Attitudes Toward Fertility and Reproductive Health Among Transgender and Gender-Nonconforming Adolescents

Diane Chen*, Margaret Matson, Kathryn Macapagal, Emilie K. Johnson, Ilina Rosoklija, Courtney Finlayson, Celia B. Fisher, Brian Mustanski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

108 Scopus citations


Purpose: Little is known about the reproductive desires of transgender and gender-nonconforming (TGNC) adolescents who may seek gender-affirming medical care that leads to infertility. The current study addressed this gap by examining attitudes toward fertility and family formation in a diverse sample of TGNC youth. Method: An online survey about sexual/reproductive health in sexual and gender minority (SGM) adolescents ages 14–17 years was conducted from September to October 2016. Results: A total of 156 TGNC adolescents (Mage = 16.1 years; 83.3% assigned female at birth; 58.3% youth of color) responded. Overall, 70.5% of TGNC adolescents were interested in adoption and 35.9% in biological parenthood; more gender-nonconforming youth (43.8%) than transgender youth (25.8%) expressed interest in biological fertility. Discussions with health-care providers about fertility and reproductive health were uncommon—only 20.5% of youth had discussed fertility in general and only 13.5% had discussed effects of hormones on fertility. However, 60.9% of respondents were interested in learning more about their fertility and family building options. Key themes emerging from qualitative comments included concerns related to fertility/reproductive health (e.g., stigma of SGM parenthood, effect of gender-affirming treatments on fertility), and the need for additional reproductive health information both tailored to their individual experience and for SGM individuals more generally. Discussion: TGNC adolescents expressed interest in multiple family building options, including adoption and biological parenthood, and identified a need for more information about these options. Thus, clinicians working with adolescents should be aware of the unique fertility and reproductive health needs of TGNC youth.

Original languageEnglish (US)
Pages (from-to)62-68
Number of pages7
JournalJournal of Adolescent Health
Issue number1
StatePublished - Jul 2018


  • Adolescents
  • Family building
  • Family formation
  • Fertility
  • Gender-nonconforming
  • Reproductive health
  • Transgender

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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