Transgender men's experiences of fertility preservation: a qualitative study
Transgender men's experiences of fertility preservation: a qualitative study
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DOI：
10.1093/humrep/dew323
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发表时间：
2017-02-01
影响因子：
6.1
通讯作者：
Rodriguez-Wallberg, K. A.
中科院分区：
文献类型：
--
作者：
Armuand, G.;Dhejne, C.;Rodriguez-Wallberg, K. A.
研究问题：跨性别男性如何通过卵母细胞冷冻保存进行生育力保存（FP）？总结回答：卵母细胞冷冻保存前所需的程序，如激素卵巢刺激和经阴道超声（TVS），对性别焦虑症有负面影响，因为它们与出生时男性的女性分配性别密切相关，这与他们目前的状况不相符。变性人往往对指定的性别特异性身体特征，如生殖器官和雄激素/雌激素反应特征高度不满。因此，进行FP，需要生殖器特异性检查，旨在获得卵母细胞冷冻保存，可能是痛苦的。由于没有以前的研究已经调查了跨性别男性的经验FP涉及冷冻保存卵母细胞，鲜为人知的是他们的经验的proceeding.Study设计，规模，持续时间：这是一个前瞻性研究的成年跨性别男性之间转介FP 2014年3月和2015年12月。FP治疗后不久进行了个人深入的定性访谈。访谈持续了62和111分钟（平均81分钟），并进行了数字记录和转录逐字。参与者/材料，设置，方法：参与者被招募到他们的第一次访问辅助生殖诊所生殖咨询。有15名男性，计划进行FP，他们选择参加这项研究（年龄19-35岁）;没有人生过孩子，8人有伴侣。数据进行了分析，主题内容analysis.Main结果和机会的作用：分析导致了三个主要类别：行程FP，反应FP诉讼和应对策略。FP的转诊是评估和诊断的重要组成部分，有时伴随着令人沮丧的等待和怀疑。对FP程序的反应显示，生殖器检查和与停止睾酮或激素刺激治疗相关的身体变化引发了性别不一致和烦躁不安。然而，对一些人来说，负面的期望并没有得到满足。参与者使用了几种应对策略来管理程序，例如专注于他们接受FP的原因，向朋友和家人寻求支持，以及不讨厌他们的身体或使用非性别名称的认知方法。结果表明，在FP procedures.Limitations，理由回避的重要性上下文敏感性：作者一直努力反思他们的前理解的现象。大多数参与者居住在大城市地区;这是可能的，生活在农村地区的跨性别男子有不同的experiences.WIDER影响的发现：由于结果是基于定性数据从15跨性别男子，结果不能很容易地推广到更大的人群。然而，该结果建议适用于其他想要通过冷冻卵母细胞进行FP的跨性别男性。研究结果显示，跨性别男性对FP场所的体验可能会引发性别不和谐和性别焦虑。然而，卫生保健人员可以通过使用不分性别的语言和首选代词来减轻痛苦。此外，令人放心的是，男性也有如何处理这种情况的应对策略。这些知识对于确保FP期间性别焦虑患者获得足够的专业支持非常重要。
STUDY QUESTION: How do transgender men experience fertility preservation (FP) by cryopreservation of oocytes?SUMMARY ANSWER: The procedures required prior to oocyte cryopreservation, such as hormonal ovarian stimulation and transvaginal ultrasound (TVS), have a negative impact on gender dysphoria as they are closely linked to the men's female assigned sex at birth, which is incompatible with their current status.WHAT IS KNOWN ALREADY: Transgender persons often have high dissatisfaction with assigned sex-specific body features, such as the genital organs and androgen/oestrogen-responsive features. Thus, undergoing FP that requires genital-specific examinations, aimed at obtaining oocytes to cryopreserve, could be distressing. As no previous studies have investigated transgender men's experiences of FP involving cryopreservation of oocytes, little is known about their experience of the procedures.STUDY DESIGN, SIZE, DURATION: This is a prospective study among adult transgender men referred for FP between March 2014 and December 2015. Individual in-depth qualitative interviews were conducted shortly after FP treatment. The interviews lasted between 62 and 111 min (mean 81 min) and were digitally recorded and transcribed verbatim.PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were recruited on their first visit to the assisted reproduction clinic for reproductive counseling. There were 15 men, scheduled for FP, who chose to participate in the study (age 19-35); none had given birth and eight had a partner. Data were analyzed by thematic content analysis.MAIN RESULTS AND THE ROLE OF CHANCE: The analysis resulted in three main categories: the journey to FP, reactions to the FP proceedings and strategies for coping. The referral for FP was an important part of the assessment and diagnosis and sometimes lined with frustrating waits and doubts. The reaction to the FP proceedings revealed that the genital examinations and the physical changes associated with discontinuation of testosterone or hormonal stimulation treatment triggered gender incongruence and dysphoria. However, for some, the negative expectations were not met. The participants used several coping strategies in order to manage the procedure, such as focusing on their reasons for undergoing FP, reaching out to friends and family for support and the cognitive approaches of not hating their body or using non-gendered names for their body parts. The results demonstrate the importance of contextual sensitivity during FP procedures.LIMITATIONS, REASONS FOR CAUTION: The authors have strived to be reflective about their pre-understanding of the phenomenon. The majority of the participants resided in large urban areas; it is possible that transgender men living in rural areas have different experiences.WIDER IMPLICATIONS OF THE FINDINGS: As the results are based on qualitative data from 15 transgender men, the results cannot readily be generalized to larger populations. However, the results are suggested to be applicable to other transgender men who want to undergo FP by cryopreservation of oocytes. The results show that transgender men's experience of FP places may elicit gender incongruence and gender dysphoria. However, health care personnel can alleviate distress by using a gender-neutral language and the preferred pronoun. Also, reassuringly, the men also have coping strategies of how to handle the situation. This knowledge is important to ensure adequate professional support for patients with gender dysphoria during FP.