Movatterモバイル変換


[0]ホーム

URL:


Skip to main content

Advertisement

Springer Nature Link
Log in

Ethical Considerations for Transgender and Non-Binary Reproduction

  • Chapter
  • First Online:

Abstract

Assisted reproductive technologies (ART) have opened the door for many people to pursue genetic parenthood when it was previously not possible for them to do so, including cisgender heterosexual couples with infertility, single individuals, and those in the LGBTQ community. In this chapter, we focus specifically on transgender and non-binary (TGNB) reproduction, providing provide an overview of some of the ethical considerations at play. First, we describe how standard definitions of infertility exclude TGNB individuals, making it more difficult and expensive for them to access ART. Such narrow definitions of infertility uphold cisnormative beliefs about who is deserving of parenthood. Second, we discuss how the highly gendered binary framework upon which reproductive medicine is based marginalizes and erases TGNB individuals. We enumerate some actions fertility clients can take to make TGNB individuals feel welcome. Third, we turn to the high cost of ART, which is a barrier for many people and raises justice concerns. TGNB individuals are especially disadvantaged due to their gender identity and other intersecting marginalized identities Fourth, we examine the challenges for TGNB individuals and clinicians in making decisions about gender-affirming and reproductive care in the face of limited data. Finally, we explore some of the specific issues for TGNB youth, including the question of whether youth should be able to make their own decisions about fertility preservation prior to gender-affirming hormones and surgery.

This is a preview of subscription content,log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
¥17,985 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
JPY 3498
Price includes VAT (Japan)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
JPY 9151
Price includes VAT (Japan)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
JPY 11439
Price includes VAT (Japan)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide -see info
Hardcover Book
JPY 15729
Price includes VAT (Japan)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide -see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Similar content being viewed by others

References

  1. Gürtin ZB, Faircloth C. Conceiving contemporary parenthood: imagining, achieving and accounting for parenthood in new family forms. Anthropol Med. 2018;25(3):243–8.

    Article  Google Scholar 

  2. Tasca C, Rapetti M, Carta MG, Fadda B. Women and hysteria in the history of mental health. Clin Pract Epidemiol Ment Health. 2012;8:110–9.

    Article  Google Scholar 

  3. Naragon MD. Communities in motion: Drapetomania, work and the development of African-American slave cultures. Slavery Abolition. 1994;15(3):63–87.

    Article  Google Scholar 

  4. Centers for Disease Control and Prevention. Infertility FAQs 2019.https://www.cdc.gov/reproductivehealth/infertility/index.htm.

  5. Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520–4.

    Article CAS  Google Scholar 

  6. Inhorn MC, Birenbaum-Carmeli D, Birger J, Westphal LM, Doyle J, Gleicher N, et al. Elective egg freezing and its underlying socio-demography: a binational analysis with global implications. Reprod Biol Endocrinol. 2018;16(1):70.

    Article CAS  Google Scholar 

  7. Mamo L. Queering reproduction: achieving pregnancy in the age of technoscience, vol. xi. Durham, NC: Duke University Press; 2007.

    Google Scholar 

  8. Mazzola J. Lesbian couples sue N.J., say fertility laws discriminate against them. NJcom. 2016 August 8.

    Google Scholar 

  9. Murphy J. Should lesbians count as infertile couples? Antilesbian discrimination in assisted reproduction. In: Purdy ADLM, editor. Embodying bioethics: recent feminist advances. Landam, Md: Rowman & Littlefield; 1999.

    Google Scholar 

  10. Centanni C. Using ART to make a baby: how Rhode Island's insurance coverage mandate is preventing same-sex couples from having biological children. Roger Williams University Law Review. 2019;24(2):331–58.

    Google Scholar 

  11. Lo W, Campo-Engelstein L. Expanding the clinical definition of infertility to include socially infertile individuals and couples. In: Campo-Engelstein L, Burcher P, editors. Reproductive ethics II. Springer International Publishing AG; 2018. p. 71–83.

    Chapter  Google Scholar 

  12. Honkasalo J. Unfit for parenthood? Compulsory sterilization and transgender reproductive justice in Finland. J Int Women's Stud. 2018;20(1):40–52.

    Google Scholar 

  13. Murphy TF. The ethics of helping transgender men and women have children. Perspect Biol Med. 2010;53(1):46–60.

    Article  Google Scholar 

  14. Marsh M, Ronner W. The empty cradle: infertility in America from colonial times to the present. Baltimore: Johns Hopkins University Press; 1996.

    Google Scholar 

  15. Daniels C. Exposing men: the science and politics of male reproduction. New York: Oxford University Press; 2006.

    Google Scholar 

  16. Barnes LW. Conceiving masculinity: male infertility, medicine, and identity. Philadelphia, PA: Temple University Press; 2014.

    Google Scholar 

  17. Almeling R. GUYnecology: the missing science of men's reproductive health. Berkeley: University of California Press; 2020.

    Book  Google Scholar 

  18. Hoffkling A, Obedin-Maliver J, Sevelius J. From erasure to opportunity: a qualitative study of the experiences of transgender men around pregnancy and recommendations for providers. BMC Pregnancy Childbirth. 2017;17(2).

    Google Scholar 

  19. Ho V, Sherqueshaa S, Zheng D. The forced sterilization of transgender and gender non-conforming people in Singapore. LGBTQ POLICY. 2016;6:53.

    Google Scholar 

  20. Bell AV. Misconception: social class and infertility in America. Rutgers University Press; 2014.

    Google Scholar 

  21. Epstein R. Space invaders: queer and trans bodies in fertility clinics. Sexualities. 2018;21(7):1039–58.

    Article  Google Scholar 

  22. Sumerau JE, Mathers LAB. America through transgender eyes. Lanham, MD: Rowman & Littlefield Publishers; 2019.

    Google Scholar 

  23. Armuand G, Dhejne C, Olofsson JI, Rodriguez-Wallberg KA. Transgender men's experiences of fertility preservation: a qualitative study. Hum Reprod. 2017;32(2):383–90.

    Article CAS  Google Scholar 

  24. Payne JG, Erbenius T. Conceptions of transgender parenthood in fertility care and family planning in Sweden: from reproductive rights to concrete practices. Anthropol Med. 2018;25(3):329–43.

    Article  Google Scholar 

  25. Access to fertility services by transgender persons: an ethics committee opinion. Fertil Steril. 2015;104(5):1111–5.

    Google Scholar 

  26. James-Abra S, Tarasoff LA, Green D, Epstein R, Anderson S, Marvel S, et al. Trans people's experiences with assisted reproduction services: a qualitative study. Hum Reprod. 2015;30(6):1365–74.

    Article CAS  Google Scholar 

  27. Charter R, Ussher JM, Perz J, Robinson K. The transgender parent: experiences and constructions of pregnancy and parenthood for transgender men in Australia. Int J Transgend. 2018;19(1):64–77.

    Article  Google Scholar 

  28. Moseson H, Zazanis N, Goldberg E, Fix L, Durden M, Stoeffler A, et al. The imperative for transgender and gender nonbinary inclusion: beyond women's health. Obstet Gynecol. 2020;135(5):1059–68.

    Article  Google Scholar 

  29. Adashi EY, Dean LA. Access to and use of infertility services in the United States: framing the challenges. Fertil Steril. 2016;105(5):1113–8.

    Article  Google Scholar 

  30. Management SfHR. 2014 employee benefits: an overview of employee benefit offerings in the US. VA: Author Alexandria; 2014.

    Google Scholar 

  31. Dupree JM, Dickey RM, Lipshultz LI. Inequity between male and female coverage in state infertility laws. Fertil Steril. 2016.

    Google Scholar 

  32. Liu JJ, Adashi E, editors. Selective justice : state mandates for assisted reproductive technology and reproductive justice 2013.

    Google Scholar 

  33. Basco D, Campo-Engelstein L, Rodriguez S. Insuring against infertility: expanding state infertility mandates to include fertility preservation technology for cancer patients. J Law Med Ethics. 2010;38(4):832–9.

    Article  Google Scholar 

  34. Campo-Engelstein L. Consistency in insurance coverage for iatrogenic conditions resulting from cancer treatment including fertility preservation. J Clin Oncol. 2010;28(8):1284–6.

    Article  Google Scholar 

  35. Kyweluk MA, Reinecke J, Chen D. Fertility preservation legislation in the United States: potential implications for transgender individuals. LGBT Health. 2019;6(7):331–4.

    Article  Google Scholar 

  36. Tishelman AC, Sutter ME, Chen D, Sampson A, Nahata L, Kolbuck VD, et al. Health care provider perceptions of fertility preservation barriers and challenges with transgender patients and families: qualitative responses to an international survey. J Assist Reprod Genet. 2019;36(3):579–88.

    Article  Google Scholar 

  37. Galic I, Negris O, Warren C, Brown D, Bozen A, Jain T. Disparities in access to fertility care: who’s in and who’s out. F&S Rep. 2020;

    Google Scholar 

  38. Crissman HP, Berger MB, Graham LF, Dalton VK. Transgender demographics: a household probability sample of US adults, 2014. Am J Public Health. 2017;107(2):213–5.

    Article  Google Scholar 

  39. Committee opinion no. 512: health care for transgender individuals. Obstet Gynecol. 2011;118(6):1454–8.

    Google Scholar 

  40. Goldman RH, Kaser DJ, Missmer SA, Farland LV, Scout ARK, et al. Fertility treatment for the transgender community: a public opinion study. J Assist Reprod Genet. 2017;34(11):1457–67.

    Article  Google Scholar 

  41. Review of the transgender literature: where do we go from here? Transgend Health. 2017;2(1):119–28.

    Google Scholar 

  42. European society of human reproduction and embryology. Female Fertility Preservation. 2020.

    Google Scholar 

  43. World Professional Association for Transgender Health. Standards of care for the health of transsexual, transgender, and gender nonconforming people. 7th ed 2011.

    Google Scholar 

  44. Moravek MB, Kinnear HM, George J, Batchelor J, Shikanov A, Padmanabhan V, et al. Impact of exogenous testosterone on reproduction in transgender men. Endocrinology. 2020;161:3.

    Article  Google Scholar 

  45. Jiang DD, Swenson E, Mason M, Turner KR, Dugi DD, Hedges JC, et al. Effects of estrogen on spermatogenesis in transgender women. Urology. 2019;132:117–22.

    Article  Google Scholar 

  46. Shuster SM. Uncertain expertise and the limitations of clinical guidelines in transgender healthcare. J Health Soc Behav. 2016;57(3):319–32.

    Google Scholar 

  47. Politi MC, Han PKJ, Col NF. Communicating the uncertainty of harms and benefits of medical interventions. Med Decis Mak. 2007;27(5):681–95.

    Article  Google Scholar 

  48. Patient access to experimental treatments. Nuffield Council on Bioethics; 2018.

    Google Scholar 

  49. Rodriguez A, Agardh A, Asamoah BO. Self-reported discrimination in health-care settings based on recognizability as transgender: a cross-sectional study among transgender U.S. citizens. Arch Sex Behav. 2018;47(4):973–85.

    Article  Google Scholar 

  50. Lerner JE, Martin JI, Gorsky GS. More than an apple a day: factors associated with avoidance of doctor visits among transgender, gender nonconforming, and nonbinary people in the USA. Sexuality Research and Social Policy. 2020.

    Google Scholar 

  51. Persky RW, Gruschow SM, Sinaii N, Carlson C, Ginsberg JP, Dowshen NL. Attitudes toward fertility preservation among transgender youth and their parents. J Adolesc Health. 2020;67(4):583–9.

    Article  Google Scholar 

  52. Feinberg J. The child's right to an open future. In: Aiken W, LaFollette H, editors. Whose child? Totowa, NJ: Rowman & Littlefield; 1980. p. 124–53.

    Google Scholar 

  53. McDougall R. The ethics of fertility preservation for paediatric cancer patients: from offer to rebuttable presumption. Bioethics. 2015;29(9):639–45.

    Article  Google Scholar 

  54. McDougall RJ, Gillam L, Delany C, Jayasinghe Y. Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven? J Med Ethics. 2018;44(1):27–31.

    Article  Google Scholar 

  55. Jayasuriya S, Peate M, Allingham C, Li N, Gillam L, Zacharin M, et al. Satisfaction, disappointment and regret surrounding fertility preservation decisions in the paediatric and adolescent cancer population. J Assist Reprod Genet. 2019;36(9):1805–22.

    Article  Google Scholar 

  56. Harris RM, Kolaitis IN, Frader JE. Ethical issues involving fertility preservation for transgender youth. J Assist Reprod Genet. 2020;37(10):2453–62.

    Article  Google Scholar 

  57. Chiniara LN, Viner C, Palmert M, Bonifacio H. Perspectives on fertility preservation and parenthood among transgender youth and their parents. Arch Dis Child. 2019;104(8):739–44.

    Article  Google Scholar 

  58. Child Welfare Information Gateway. Planning for adoption: knowing the costs and resources. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau; 2016.

    Google Scholar 

  59. Stack L. Texas bill would let adoption agencies reject families on religious grounds. New York Times. 2017; May 11

    Google Scholar 

  60. Informed consent, parental permission, and assent in pediatric practice. Committee on Bioethics, American Academy of Pediatrics. Pediatrics. 1995;95(2):314–7.

    Google Scholar 

  61. Weithorn LA, Campbell SB. The competency of children and adolescents to make informed treatment decisions. Child Dev. 1982;53(6):1589–98.

    Article CAS  Google Scholar 

  62. Blake V. Minors' refusal of life-saving therapies. Virtual Mentor. 2012;14(10):792–6.

    Google Scholar 

  63. Weddle M, Kokotailo PK. Confidentiality and consent in adolescent substance abuse: an update. Virtual Mentor. 2005;7:3.

    Google Scholar 

  64. Johnson EK, Finlayson C. Preservation of fertility potential for gender and sex diverse individuals. Transgend Health. 2016;1(1):41–4.

    Article  Google Scholar 

  65. McCabe MA. Involving children and adolescents in medical decision making: developmental and clinical considerations. J Pediatr Psychol. 1996;21(4):505–16.

    Article CAS  Google Scholar 

  66. Schoendorff v. Society of New York Hosp., 105 N.E. 92, 93 (N.Y. 1914).

    Google Scholar 

  67. Strang JF, Jarin J, Call D, Clark B, Wallace GL, Anthony LG, et al. Transgender youth fertility attitudes questionnaire: measure development in nonautistic and autistic transgender youth and their parents. J Adolesc Health. 2018;62(2):128–35.

    Article  Google Scholar 

  68. Riggs DW. An examination of ‘just in case’arguments as they are applied to fertility preservation for transgender people. The Reproductive Industry: Intimate Experiences and Global Processes. 2019:69.

    Google Scholar 

  69. Kyweluk MA, Sajwani A, Chen D. Freezing for the future: transgender youth respond to medical fertility preservation. Int J Transgend. 2018;19(4):401–16.

    Article  Google Scholar 

  70. Fertility preservation and reproduction in cancer patients. Fertil Steril. 2005;83(6):1622–8.

    Google Scholar 

  71. Shnorhavorian M, Johnson R, Shear SB, Wilfond BS. Responding to adolescents with cancer who refuse sperm banking: when "no" should not be the last word. J Adolesc Young Adult Oncol. 2011;1(3):114–7.

    Article  Google Scholar 

  72. Nahata L, Tishelman AC, Caltabellotta NM, Quinn GP. Low fertility preservation utilization among transgender youth. J Adolesc Health. 61(1):40–4.

    Google Scholar 

  73. Chen D, Simons L. Ethical considerations in fertility preservation for transgender youth: a case illustration. Clin Pract Pediatr Psychol. 2018;6(1):93.

    Google Scholar 

  74. Giordano S. Lives in a chiaroscuro. Should we suspend the puberty of children with gender identity disorder? J Med Ethics. 2008;34(8):580–4.

    Article CAS  Google Scholar 

  75. Cochran BN, Stewart AJ, Ginzler JA, Cauce AM. Challenges faced by homeless sexual minorities: comparison of gay, lesbian, bisexual, and transgender homeless adolescents with their heterosexual counterparts. Am J Public Health. 2002;92(5):773–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute for Bioethics & Health Humanities, University of Texas Medical Branch, Galveston, TX, USA

    Lisa Campo-Engelstein & Rebecca M. Permar

Authors
  1. Lisa Campo-Engelstein

    You can also search for this author inPubMed Google Scholar

  2. Rebecca M. Permar

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence toLisa Campo-Engelstein.

Editor information

Editors and Affiliations

  1. Department of Obstetrics & Gynecology, University of Michigan–Ann Arbor, Ann Arbor, MI, USA

    Molly B. Moravek

  2. Obstetrics and Gynecology, Northwest Permanente, Portland, OR, USA

    Gene de Haan

Rights and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Campo-Engelstein, L., Permar, R.M. (2023). Ethical Considerations for Transgender and Non-Binary Reproduction. In: Moravek, M.B., de Haan, G. (eds) Reproduction in Transgender and Nonbinary Individuals. Springer, Cham. https://doi.org/10.1007/978-3-031-14933-7_12

Download citation

Publish with us

Access this chapter

Subscribe and save

Springer+ Basic
¥17,985 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
JPY 3498
Price includes VAT (Japan)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
JPY 9151
Price includes VAT (Japan)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
JPY 11439
Price includes VAT (Japan)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide -see info
Hardcover Book
JPY 15729
Price includes VAT (Japan)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide -see info

Tax calculation will be finalised at checkout

Purchases are for personal use only


[8]ページ先頭

©2009-2025 Movatter.jp