At work I have a bunch of different searches set up to email myself different journal articles related to queer bioethics, LGBT research ethics, transgender stuff, etc. Lately I’ve come across a number of different articles on the ethics of fertility preservation in the trans community (particularly with any type of body modification)
I’m probably less interested in the ethical debates and more interested in the implementation. Things like providers having conversations with their trans patients/clients and establishing clinical guidelines and protocols for these discussions. It’s nice to see that some places include fertility, like UCSF’s Center of Excellence for Trans Health’s “Primary Care Protocol For Trans Health”.
Thinking back to the time (about 7 years ago now) when I started taking testosterone no physical or mental health providers ever discussed fertility issues with me. Granted, I may laughed in their face. I was around 25 or 26 at the time. I wasn’t ready to think about kids. I was totally absorbed with surviving day-to-day and jumping through hoops so I could finally begin my transition and feel more comfortable in my body.
Things get even more important/interesting/complicated as youth begin to transition at earlier ages. I know there is quite a bit written about having discussions about fertility in the oncology field, with teenagers who have cancer, but I haven’t found much of anything about teens and transition and fertility.
Some of the research I currently work on is related to patient education and risk communication related. Specifically we look at improving ways of presenting risks and benefits of different treatments to help patients make better decisions. I often think about the decision to begin hormone therapy for trans folks….but I wonder how effective even the best designed health education materials could really be. I’m sure everyone has their own unique experiences but personally my drive for self-actualization was so strong that I paid little attention to the risks (or just minimized them).
In my case I think I would have responded similarly if a provider would have tried to discuss fertility with me back then, yet now I really wish they would have.