How exactly does fertility decrease by taking gender-affirming hormones?
Transgender men taking testosterone hormones can decrease the hormones in their body that support fertility. The effect of hormone therapy on fertility is potentially reversible, but the extent is not clear. (The reason why this correlation is not studied more is because medical research has been very binary and hetero-beneficial until very recently.)
For more information, check out our Gender Inclusivity Period Talk guide, made in partnership with Schuyler Bailar!
Transgender individuals who undergo gender-affirming medical or surgical therapies are at risk for infertility. Suppression of puberty with gonadotropin-releasing hormone agonist analogs (GnRHa) in a pediatric transgender patient can pause the maturation of germ cells, and thus, affect fertility potential. Testosterone therapy in transgender men can suppress ovulation and alter ovarian histology, while estrogen therapy in transgender women can lead to impaired spermatogenesis and testicular atrophy. The effect of hormone therapy on fertility is potentially reversible, but the extent is unclear. Gender-affirming surgery that includes a hysterectomy and oophorectomy in transmen or orchiectomy in transwomen results in permanent sterility.
