Trans Family Building

Everyone has a different path to parenthood, filled with medical, legal, and socio-emotional considerations. For transgender, nonbinary, and gender-nonconforming folks, preparing for parenthood includes all the typical planning — What path do we take? How much will it cost? What’s the best stroller, and where can we find a sale? — in addition to navigating questions around hormones, self-advocacy, and more. As you embark on this journey, explore Family Equality’s various resources on general paths to parenthood and the trans-specific resources on this page! 

Explore: RESOURCES | FAQ | COSTS | AFFIRMING PROVIDERS

Supporting Trans Pregnancy
Supporting Trans Pregnancy
Trans Fatherhood
Trans Fatherhood
Growing Up with Trans Parents
Growing Up with Trans Parents
View all our LGBTQ+ family stories

Trans Fertility Resources

To help put safe, accurate, inclusive fertility information directly into the hands of the trans community, Family Equality partnered with Fertility IQ. Drawn from dozens of medical and academic studies as well as personal experiences, the resources below cover a wide variety of topics related to trans fertility—including understanding how hormones impact fertility, when and how to preserve your fertility if you’re going to transition, and how to get emotional support throughout your family-building process.

There are also resources for helping trans and gender-nonconforming people advocate for themselves within medical spaces and build resiliency when dealing with hardships related to the family-building process.

Explore transfeminine fertility resources

Explore transmasculine fertility resources

Trans Fertility: Frequently Asked Questions

How does testosterone affect egg health? 

You might’ve heard medical providers tell you that testosterone causes sterility. Yet, thousands of transgender men all over the world have successfully given birth or contributed their eggs to a pregnancy. In fact, a 2019 study from Boston IVF found that transgender men who went through at least one egg-harvesting cycle produced the same quality and amount of mature eggs as cisgender patients. 

If you take testosterone regularly (i.e., you don’t miss any shots, aren’t too early or too late on a shot, etc.), it should stop ovulation from occurring. But if you stop taking testosterone, it takes an average of four months for your menstrual cycle to return, at which time, you could ovulate and become fertile. 

How does hormone replacement therapy (HRT) affect fertility for transgender women? 

In short, we’re not sure. That’s why we encourage anyone taking HRT and considering becoming a parent to explore fertility preservation options prior to transitioning. It’s also important to remember that there’s no “right” way to form a family, which means it’s more than okay to prioritize your transition over your fertility — that doesn’t mean that becoming a parent is off the table! 

How can I prepare for pregnancy as a nonbinary person? 

First: Congratulations on taking this step towards welcoming a baby into your family! Preparing for pregnancy as a nonbinary person involves all the joy and challenges of a typical pregnancy, of course, but there are additional factors to consider around identity, safety, chest-feeding, provider care, and more. 

My child is transgender. What should we know about how their transition might impact future fertility? 

We don’t have a full picture of how fertility might be impacted by hormonal intervention at puberty, a 2017 study shows that a vast majority of trans youth don’t preserve their fertility before transitioning. That being said, trans adults overwhelmingly report that they wish they had preserved their fertility if it was presented as an option. So, our best advice is to have constructive, developmentally appropriate conversations with young people about family planning and fertility. 

How can I advocate for myself or my trans partner in the doctor’s office?

If you’ve experienced bias, discrimination, harassment, or refusal of care, you’re not alone. According to Lambda Legal, 26.7% of trans patients have experienced refusal of care. In addition to working together to ensure that all providers are thoroughly trained in trans health, trauma-informed care, and inclusivity, there are a few “harm reduction” approaches to self-advocacy we recommend. 

Additional costs for trans people considering becoming parents

Depending on your relationships, anatomy, health, and personal choices, becoming a parent could involve the typical costs related to adoption, insemination, assisted reproduction, surrogacy, and securing legal parentage. However, trans, nonbinary, and gender-nonconforming folks might also choose to preserve their fertility by freezing eggs or sperm prior to transitioning medically.

Unfortunately, the costs associated with fertility preservation can be steep due to outdated and uninclusive insurance policies. More specifically: 

  • The average costs for sperm freezing are $250 – $1,500 per specimen, with annual storage fees of $175-750 per year. 
  • The average costs for egg freezing includes the additional cost of egg retrieval. This will add up to an average of $7,000 – 12,000 per cycle, with annual storage fees of $350 – 700 per year. 

Additional Trans Family-Building Resources

Fertility for Transgender Women Before HRT: New Study Provides Answers
Fertility for Transgender Women Before HRT: New Study Provides Answers
Trans Fertility: How Does Testosterone Affect Egg Health?
Trans Fertility: How Does Testosterone Affect Egg Health?
Preparing for Pregnancy as a Non-Binary Person
Preparing for Pregnancy as a Non-Binary Person
Family Building for the Trans Community
Family Building for the Trans Community

Finding an affirming provider

If you’re looking for providers competent in trans family-building, Family Equality recommends exploring our provider directory! 
You can also print out and share our medical provider form to encourage your providers to make changes in their practice that foster a culture of inclusivity.

Looking for support on your trans parenting journey?

Family Equality hosts a virtual peer group every other Wednesday for transgender, nonbinary, and gender-nonconforming parents! Register today to receive log-in information.

Learn more and sign up