Transitions and Fertility

A transgender person and their wife take the next important steps towards family planning.

A few weeks ago, I wrote about the ongoing attempts that my wife, Kat, and I have been undergoing in order to have a child before I transition. After a long time of trying unsuccessfully on our own, we visited a fertility specialist and found that my sperm count was practically nonexistent, likely due to a short period of time on HRT.

Since my last update on the matter, I've been struggling with a lot of nerves, depression, and even confusion. Where did all of this leave me? How would infertility affect me long term? How would it affect my marriage? Kat already had many mixed emotions regarding the concept of my transition, and while she has come a long way in accepting me as Crystal, I was terrified that this could be the last straw. I was sure that my starting transition before looking into the fertility option might have ruined my chance of having a biological child. What if I could never produce a healthy sperm again and Kat couldn’t handle it? She tells me that things will be ok, but it's easy to think positive when you haven’t been told that it's definitely off the table. Would she resent me if we ended up adopting, because I denied her the chance of carrying a pregnancy? Would she look at me differently if we used a donor sperm? Knowing that this child wasn’t genetically my own?


So now I was being sent to visit, Dr. S, a urologist who specializes in "male infertility," a slightly ironic requirement, all things considered, but of course, a necessary one if Kat and I were going to avoid using a donor sperm. This doctor did some standard exams including a sonogram and told me that everything physically was in good shape and ordered me to undergo a few additional tests including bloodwork and another sample. Two weeks later, I found myself back in that awkward little private room with a cup in one hand and… well, you get the idea.

When my follow-up appointment came around, I was more anxious then I think I ever had been before. This appointment was it, as far as I was concerned; possibly the final strike that told me that I would never have a child of my own, one that shared in my DNA, shared in my soul. This brings me back to my previous fears, don't get me wrong, if we end up using a donor sperm, or even if we end up adopting, I know deep down that I would still love that child with every ounce of my being, but at this stage, being a prospective and still having every door open in front of you, of course a biological child is the first choice.

Photo by Nynne SchrøderUnsplash

As Kat and I sat down in the office, I reached for her hand and gripped it tightly. Dr. S started with the results of my bloodwork, which all looked pretty decent. My testosterone was on the moderate-low side of normal, which wasn't something he was concerned about; my estrogen level was high (at least what is considered high for a cisgender male) and Dr. S explained that there were options out there, if I so desired, that could lower my estrogen levels in order to make my samples more viable. At this point, I was almost shaking with anticipation; obviously this statement was a prelude to telling me that I had another worthless sample, that my testicles were as dry as the Sahara.


Kat squeezed my hand tighter; I felt the tears beginning to form, but not yet quite ready to flow. Dr. S shuffled the papers on his desk and announced the shift to the results of my sample. My brain shut down for a moment, and I don't think I fully heard him as he began to read the results, I certainly don’t remember the exact numbers he told me, but when my ears decided to start working again, I was being told that this was definitely a sample that could be worked with. I squeezed my eyes shut for a second and shook off the numb feeling, trying to make sure I was hearing everything correctly.

Dr. S continued by asking if we had considered freezing for future use, his recommendation was that I come back in a few weeks and give a new sample to be frozen as a sort of insurance policy. When we have scheduled the proper time to try for in-vitro fertilization, they could take a fresh sample directly, and then keep the frozen samples in case there might be a need for future attempts; this way, I could potentially speed up my timeline of transition without having to worry about fertility.

I scheduled my appointment to cryo-freeze a sample, and now it's a waiting game until we can plan and schedule the next steps in our process. I hope that everything works positively for us. We are of course keeping an open mind, we know that there are still many "what ifs" floating around, so we're trying to keep our heads level without getting either too optimistic or pessimistic. The journey is long, and we're still at the onset, but the path is well lit and we're excited to see this through.