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Health care provider perceptions of fertility preservation barriers and challenges with transgender patients and families: qualitative responses to an international survey

  • Fertility Preservation
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Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To examine provider perceptions of practice behaviors and barriers related to fertility counseling, fertility preservation, and family building among transgender patients.

Methods

Participants were medical and mental health professionals who treat adult and youth transgender patients. Recruitment occurred online and in person, via professional listservs for transgender professionals, conferences, and gender clinics. From August–November 2017, 110 participants representing nine countries responded to four open-ended questions included on a survey related to provider practice behaviors and perceived barriers to fertility counseling, fertility preservation, and family building with transgender patients. Thematic coding analysis was used to identify themes.

Results

Multiple themes were identified including the following: access and cost issues; urgency for gender-affirming treatment; patient maturity and inability to make future-oriented decisions; and provider-related challenges pertaining to knowledge, role, and general lack of information in the nascent field of transgender reproductive health.

Conclusion(s)

This study yielded insights into practice behaviors, challenges, and perceived barriers to fertility counseling with transgender individuals and can serve as a basis for intervention development to optimize clinical practices with this population.

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Authors and Affiliations

  1. Departments of Endocrinology and Psychiatry, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA

    Amy C. Tishelman

  2. Harvard Medical School, Boston, MA, 02115, USA

    Amy C. Tishelman

  3. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, 33612, USA

    Megan E. Sutter

  4. Division of Adolescent Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, 60611, USA

    Diane Chen & Victoria D. Kolbuck

  5. Department of Child and Adolescent Psychiatry, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, 60611, USA

    Diane Chen

  6. Departments of Psychiatry and Behavioral Sciences, and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Diane Chen

  7. Departments of OB-GYN and Population Health, New York University School of Medicine, New York, NY, 10016, USA

    Amani Sampson & Gwendolyn P. Quinn

  8. Division of Endocrinology and Center for Biobehavioral Health, Nationwide Children’s Hospital, Columbus, OH, 43205, USA

    Leena Nahata

  9. The Ohio State University College of Medicine, Columbus, OH, 43205, USA

    Leena Nahata

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  1. Amy C. Tishelman
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  2. Megan E. Sutter
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  5. Leena Nahata
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  7. Gwendolyn P. Quinn
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Correspondence to Amy C. Tishelman.

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Tishelman, A.C., Sutter, M.E., Chen, D. et al. Health care provider perceptions of fertility preservation barriers and challenges with transgender patients and families: qualitative responses to an international survey. J Assist Reprod Genet 36, 579–588 (2019). https://doi.org/10.1007/s10815-018-1395-y

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  • DOI: https://doi.org/10.1007/s10815-018-1395-y

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