Thursday, January 12, 2012

Helping trans-men and trans-women have children

The subject of helping trans-men and women have children with the help of assisted reproductive treatments has received a lot of attention lately.  Strictly FYI, here’s a short review of materials and professional meetings addressing those issues. 


Timothy F. Murphy (2010). The Ethics of Helping Transgender Men and Women Have Children. Perspectives in Biology and Medicine 53 (1):46-60.

In this article, I defend access to ARTs by transgender men and women, even if – as some think – transgenderism is a mental disorder.  There is nothing about transgenderism that disables anyone’s ability to understand the nature and consequences of parenthood, and there is insufficient evidence to show that children of transgender men and women are harmed in any way that would justify prohibition of this kind of parenthood.   


The World Professional Association for Transgender Health issues the 7th version of its standards of care.  This document advises clinicians to ensure that people undergoing hormonal or surgical body modifications for purposes of gender expression be aware of the effects of those treatments on fertility.  Some may suppress gametes temporarily, while other interventions will leave people permanently unable to produce gametes.  The document also advises that clinicians take steps to make sure that men and women are aware of possible means of preserving their ability to have genetically related children later on, through various established and experimental means of gamete and tissue preservation. 


At its annual meeting, the American Society of Reproductive Medicine held a session on transgender men and women. 

Male to Female Transgender Surgery: Techniques, Results, and Postoperative Sexuality
Joint Session presented by the Society of Reproductive Surgeons and the Sexuality Special Interest Group. 

Stanton C. Honig, M.D (Chair), University of Connecticut School of Medicine.  Jared C. Robins, M.D, The Warren Alpert Medical School of Brown University.  Christine McGinn, M.D., Papillon Center.


The professional meeting ‘Controversies in Obstetrics, Gynecology, and Infertility’ held a pre-conference session on transgenderism in general and ARTs as well at its November meeting in Paris.  This is the program: 


Dealing with transsexuals presents a great surgical, endocrinological and medico-legal challenge. The ability to reproduce following such surgery presents another level of complexity and requires a multidisciplinary approach to formulate the optimal solution. What kinds of skills are required to embark into such complex treatments?  

Part I.  Surgical, medical and medico legal considerations

·         Planning for transsexual surgery: which approach should be offered? - S. Pinho, Brazil
·         Which hormonal treatment should be formulated following surgery? - R. Andrade, Brazil
·         Transsexual who is opting to conceive: what are the medico-legal aspects?  Á. Petracco, Brazil

Part II   Clinical experience

·         Psychological aspects: follow up 150 patients female to male - J.M. Ayoubi, France;
L. Karpel, France
·         Androgens and ovary:  what can we learn? - J-N. Hugues, France
·         Donor insemination in the transsexual; - P. Jouannet, France


The European Society for Health Reproduction and Embryology will hold a one-day program on transgender issues at its professional meeting in Istanbul, July 1.  See: 

‘Non-standard requests?’ – Ethical and legal aspects of medically assisted reproduction in singles, lesbian and gay couples, and transsexuals

Course co-ordinators:  Guido M.W.R. de Wert (The Netherlands) and Wybo J. Dondorp (The Netherlands)

·         Assisted reproduction in single women: problematic or not at all? - Berna Arda (Turkey)
·         Lesbian couples sharing biological motherhood: IVF for reproductively healthy women? Wybo Dondorp (Netherlands)
·         Two men and a baby: ethical and legal issues in surrogacy and egg donation for gay male couplesJuliet Tizzard (United Kingdom)
·         Clinically assisted reproduction and fertility preservation with transgender men and womenTimothy Murphy (USA)
·         Welfare of the child: scrutinizing evaluation criteriaGuido Pennings (Belgium)
·         Non-discrimination, human rights and institutional autonomy in the provision of assisted conception services Emily Jackson (United Kingdom)
·         Gifts with moral strings attached: Should gamete donors have a right to exclude non-standard couples/persons as recipients? ­– Christoph Rehmann-Sutter (Germany)
·         Conclusions Guido de Wert (The Netherlands)


The Cambridge Quarterly of Healthcare Ethics will publish a case of a transgender couple who seek clinical help in having a child.  The clinicians involved seek the advice of an ethics committee.  The case will be accompanied by commentaries by Timothy F. Murphy, Lance Wahlert and Autumn Fiester, and Sarah Hunger. 


  1. I want to thank you for this post. This information was very helpful.Please keep up the good work and I look forward to more of your great posts! tekken

  2. Helping trans-men and trans-women to have children would be in the hands of technology. Doctors can help them in other way to create new life and happiness for them.