Fertility Considerations in Early Pubertal Trans Youths’ Decision-Making about Pubertal Suppression Treatment
Session Number
Project ID: BHVSO 03
Advisor(s)
Dr. Diane Chen; Ann & Robert H. Lurie Children’s Hospital of Chicago / Northwestern University, Feinberg School of Medicine
Dr. Briahna Yuodsnukis, PhD, Ann & Robert H. Lurie Children’s Hospital of Chicago
Discipline
Behavioral and Social Sciences
Start Date
19-4-2023 10:05 AM
End Date
19-4-2023 10:20 AM
Abstract
Gonadotropin-releasing hormone analogs (GnRHa) are considered standard-of-care treatment for gender dysphoria among early pubertal transgender youth. GnRHa suppress endogenous puberty, preventing the development of gender incongruent secondary sex characteristics. However, treatment with GnRHa also prevents the maturation of germ cells. Germ cell maturation is necessary for fertility. While GnRHa does not permanently impair fertility, as discontinuing GnRHa treatment would result in pubertal development resuming and the subsequent maturation of oocytes and sperm, most transgender youth pursue gender-affirming hormone treatment. The long term effects of GnRHa and cross hormone treatment on fertility potential is unclear. Recent studies have focused on how potential fertility implications of gender-affirming medical treatment impact treatment decision-making in an older cohort of pubertal transgender adolescents and their parents. No research to date has focused on how fertility implications of GnRHa affect treatment decision-making in a younger cohort of early pubertal transgender youth. To address this gap, we conducted semi-structured interviews with 10 transgender youth ages 9-13 to answer 3 key questions: (1) What do early pubertal transgender youth know about fertility?; (2) What do early pubertal transgender youth know about how GnRHa impacts fertility?; and (3) How, if at all, does their understanding of GnRHa impacts on fertility affect their decision making about GnRHa treatment? Interviews were transcribed and thematic coding is ongoing. The result of analyzing the interviews will help clinicians navigate counseling of transgender youth regarding decisions about GnRHa.
Fertility Considerations in Early Pubertal Trans Youths’ Decision-Making about Pubertal Suppression Treatment
Gonadotropin-releasing hormone analogs (GnRHa) are considered standard-of-care treatment for gender dysphoria among early pubertal transgender youth. GnRHa suppress endogenous puberty, preventing the development of gender incongruent secondary sex characteristics. However, treatment with GnRHa also prevents the maturation of germ cells. Germ cell maturation is necessary for fertility. While GnRHa does not permanently impair fertility, as discontinuing GnRHa treatment would result in pubertal development resuming and the subsequent maturation of oocytes and sperm, most transgender youth pursue gender-affirming hormone treatment. The long term effects of GnRHa and cross hormone treatment on fertility potential is unclear. Recent studies have focused on how potential fertility implications of gender-affirming medical treatment impact treatment decision-making in an older cohort of pubertal transgender adolescents and their parents. No research to date has focused on how fertility implications of GnRHa affect treatment decision-making in a younger cohort of early pubertal transgender youth. To address this gap, we conducted semi-structured interviews with 10 transgender youth ages 9-13 to answer 3 key questions: (1) What do early pubertal transgender youth know about fertility?; (2) What do early pubertal transgender youth know about how GnRHa impacts fertility?; and (3) How, if at all, does their understanding of GnRHa impacts on fertility affect their decision making about GnRHa treatment? Interviews were transcribed and thematic coding is ongoing. The result of analyzing the interviews will help clinicians navigate counseling of transgender youth regarding decisions about GnRHa.