Iris de Nie

141 GENERAL DISCUSSION AND FUTURE PERSPECTIVES 9 Lastly, it might be worthwhile to repeat the cohort studies on cancer incidence in ten years, to establish a larger cohort size and a longer follow-up time, and hereby draw even more reliable conclusions on testicular and prostate cancer risk in trans women. CONCLUSIONS Overall, the results of this thesis are reassuring for trans women. We identified life style factors that negatively influence semen quality in trans women, which enables optimization of fertility counseling on how to adjust this lifestyle prior to semen cryopreservation. Furthermore,we found that there may still be options for fertility preservation after initiation of GAHT, either by a temporary cessation of GAHT, or by harvesting germ cells from testicular tissue obtained during GAS. Lastly, we observed no increased risk for testicular and prostate cancer in trans women using GAHT. Taken all these results into account, the perspectives for (new) life after transition seem positive.