Fertility Considerations in Parental Decision-Making about Pubertal Suppression Treatment for Their Transgender and Gender-Diverse Children

Transgender and gender diverse (TGD) youth receiving pubertal suppression treatment may be at risk for future infertility if they progress on to gender-affirming hormones. Little is known about whether and how parents of TGD youth consider fertility-related implications when making medical decisions about pubertal suppression treatment. We conducted interviews with 13 parents of 11 TGD youth about fertility-related considerations in the context of treatment decision-making. Three major themes were identified: (1) current fertility knowledge and counseling experiences, (2) barriers to parent-child discussions around fertility, and (3) importance of fertility in treatment decision-making. Findings highlight the complex nature of fertility considerations in this population.