Most transgender men retain their natal reproductive organs and genitalia. Approximately 70% of OB-GYN's report discomfort when providing care for this population. To ascertain the needs and experiences of transgender men who seek reproductive health care we conducted a mixed methods study among transgender men.
Self-identified transgender men participated in focus groups featuring questions about reproductive health care and completed a survey regarding reproductive goals. Descriptive statistical analysis was performed on survey data, and focus group data were transcribed and analyzed to identify emergent themes.
Nine transgender men participated; mean age was 29, six were on hormone therapy. All had their uterus and ovaries in situ, and four reported recent vaginal receptive intercourse. Only two reported receiving fertility preservation information from a physician; five desired future children. Five reported current or past use of contraception, even after starting testosterone. Two reported history of unintended pregnancy and miscarriage. Themes identified through focus groups: reference to gynecologists as the “necessary evil”; sensing provider uncertainty about or avoidance of reproductive health topics, especially during the patients' reproductive transition'; systemic issues including insurance and financial barriers for gynecologic care and fertility preservation; and avoidance of gynecologic care due to dysphoria and lack of transgender-knowledgeable OB/GYN providers.
These findings indicate that transgender men often retain their reproductive organs, use contraception, and desire childbearing, necessitating reproductive health care from OB/GYN providers. Strategies to increase providers awareness of these findings are needed so transgender men's access to and experiences of reproductive health are improved.