More than a million Americans consider themselves to be transgender, meaning their personal gender identity is different from their sex at birth. Among the many frustrations experienced by people struggling with gender identity issues is how to become a parent, if that is a goal. Fortunately, modern medicine offers a range of solutions that can help transgender men and women become moms and dads.

At Yale Fertility Center, we offer an array of treatment choices for transgender men and women. We provide all possible support during the process of transition, including resources for hormonal management. Our center also offers fertility preservation for female-to-male and male-to-female transgender patients, as well as assistance in third-party reproduction options.

“This is specialized care you won’t find elsewhere in the state,” says Amanda Kallen, MD, a Yale Medicine reproductive endocrinologist and infertility specialist. “Reproductive options are confusing to navigate, and not something you are necessarily thinking about when you’re pursuing transitional services. We always walk you through the options so you can make informed decisions.”

According to Dr. Kallen, transgender individuals don’t always have access to or information about the services and support they need. “Everyone should have the opportunity to have a child with their own eggs or their own sperm, and it shouldn’t have anything to do with gender identity or financial situation,” she says.

Transgender women may freeze sperm, which can later be utilized by a female partner or gestational carrier (see below). For such patients, Yale Fertility Center offers state-of-the-art sperm freezing (cryopreservation) services, using an on-site lab, where sperm can be safely and indefinitely preserved for use when the time is right.  

Transgender women with a female partner may choose to utilize cryopreserved sperm for partner insemination. MtF patients with cryopreserved sperm who do not have a female partner may utilize a gestational carrier. In this case, eggs would be obtained from a pre-screened donor, which would then be inseminated with the frozen sperm, and resulting embryos would be transferred to the gestational carrier.

Transgender men can opt to freeze eggs or embryos, or even ovarian tissue. “While ovarian tissue freezing is experimental, it can be considered in carefully selected and counseled patients” Dr. Kallen says.

For FtM patients who have frozen eggs or embryos, gestational surrogacy is an option, or transgender men who have not had a hysterectomy may considering carrying a pregnancy themselves. Egg or embryo donation is also available.  

In addition to the reproductive options and support Yale Fertility Center offers transgender individuals, Yale Medicine is a pioneer in treating transgender individuals. For young patients, the Pediatric Gender Program helps children and their families who are grappling with gender identity, expression and related issues. The program combines mental health care with medical treatment, in the form of puberty blockers and hormones, when appropriate.