Iris de Nie

26 C H A P T E R 2 troublesome to have become infertile at time of this study were wanting genetically related children (74%) and feeling it is an emotional topic which is difficult to handle (35%). One participant reported: “I would love to raise a child. However, with my past, the chances of adoption are nil. This makes the chances of me ever raising a child incredibly low, much to my regret.” People who did not find it troublesome to have become infertile mentioned not having a desire for children (21%), not wanting genetically related children (21%), and finding medical treatment for gender dysphoria more important than staying fertile (67%) as most important reasons. Other mentioned reasons for not finding the loss of fertility troublesome, were being happy to be rid of their biological reproductive organs and/or not wanting children with their biological reproductive organs, one trans man explained this as follows: “For me, getting pregnant myself or passing on female genes was never an option. I did not attach any emotional value to my uterus or ovaries, nor did I feel that my gonadectomy was the actual moment I became infertile. To be honest, I never saw having children as an option because I was not a woman, but I also wasn’t able to make sperm”. Also, infertility being a logical consequence of decisions made in the past and not having had other options, were mentioned as reasons for being at peace with the acquired infertility. With today’s knowledge, 14% of trans masculine and 17% of trans feminine people would not have chosen to undergo gonadectomy. In addition, 44% of trans masculine and 35% of trans feminine people would pursue fertility preservation, respectively 23% and 30% reported not to know if they would choose fertility preservation. Of all trans feminine people, 39% would prefer to freeze surgically obtained spermatozoa over ejaculated sperm because masturbation would be too burdensome for them. Current desires regarding fertility and family building As shown in Figure 1, 56% of participants reported to currently have a desire for children, to desire children in the future, or to have children. Figure 2 shows how participants would prefer to fulfill their desire to have children. Whereas 32% of trans masculine people would prefer to use a sperm donor, none of the trans feminine would consider this an option to fulfill their desire for children. A total of 20 trans masculine people reported to currently have children of whom one person did not undergo gGAS and was therefore able to become pregnant and have a biological child. Among the other 19 people, 13 had children with a female partner and a sperm donor, 6 had stepchildren, and 2 people reported to have children through adoption or foster care.