Transgender Fertility and Fertility Preservation: Scoping Review with ☸️SAIMSARA.

Name: SAIMSARA Evidence Object longevity::TRANSGENDER_FERTILITY_SS
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsaraea868144

SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Transgender Fertility and Fertility Preservation: Scoping Review with ☸️SAIMSARA.

Longevity & Public Health

Issue 2, Volume 1, 2026

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DOI: 10.62487/saimsaraea868144

Editorial note

• Last update: 2026-05-23 21:22:56

What is this paper about

Transgender fertility care is not a niche issue but a recurring clinical gap: many TGD people want future parenthood, yet fertility preservation remains limited by cost, dysphoria, delayed counseling, and uneven access. The full evidence map helps readers see where fertility potential is preserved, where hormone effects remain uncertain, and how counseling, tissue/gamete preservation, ART, and inclusive care pathways should be clinically structured.

Human-verified editorial review Verified by World ID proof-of-human. This editorial layer was submitted from a SAIMSARA account verified as a unique human.

Abstract: To map and synthesize the original research evidence on fertility, fertility preservation, reproductive potential, counseling, and family-building among transgender and gender-diverse populations. The review uses 121 references and builds its evidence map from 147 original studies with 34107 total participants/sample observations (topic-deduplicated ΣN). This scoping review suggests that although many transgender and gender-diverse people express interest in future parenthood, actual fertility preservation uptake remains low and uneven, with sperm-based options completed more frequently than oocyte- or tissue-based approaches—exemplified by FP rates of 40.4% in trans women versus 5.8% in trans men in one cohort. Cost, procedure-related dysphoria, reluctance to delay gender-affirming hormone therapy, and inconsistent counseling recur as dominant barriers across adolescent and adult settings. At the same time, accumulating evidence indicates that oocyte cryopreservation after testosterone exposure and sperm recovery after GAHT cessation are often feasible, supporting individualized rather than exclusionary FP pathways. The main practical implication is that early, repeated, equity-focused fertility counseling integrated within multidisciplinary gender-affirming care is warranted. Future prospective longitudinal studies tracking reproductive, decisional, and psychosocial outcomes after FP and GAHT are needed to resolve persistent uncertainty about long-term fertility trajectories.

Keywords: Transgender fertility; Fertility preservation; Gender-affirming hormones; Fertility counseling; Gamete cryopreservation; Oocyte cryopreservation; Sperm cryopreservation; Testicular tissue cryopreservation; Transgender adolescents; Reproductive health

Review Stats

Final search date and database lock: 2026-05-18 19:17:55 CEST
Plan: Pro (expanded craft tokens; source: Semantic Scholar)
Source: Semantic Scholar
Total Abstracts/Papers: 414701
Downloaded Abstracts/Papers: 1000
Included original and non-original Abstracts/Papers (all): 215
Included original Abstracts/Papers (Vote counting by direction of effect): 147
Reference Index (links used in paper): 121
Total participants/sample observations (topic deduplicated ΣN): 34107

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Reference Index (118)

[1] Fertility in transgender and gender diverse people: systematic review of the effects of gender-affirming hormones on reproductive organs and fertility. — https://doi.org/10.1093/humupd/dmae036
[2] The attitudes of transgender and gender-diverse adolescents and their parents regarding fertility, parenthood, and fertility preservation before the start of puberty suppression or gender-affirming hormone therapy. — https://doi.org/10.1093/jsxmed/qdaf029
[3] A legal alien: Transgender men's gender identity experienced through fertility, pregnancy, and childbirth. — https://doi.org/10.1037/ort0000827
[4] Making fertility preservation happen for the transgender community. — https://doi.org/10.1016/j.bpobgyn.2025.102652
[5] Fertility Preservation for Transgender, Non-binary, and Gender-expansive Individuals in France: A Comprehensive Assessment of Healthcare Services and Practices. — https://doi.org/10.1016/j.jogoh.2025.103002
[6] P-391 A mixed-methods study exploring fertility preservation and parenthood experiences among transgender individuals — https://doi.org/10.1093/humrep/deaf097.697
[7] Social media engagement with transgender fertility content — https://doi.org/10.1016/j.xfre.2021.12.005
[8] Transgender persons’ view on previous fertility decision-making and current infertility: a qualitative study — https://doi.org/10.1093/humrep/deae155

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