跨性别患者的生育选择:医生如何提供更具包容性的护理?

Julian K. Marable, M. Etchéverry, Bailey Liter, Melissa Wu
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引用次数: 0

摘要

计划生育对所有患者的性健康和生殖健康至关重要。对于跨性别者,使用性别偏好的方式受孕和预防可以最大限度地减少性别不一致和不安。目前,文献描述了几种妊娠选择,包括自然受孕、配子冷冻保存、体外受精和子宫移植。预防方法与治疗顺性患者的方法类似,如口服避孕药、宫内节育器、避孕套和各种外科手术。然而,重点在于选择一种最能支持患者所选择的性别认同的方法。本综述支持卵母细胞和精子冷冻保存作为妊娠的首选方法,并与文献一致认为没有最好的预防方法。因此,医生应该优先与患者进行早期讨论,并密切合作,使用适合每位患者需求和期望的治疗方式。随着关于LGBTQ+健康的文献不断增加,本综述将有助于扩大跨性别患者的计划生育知识。
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Fertility Options for Transgender Patients: How Can Physicians Provide More Inclusive Care?
Family planning is critical to the sexual and reproductive health of all patients. For transgender individuals, using gender-preferred modalities for conception and prevention can minimize gender incongruence and dysphoria. Currently, the literature describes several pregnancy options including natural conception, gamete cryopreservation, in vitro fertilization, and uterine transplantation. Prevention methods remain similar to those for cisgender patients such as oral contraception, intrauterine devices, condoms, and various surgical procedures. However, great emphasis lies on choosing a method that best supports the chosen gender identity of the patient. This review supports oocyte and sperm cryopreservation as the preferred method for pregnancy and finds consensus with the literature that there is no best method for prevention. As such, physicians should prioritize early discussions with patients and work closely to use modalities that fit each patient’s needs and expectations. As the body of literature on LGBTQ+ health continues to grow, this review will help to expand the knowledge around family planning for transgender patients.
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