Reproductive options for women in our community

Anyone considering starting hormonal therapy, orchiectomy or vaginoplasty as part of a gender transition should think carefully about the issue of sperm storage prior to doing these.

Some, including the less circumspect members of our own community, think this indicates you aren't serious about transition or are using it as some sort of psychological safety net to hold onto your "maleness." These people sometimes think of sperm storage as fatherhood or equate it with masculinity, but this personal view should not be applied in judgment to others.

A fundamental right

Reproductive choice is one of the most private and personal decisions you will make. It is up to you alone whether you will exercise this option or not, and it should not have any bearing on your ability to receive transition-related services.

If for some reason your therapist or gender clinic thinks you shouldn't, remember that it's your body and that reproductive choices of any kind are guaranteed in the United States under the 14th Amendment. Don't let anyone try to persuade, threaten, or shame you out of doing this if you want to.

Reproductive freedom is one of your most fundamental rights in the United States, and anyone who tries to deprive you of that right is in direct conflict with the U.S. Constitution.

Sperm storage and the Standards of Care

The Harry Benjamin International Gender Dysphoria Association's Standards of Care states:

Reproductive Options. Informed consent implies that the patient understands that hormone administration limits fertility and that the removal of sexual organs prevents the capacity to reproduce. Cases are known of persons who have received hormone therapy and sex reassignment surgery who later regretted their inability to parent genetically related children. The mental health professional recommending hormone therapy, and the physician prescribing such therapy, should discuss reproductive options with the patient prior to starting hormone therapy. Biologic males, especially those who have not already reproduced, should be informed about sperm preservation options, and encouraged to consider banking sperm prior to hormone therapy. Biologic females do not presently have readily available options for gamete preservation, other than cryopreservation of fertilized embryos. However, they should be informed about reproductive issues, including this option. As other options become available, these should be presented.

Many advantages, but also some drawbacks

Reasons to store sperm

If you are planning an orchiectomy or vaginoplasty.

If you are planning to start hormone therapy.

and are unsure about how extensively you want to transition.

and want to try hormones as an experiment first.

and plan to take hormones in hopes of diminishing crossdressing urges.

If you think you may want biological children of your own some time.

If you have not yet had biological children and sometimes consider the possibility.

If you seek a compromise with a spouse or partner who is interested in future children and is concerned about your taking hormones.

In the event of future scientific advances, such as ex vitro fertilization, etc.

In the event that your sexual orientation or partner may change over the course of your life.

Using your own reproductive material can mean less legal hassles compared to lesbian / TS adoption or surrogate parenting.

Potential problems

Cost may not be worth the benefit for you.

Some people's sperm is no longer viable after freezing. Some studies indicate this may affect one in ten people.

Despite the best efforts, you may be unable to reproduce, despite banking sperm.

I decided to do it as part of an agreement with my partner at the time. I do not see how children would fit in my life right now, but if that changes, it's nice to know the possibility exists.

To find a clinic or cryobank

Ask your personal physician for a recommendation.

Ask your therapist for a recommendation.

Ask local TSs/support groups for a recommendation.

Most major hospitals (especially university hospitals) have an affiliated fertility clinic.

You can sometimes find clinics/banks in the Yellow Pages under Physicians.

Larger cities will have physicians listed by specialty. If this is available, look under

Infertility
Urology
Endocrinology
Gynecology

Some national clinics offer mail-in dry ice kits you can use at home, but I'd recommend going in to a local clinic if possible. The kits used at home must be done exactly right in order not to kill the sperm. However, this might be an option for people who for whatever reason feel they cannot use a clinic.

Costs

The biggest drawback for most of us is that sperm storage is yet another cost to add to an already enormous financial burden. Sadly, this means that the option may not be available if you aren't doing OK financially. However, if you have prioritized your transition carefully, and you find that this is a very important issue for you, it's important to set aside that money and hold off on something else. After all, this is usually one of the irreversible parts of transition.

Usually there is a fee for each deposit, and it's generally reported to be around $100-150. Mine was $120 for each of three sessions.

After your first session, they will be able to tell you how many doses they were able to extract from your sample, and many clinics will also do analysis to determine the viability and general health of the sample. After this, they will suggest a number of doses you will want to save for optimal results. For some, one trip will be enough, while for others, several may be required. Depending on how important this is to you, you may want to do more than they recommend to better your chances.

There is usually an annual storage fee as well, often around $200-400. Mine is $350. Costs can be considerably higher, though. A rader notes:

The bank I called recommended 5 deposits per perspective child (compared to ~3 for 2 children reported by another girl), and requested $700 lab fees + $300/deposit and $200/yr/deposit storage fee - so, for 5 deposits (their recommended value) it would be $2200 + $1000/yr. This was about 3x the cost others on your website reported, and as a student, I decided against it ultimately.

Tips and recommendations

The procedure is pretty straightforward: go into a room and masturbate into a sample cup. They often supply pornography, but I suppose you could bring your own arousal method.

They usually require no sexual activity for 24-72 hours. The longer you wait, the better.

Tight clothing and tucking can decrease sperm production. If possible, avoid tight clothing for a period of time prior to storage.

Notify a friend or relative that you've done this, and outline your wishes regarding stored sperm in a legally binding will.

Be sure to contact the storage facility after your legal name change to ensure your sample is not lost and you receive annual payment notifications.

Other women's experiences

Be sure to read a first-hand experience from GenderPsychology, and here are a few other submissions.

A reader writes:

You might want to note on your banking web page that it's dry masturbation. I was required to wash my hands and genitals and was not permitted any lubrication. I was pretty raw when I was done. Had I known, I might have brought something sheer like a sterile silk, satin or fur cloth.

I think its also important to emphasize that even though fertility might come back after stopping hormones, that there is evidence of increased sperm deformities afterwards. This may or may not lead to an increase in birth defects. Personally, I would not be willing to take a chance. Once I started hormones I assumed that all sperm produced thereafter would be tainted.

Marilyn writes in two posts I've combined:

Since my wife and I "really" want children one day, I toddled down to the local bank and made my deposit against the day I would lack fertility. It cost $660US to make three deposits ($220 per visit - they check the first batch to see if there are enough viable sperm to bother continuing) and there is a yearly maintenance cost of $200US. According to the fertility clinics I have checked with, insemination will run about $300US per try and the success rate is about 30% if my sperm is any good. In three visits I saved up enough for 10 tries - hopefully two children.

Why? We both would like kids and she wants to birth them herself. Granted, there are a pretty good range of volunteers around who would be happy to father for us, but with our luck, the father would want to share in the raisin'. She probably wouldn't sleep with anyone who wasn't of that cut anyway. So then there's legal crap to put up with, which if we use my genetic material, no questions.

My wife had a tremendous emotional investment in her vision of the family we would have together - losing that life dream was a BIG ONE for her. A few days ago I found that she was able to see that her family ideal was based on the dysfunctions of her own childhood. It was an illuminating discussion. From my point of view, it is also comforting to know that we have passed that issue.

I actually could care less whose genetic material makes up my children. There is no evidence that I have any special evolutionary advantages to pass on. Perhaps the biggest reason that we saved some was so that my wife could carry a child - that aspect is important enough to her to spend the money. If what we saved is not enough however, we can adopt. There are plenty of children, particularly ones with special needs, who need a home and unconditional love.

A good question is whether I would continue to take up space in Duke's freezer if Michelle and I broke up. My answer is no if my next pair is a man. If it is a woman and she wanted to have kids and thought that was the best way to handle it, then OK. However, I'm getting old. In a few more years I'll be past the age when children are a reasonable option lifestyle wise. I can't really see ^starting^ a family after 45. I'd like to retire some day.

Just some things to think about.

Rachel writes:

This is really the only thing that gives me pause. I don't want children now, but as I said on my web site, I've surprised myself by getting broody feelings from time to time - they usually last until I see some harried mother trying to deal with a petulant screaming toddler! But anyway, the doubt I have is no more than if I was just going for a vasectomy. It's not the specific equipment I'm attached to (well, it *is*, that's just the problem of course, but you know what I mean...), but the permanent loss of the ability to pass on genetic material.

It's probably the most urgent reason why I want to transition as soon as possible. I've been on hormones since November. I want to put myself through at least part of RLT before my fertility has gone for good. And once it has gone, there's really nothing further to lose in changing sex as far as I'm concerned. I might as well go forward as back.

It seems such a remote possibility, that I might, afterwards, find the right woman for me - and a genetic woman at that, who could, and would want to, have a child by me. And I'm sure it would cost money. I don't even know how my sexuality is going to pan out yet. I've always been more attracted to girls, but I'm no longer convinced it was a sexual attraction, or just envy, or what, or if I'm actually sexual at all.

I don't think I would ever want to have children - *really* - but the imminent prospect of losing the ability forever is concentrating the mind somewhat.

Luccia writes:

This topic was especially important to a former girlfriend and me. I had orchiectomy in late spring 1996, decided not to save genetic material as I already reproduced and passed along my DNA. I met her in late summer 1997.

As the relationship progressed, we each found that we felt the other would make a great mom. We talked of raising children together someday and we both were upset that I had not saved sperm. We are both Ph.D. students, in good health with no serious life-threatening habits (moderate and no alcohol, no dangerous drugs, no smoking, very healthy diets, a little caffeine and chocolate), and no high-risk genetic histories.

Today, I regret not saving sperm. Chalk it up to deep enculturation, but children who are genetically related to both of us would be a wonderful thing. Yes, there is adoption. Yes, we both have male friends who would make great donors and who would agree beforehand to whatever level of involvement we would decide upon. But frankly, being two wymyn together raising a child that is ours genetically is one gift of being TS.

I recommend anyone considering sperm or ovum banking to do so. After all, one never knows when one will have the opportunity to partner with someone who would make a great co-parent.

Susan writes:

i am post op (mtf) transsexual from germany. i just studied your nice website. the item sperm storage is very important. maybe you can publish my (negative) experience too. i started taking female hormones which i obtained in the beginning without control of a physician. after about one year of feminization i considered how i could preserve my genes for future fatherhood. so i went to a cryobank to donate my sperm. however it was to late. even i tried hard but could not ejaculate any more. the doctors tried to find some useable sperm by surgery; but also without success. so actually i will never be able to become biological parent of a child of my own.

Other resources

• = recommended reading

• LINK: Reproductive options by Katherine Heather (2002)

• LINK: A Transsexual's Experience Trying to Preserve Her Reproductive Options by Katherine Heather (2002)

• LINK: The desire to have children and the preservation of fertility in transsexual women: A survey by De Sutter et al (2002)

• LINK: Gender Reassignment and Assisted Reproduction by Paul De Sutter (2001)

http://www.annelawrence. com/grrepro.html

• LINK: How do transsexual people cope with their wish for a child? by Paul De Sutter (2000) via GENDYS

• LINK: Meeting the Reproductive Needs of Transsexual Women by Anne Lawrence (1997)

http://www.annelawrence.com/repro.html

Cryobank resources

For information only. No endorsements implied. Examples were selected for the quality of online information, not necessarily quality of service.

• LINK: List of cryobanks in the US and Canada.

• LINK: Genome Resources

A reader wites: This is a division or "sperm bank brand" of the company General Biotechnology, LLC (Indianapolis, Indiana). I it has a BBB rating of A+ with no complaints filed in the last three years, has been in business since 1997 and is owned an run by several well educated and trained doctors and receives grands of around $1M (which would require regular audits) for research. In short, it appears to be completely reputable. Genome Resources offers a bank by overnight delivery service for $595 for up to three specimens ($195 additional specimen). Annual storage is $100 for up to 10 vials ($10 per additional vials). This is very reasonable pricing (about $200/specimen) and is much cheaper than most other by-mail banks (additionally, note how low the annual storage fee is). Inquiring by phone, I was told it does all of the typical sperm bank testing (sperm count, determines number of vials, etc. It does not wash sperm - I now understand that this is generally unnecessary at the time of freezing). I contacted the UIC (university of Illinois at Chicago) andrology lab which offers the same overnight banking service at about the same cost. Apparently, this does not significantly affect the samples.

• LINK: Cryogenic Laboratories has a typical national storage program offers a CryoFly Kit for at-home use as well as on-site banking.

• LINK: The Fairfax Cryobank at Genetics & IVF Institute is another typical private/commercial storage company.

• LINK: University of Illinois at Chicago has a typical university hospital storage program and lab.

• LINK: International Cryogenics, Inc. in the US was suggested by a reader.

• LINK: The Bridge Centre in the UK is known for working with our community.