Table of ContentsView AllTable of ContentsSexual Reproduction 101Factors Affecting Transgender ReproductionTransgender People and ChildbearingEffect of SurgeriesTransfeminine People and ChildbearingBanking SpermTransgender BreastfeedingA Word From Verywell
Table of ContentsView All
View All
Table of Contents
Sexual Reproduction 101
Factors Affecting Transgender Reproduction
Transgender People and Childbearing
Effect of Surgeries
Transfeminine People and Childbearing
Banking Sperm
Transgender Breastfeeding
A Word From Verywell
Many transgender people are interested in having biological children. How easy or difficult it is depends on a number of factors. For example, it is far more difficult to save gametes for future assisted reproduction in people who medically transition before puberty. On the other hand, a transgender man or transgender non-binary person who is not opposed to carrying a child may be able to carry a child with relative ease.
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Factors that affect the complexity of being able to have biological children for someone who is transgender include:
People born withovariesand a uterus are typically assigned female at birth. Persons assigned female at birth who identify as having a male gender are termed transgender males, or gender non binary if they do not identify with being of either gender. Because these persons are born with ovaries and a uterus, they are capable of becoming pregnant and carrying a pregnancy to term..
Testosterone therapy usually leads to anovulation and amenorrhea (when the ovaries stop releasing eggs during a menstrual cycle and when the menstrual cycle stops). Stopping testosterone therapy may or may not reverse the effects, thus it can potentially affect fertility.
If a transgender man or non-binary person assigned female at birth has a cisgender woman as a partner, either of them can potentially carry their child. However, the couple will need donor sperm in order to become pregnant.
If a transgender man or non-binary person assigned female at birth has had a hysterectomy, either on its own or in preparation for a gender-affirming surgery such asphalloplastyor metoidioplasty, they can not carry a pregnancy. Since the ovaries are often removed at the time of a hysterectomy, they should consider egg retrieval if they may wish to have biological children in the future.
However, since egg retrieval usually requires a stimulated cycle, this option may not be acceptable to some. A stimulated cycle can be very dysphoric and cause symptoms such as anxiety and depression.
Transgender men and non-binary people assigned female at birth may also be encouraged to store eggs prior to any medical transition. This also requires a stimulated cycle. Standard pathways of egg banking are not generally an option for those who transition prior to puberty.
However, some researchers and doctors are exploring experimental oncofertility (cancer fertility) techniques to retrieve gametes in individuals who transition early.
These techniques were designed to help children with cancer preserve their fertility in the face of treatments that would otherwise damage or destroy their ability to reproduce.
There is a somewhat common misconception that transgender women and transfeminine people can get pregnant after undergoing avaginoplasty. That is not accurate. In order for someone in this group to become pregnant, she would have to have a uterus transplant.
This is not a surgical option that is currently available for this population. (There have been reports of a cisgender woman withMRKHgiving birth after a uterus transplant.)
Transgender women and transfeminine people can, however, contribute sperm to a pregnancy. Some bank sperm prior to any medical transition. This is much more straightforward than the procedure for banking eggs. They may also be able to produce and retrieve sperm while on hormones, either through ejaculation or testicular sperm extraction.
However, where it is feasible, those in this population who are interested in having biological children are encouraged to bank sperm prior to medical transitioning. This is not generally possible for those who transition prior to puberty. Still there are some experimental techniques for gamete harvesting under development.
If sperm banking is to be done, it must be done before vaginoplasty.
During vaginoplasty, the testes are removed. After this point, it is not possible to make sperm.
In addition, some transgender women and transfeminine people have anorchiectomyto remove their testicles without vaginoplasty. This allows them to reduce the strength of their cross-sex hormone therapy. Sperm banking must be done before orchiectomy as well.
If a transgender woman or transfeminine person has a partner assigned female at birth, they can have a child who shares both of their genes. The transgender woman or feminine person can provide sperm and the partner assigned female at birth can provide an egg and carry the pregnancy—or, they can use a surrogate.
If a transgender woman has someone assigned male at birth as a partner, only one of them will be able to contribute their genes to a child. They will need to use a donor egg and have a surrogate carry the pregnancy.
Breastfeeding can be a very meaningful way of connecting to your child. Theoretically, all trans people are capable of breastfeeding. This is because breast tissue is very similar across gender. Stimulating milk production just requires the right combination of hormones.
In 2018, scientists published the first report of a transgender woman successfully nourishing a child through stimulated lactation.
Transgender men and non-binary people assigned female at birth who intend to chest-feed a child may wish to either postpone chest reconstruction or discuss nipple-preserving options with their surgeon.
Regardless if a transgender person chooses to have children biologically, to adopt, or to not have children at all, it’s important to know what is and isn’t possible. Discussions about fertility should be an important part of transition care. When someone wants to preserve fertility, it may be easier to do so earlier on. It is important to note that people have very different priorities around balancing the urgency to transition with any desire to have children. Some people put pregnancy above all else. Others put transition first and foremost. There is no one pathway to an affirmed life or successful parenthood.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Obedin-Maliver J, Makadon HJ.Transgender men and pregnancy.Obstet Med. 2016;9(1):4–8. doi:10.1177/1753495X15612658Light AD, Obedin-Maliver J, Sevelius JM, Kerns JL.Transgender men who experienced pregnancy after female-to-male gender transitioning.Obstet Gynecol. 2014;Dec;124(6):1120-7. doi:10.1097/AOG.0000000000000540Cheng PJ, Pastuszak AW, Myers JB, Goodwin IA, Hotaling JM.Fertility concerns of the transgender patient.Transl Androl Urol. 2019;8(3):209–218. doi:10.21037/tau.2019.05.09Reisman T, Goldstein Z.Case report: induced lactation in a transgender woman.Transgender Health. 2018;Jan 1;3(1):24-26. doi:10.1089/trgh.2017.0044Additional ReadingDe Roo C, Tilleman K, T’Sjoen G, De Sutter P.Fertility options in transgender people.Int Rev Psychiatry. 2016;28(1):112-9. doi:10.3109/09540261.2015.1084275MacDonald T, Noel-Weiss J, West D, Walks M, Biener M, Kibbe A, Myler E.Transmasculine individuals' experiences with lactation, chestfeeding, and gender identity: a qualitative study.BMC Pregnancy Childbirth. 2016;May16;16:106. doi:10.1186/s12884-016-0907-y
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Obedin-Maliver J, Makadon HJ.Transgender men and pregnancy.Obstet Med. 2016;9(1):4–8. doi:10.1177/1753495X15612658Light AD, Obedin-Maliver J, Sevelius JM, Kerns JL.Transgender men who experienced pregnancy after female-to-male gender transitioning.Obstet Gynecol. 2014;Dec;124(6):1120-7. doi:10.1097/AOG.0000000000000540Cheng PJ, Pastuszak AW, Myers JB, Goodwin IA, Hotaling JM.Fertility concerns of the transgender patient.Transl Androl Urol. 2019;8(3):209–218. doi:10.21037/tau.2019.05.09Reisman T, Goldstein Z.Case report: induced lactation in a transgender woman.Transgender Health. 2018;Jan 1;3(1):24-26. doi:10.1089/trgh.2017.0044Additional ReadingDe Roo C, Tilleman K, T’Sjoen G, De Sutter P.Fertility options in transgender people.Int Rev Psychiatry. 2016;28(1):112-9. doi:10.3109/09540261.2015.1084275MacDonald T, Noel-Weiss J, West D, Walks M, Biener M, Kibbe A, Myler E.Transmasculine individuals' experiences with lactation, chestfeeding, and gender identity: a qualitative study.BMC Pregnancy Childbirth. 2016;May16;16:106. doi:10.1186/s12884-016-0907-y
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Obedin-Maliver J, Makadon HJ.Transgender men and pregnancy.Obstet Med. 2016;9(1):4–8. doi:10.1177/1753495X15612658Light AD, Obedin-Maliver J, Sevelius JM, Kerns JL.Transgender men who experienced pregnancy after female-to-male gender transitioning.Obstet Gynecol. 2014;Dec;124(6):1120-7. doi:10.1097/AOG.0000000000000540Cheng PJ, Pastuszak AW, Myers JB, Goodwin IA, Hotaling JM.Fertility concerns of the transgender patient.Transl Androl Urol. 2019;8(3):209–218. doi:10.21037/tau.2019.05.09Reisman T, Goldstein Z.Case report: induced lactation in a transgender woman.Transgender Health. 2018;Jan 1;3(1):24-26. doi:10.1089/trgh.2017.0044
Obedin-Maliver J, Makadon HJ.Transgender men and pregnancy.Obstet Med. 2016;9(1):4–8. doi:10.1177/1753495X15612658
Light AD, Obedin-Maliver J, Sevelius JM, Kerns JL.Transgender men who experienced pregnancy after female-to-male gender transitioning.Obstet Gynecol. 2014;Dec;124(6):1120-7. doi:10.1097/AOG.0000000000000540
Cheng PJ, Pastuszak AW, Myers JB, Goodwin IA, Hotaling JM.Fertility concerns of the transgender patient.Transl Androl Urol. 2019;8(3):209–218. doi:10.21037/tau.2019.05.09
Reisman T, Goldstein Z.Case report: induced lactation in a transgender woman.Transgender Health. 2018;Jan 1;3(1):24-26. doi:10.1089/trgh.2017.0044
De Roo C, Tilleman K, T’Sjoen G, De Sutter P.Fertility options in transgender people.Int Rev Psychiatry. 2016;28(1):112-9. doi:10.3109/09540261.2015.1084275MacDonald T, Noel-Weiss J, West D, Walks M, Biener M, Kibbe A, Myler E.Transmasculine individuals' experiences with lactation, chestfeeding, and gender identity: a qualitative study.BMC Pregnancy Childbirth. 2016;May16;16:106. doi:10.1186/s12884-016-0907-y
De Roo C, Tilleman K, T’Sjoen G, De Sutter P.Fertility options in transgender people.Int Rev Psychiatry. 2016;28(1):112-9. doi:10.3109/09540261.2015.1084275
MacDonald T, Noel-Weiss J, West D, Walks M, Biener M, Kibbe A, Myler E.Transmasculine individuals' experiences with lactation, chestfeeding, and gender identity: a qualitative study.BMC Pregnancy Childbirth. 2016;May16;16:106. doi:10.1186/s12884-016-0907-y
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