Successful restoration of spermatogenesis following gender-affirming hormone therapy in transgender women

Increasing numbers of transgender individuals are presenting for gender-affirming medical care. For trans women, gender-affirming hormone therapy (GAHT) promotes feminization but also inhibits spermatogenesis. There is a common untested assumption that this inhibition is permanent, resulting in infertility. In this longi-tudinal study, we report the recovery of viable spermatozoa in nine trans women who stopped GAHT for reproductive purposes. Our preliminary findings suggest that the negative impact of GAHT on spermatogen-esis can be reversed, casting doubt on previous claims that GAHT in trans women inevitably leads to perma-nent infertility. Larger studies are needed to confirm our findings, which have implications not only for fertility counseling and the reproductive options of transgender individuals but also efforts to restrict access to GAHT based on fertility grounds.

Automated summary

An increasing number of transgender individuals are seeking gender-affirming medical care. Preliminary findings from a longitudinal study show that the negative impact of gender-affirming hormone therapy (GAHT) on spermatogenesis in trans women can be reversed, casting doubt on claims of permanent infertility. Larger studies are needed to confirm these findings, which have implications for fertility counseling, reproductive options, and restrictions on access to GAHT based on fertility grounds.