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Most of us are taught in school that as we get older our bodies go through changes called ‘puberty’. This includes things like girls getting periods and boys getting deeper voices. For transgender people, this can be an upsetting time, because the idea of growing into the wrong body causes bad feelings called ‘gender dysphoria’. For instance, a transgender girl might not want to get a deeper voice, and a transgender boy might not want to have periods.

Young transgender people have the option of taking a medicine called ‘puberty blockers’, or just ‘blockers’ for short. It works by telling your brain not to produce the chemicals (or hormones) that make these changes happen in your body.

If you decide you want to take puberty blockers, you’ll be asked some questions about your fertility. Fertility means our ability to have babies. In people born as boys, it’s to do with your ability to produce sperm, and in people born as girls, it’s to do with your ability to produce eggs.

So why does anyone need to know about your fertility at this age? It’s because if you take puberty blockers your body doesn’t go through the physical changes that give you the ability to have babies. This means that if, when you’re older, you do want to start a family, you might have to make some changes first.

Some people in the news say that taking puberty blockers means you can’t have children at all. This is NOT TRUE. There are several options you can take depending on where you are in the world.

  • In Australia, Norway, and some parts of the United States, a doctor can take a tiny sample of cells from your testicles or your ovaries and freeze it. Then, when you’re ready to have children, you can unfreeze the cells. The sperm can be used to fertilise an egg, or the egg can be fertilised and put back in your own womb, or someone else’s. The freezing process is called ‘cryopreservation’, and the process of putting a fertilised egg back into a person is called ‘in vitro fertilisation’, or IVF.
  • Alternatively, you can wait until you’re ready to have children and stop taking your blockers and any hormone medication. This will cause puberty to start naturally, and your body will go through the necessary changes to have babies.
  • For transgender boys or non-binary people with ovaries, it may be possible to stop your blockers and any hormone medication for a period of time, then extract some eggs using a process called ‘follicle stimulation’. These are frozen until you want to use them, and you can go back on your blockers afterwards.

Decisions around blockers and fertility can be really stressful, and it can feel like people are pressuring you to make a choice. The most important thing is that you have informed consent – this means that you understand completely what is happening, and are happy with the choices you’re making. If there’s anything you don’t understand you should always ask your doctor.

It’s okay to ask for more time, but once the physical changes of puberty start they can’t be reversed by blockers. You might find that you want to start taking blockers to prevent these changes, and see how you feel later. This is completely reversible and will not harm your health.

When you’re considering starting blockers, or thinking about whether you want to start a family in future, you might find that your friends and family want to talk to you about it a lot. This can be really stressful, especially if you feel like they’re putting pressure on you. For instance, some people’s parents have their own opinions about whether their children should or should not have their cells frozen. It’s okay to ask them to give you some space, but it’s important to remember that they may be just as stressed as you are. It might help to try and explain to them what you’re feeling and what you want.

You might also find that talking about fertility makes you feel bad or sick. This is that feeling we mentioned before, gender dysphoria. For instance, some transgender boys might never want to be pregnant, and hate the idea of it. This is completely fine, and everyone’s experience is different. It’s important to explain what you’re feeling to your family and your doctor, so that they can help support you to make the best decisions that are right for you.

Being transgender can be really stressful, and making decisions about your future – when it seems so far away – can seem like just another way to pile on the pressure. However, with support and proper guidance it can also be a positive process that helps you grow into the person you want to be.