Because hormone therapy is known to slow and eventually stop sperm production, trans women who wish to have biological children must store their sperm before starting hormones. It is not known whether sperm production will resume if hormones are discontinued. Both the WPATH and Endocrine Society guidelines recommend considering sperm storage before starting hormone therapy.
Those recommendations aren’t without conflict. Some in the medical field have expressed concerns about the welfare of children born to trans parents. There are no empirical data available on those kids, but the authors of this study comment that “the lack of reassuring evidence cannot be used as a barrier against reproduction after gender transition.” I think they’re absolutely right. Further, the data on same-sex parenting help reinforce that it’s not the gender of the parent(s) that’s important for a child’s well-being. Factors like cooperation and stability are far more influential.
The authors note that there is little research surrounding reproduction in trans women, and that the research world has little understanding of the motivations and concerns affecting trans women’s reproductive decisions. Several issues they mention seeing in their clinic include cost, desire to transition quickly, and difficulty producing sperm for freezing. They also call for more research, so that clinicians better understand what trans women are facing and can improve health care.
I was really glad to see this article published. There was a lot of discussion of reproductive options for young trans people at the latest Gender Spectrum conference. It’s good to see it being discussed respectfully in the literature.
Link (Archives of Sexual Behavior)
EDIT: Yes, that title does look weird, doesn’t it? It really is the title of the article that was published.