Will Baby Make Three?

Coming off hormones, a transgender woman and her partner visit a fertility specialist to try and start a family.

I was 5 weeks into hormone replacement therapy when I finally realized just how badly I wanted to be a parent. After finding a fertility specialist in the area, I made the decision to stop taking my hormones and make an appointment. Two weeks later, Kat and I had our first appointment with Dr. K. The feeling as we walked into his office was unlike anything I ever felt before, and I wondered if this was what Alice felt like as she slid down the rabbit hole into Wonderland.

Dr. K. spoke to us the way that few doctors had ever spoken to me before; not like a medical professional, but more like a friend. It was obvious that helping couples like us was a deep passion of ours, and he was prepared to make it his personal mission to make sure we could have a child. We spoke about our medical histories. I opened up about my gender identity and explained that I had been on hormones for about 5 weeks, before stopping them to make this appointment. He then led us towards the exam area of the facility so that we could start the process.

Kat had a quick ultrasound which showed that everything seemed to be healthy. We both had several vials of blood drawn to check not only for any possible illness but also genetic markers that could cause problems down the road. Finally, I was given a little cup and led to a private room. I was terrified. I knew it was an important test, and I certainly had experience performing this type of test, but the idea of doing the deed anywhere but in the privacy of my own home just felt awkward. I tried to ignore the voices of the people passing by the door, and fought the urge to give up in frustration when a group decided to have a full conversation right outside.


Eventually, I did what I had to do, but felt increased anxiety due to, forgive the details, a very minimal sample. I stared into the little cup, not understanding how it was possible to create so little of something that was so abundant in men. I had followed directions in the amount of time to abstain and I had spent two excruciating weeks avoiding coffee after learning that it could reduce a sperm count. I was terrified of leaving the room and speaking to the lab tech because he had no idea that I was transgender. Would I be judged from the size of the sample? Would I be deemed to be "less of a man?" Would he laugh at me and exclaim, "Well no wonder your wife can't get pregnant." Thankfully, he did none of those things and was extremely professional and reassuring. He told me that it shouldn’t be an issue, that I'd be surprised as to how much they could find even in the most minimal of specimens, and I went on my way. Kat and I left the office feeling excitement at the steps to come.

A week later we returned for one more test and hoped for some results. Kat had to have a second scan which would give a more detailed look at her uterus and fallopian tubes, and we were relieved to learn that everything was nice and healthy. There seemed to be no reason for her to not be able to get pregnant, which of course immediately prompted the thoughts through my mind, if she's healthy, then I must be the problem.


As Kat was brought to another room where she could get dressed and prepare to head home, I sat down with Dr. K. to ask about the sample that I gave the previous week, and it was here where my heart sunk. The doctor pulled up the report on his computer and very sympathetically told me that in my entire sample, there were only three sperm that could be found, and none of them could swim.

I almost burst into tears right then and there. Kat was in the next room changing after her procedure and I could feel my legs almost turn to mush. How could I look her in the eyes and tell her that I was apparently infertile? Then the next thoughts came racing through my mind… was I always like that? Or did the 5 weeks of hormone therapy perform a mass genocide of my little swimmers?

Our appointment ended and we were recommended to schedule to see first a counselor and then the doctor again in order to go over everything and discuss our next steps. As the next few weeks come, we will have to discuss if there are ways in which we can still have a child that is biologically ours. Can something be done about my current lack of swimmers? Was it just a bad sample? Would a longer period of time off of hormones solve the problem? And what if it can never be remedied? Do we want to consider using a donor that would allow Kat to become pregnant and have the child who isn’t genetically mine? Or do we just move on from all of this return to considering adoption as our only remaining option at parenthood? We made our next appointment for another 3 weeks later to sit down with Dr. K. and start figuring out what our next options are.