Projet Ferring Grant : Access to oocyte cryopreservation and medically assisted reproduction for trans men in France

Résumé du projet :

Brief overview :

The revision of the law of bioethics in 2021 authorized access to ART for « all » but exclusively coupleswoman/man, woman/woman and single women. However, trans people were excluded from the bill. The argument put forward is that "only the sex indicated in the civil status is taken into account". However, more and more trans people freeze their gametes prior to the initiation of gender-affirming hormonal treatment and the question of the reuse of frozen gametes arises.

Scientific rationale and aims of the project :

The revision of the law of bioethics in 2021 authorized access to ART for « all » but exclusively coupleswoman/man, woman/woman and single women. However, trans people were excluded from the bill. The argument put forward is that "only the sex indicated in the civil status is taken into account". However, more and more trans people freeze their gametes prior to the initiation of gender-affirming hormonal treatment and the question of the reuse of frozen gametes arises.
Access to oocyte cryopreservation and medically assisted reproduction for trans men in France
Studies show that between 14%(1) and 62%(2) of the trans community wants to access parenthood. In addition, gender-affirming hormone treatment has an impact on long-term fertility, not to mention the sex affirmation surgery. In this context, international guidelines stipulate that fertility preservation should be offered to people prior to initiation of hormonal treatment (3).
The first fertility preservation cycles began in 2018 in French centers. While almost all trans women who were informed of the
risks on their fertility froze semen, only 34% of trans men froze oocytes in our facility and 11.3% at the national level (4). In addition, only about fifty centers are authorized for fertility preservation in France, but it seems that only a few of them provide services to trans people.
Our research aims to quantify and understand the procreative possibilities of trans men in France. How do they access fertility preservation? What are their expectations and experiences of oocytes freezing and ART? What obstacles do they encounter or, on the contrary, what resources do they have to access their reproductive rights?
This project is articulated around three axes and was designed with trans people
1 - Quantitative and qualitative research on access to fertility preservation for trans people in France through a questionnaire sent to all fertility preservation facilities in France.
2- A qualitative research on the conditions of access to fertility preservation for trans people thanks to a questionnaire sent via associations, social networks and a network of trans people that we already have. It is important to assess the differences between trans men and women before looking particularly at trans men's access.
3- Directed interviews will be proposed to trans men participants, in order to better understand the specificities related to their management and the low recourse to fertility preservation.
The expectations of this project are:
- a mapping of fertility preservation services for trans people in France and possible geographical and social disparities in care access. Delays in access to care are also important to consider.
- a better understanding of the obstacles encountered by trans people achieving fertility preservation in order to better respond to their request and to better inform about fertility preservation in this population.
We hope that this project will expand access to fertility preservation for trans people in France and better meet their expectations.
In addition, the question of assisted reproduction will arise very soon.