including adoption and biological parenthood, and identified a need for more information about these options. Thus, clinicians working with adolescents should be aware of the unique fertility and reproductive health needs of TGNC youth.

Keywords: Adolescents; Family building; Family formation; Fertility; Gender-nonconforming; Reproductive health; Transgender.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Attitude*
  • Female
  • Fertility / physiology*
  • Humans
  • Internet
  • Male
  • Reproductive Health*
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Surveys and Questionnaires