Can Trans Women Have Babies?

Editor:
Olha Rybak

Author:
Olha Rybak
Olha Rybak (she/her) is Fiorry’s Chief Editor, where she executes and operates in a writer, editor, and content creator capacity. At university, she studied English language and literature but found she loved psychology almost as much. Olha is an industrious content creator as well as a committed team leader. She says her academic background gives her a unique perspective into the complicated nooks and crannies of human behavior and communication. As a hobby, Olha also translates literature, which she passionately reads and seeks out stories that she’ll be completely absorbed by.

Key takeaways
Can trans women have babies? A topic bound to science, personal experience, and the ever-changing gender and female reproductive system and health. As society becomes more accepting and more educated about transgender identities, it’s time to talk about the reproductive options available to trans women. This article is an attempt to impart knowledge about the reproductive potential of trans women and to emphasize the necessity of including trans women in the conversations around the male-to-female transgender reproductive system and health.
Overview of Trans Woman Reproductive Options
Reproductive health concerns of trans women, also called male-to-female (MtF) people, are unique. Many trans women assigned male at birth who do not have a uterus consider surrogacy or adoption to build their families while they were assigned male at birth. The hormone therapy may lead to the development of some breast tissue in some patients, making it possible for these patients, under special circumstances, to produce milk. But trans women don’t have female reproductive organs, so the biological ability to get pregnant by another girl or have menstruation, as cisgender women do, isn’t possible.
Beyond this, it is necessary to understand the differences in the reproductive health and family-building options of female to male (FtM) people.
Importance of Reproductive Inclusivity
Promoting a more inclusive society means understanding and acknowledging the reproductive rights and options for trans women. LGBTQ+ communities deserve discussions around reproductive health, too. Trans males and trans girls need comprehensive resources supporting their reproductive choices. An inclusive dialogue can assist in dismantling stigmas so that people decide to pursue how they want to build the family—whether adoption, fostering, or other ways—and support individuals to do so. How can we address the question of whether trans women have babies or the idea of impregnation in a thoughtful way when our representation of the human experience of individuals in the transgender community fails to account for a wide variety of experiences?
Fertility Preservation
Fertility preservation is a vital consideration for individuals undergoing gender transition, whether they are transgender women (MtF) or transgender men (FtM). For trans women, options like sperm freezing allow them to retain the ability to conceive biological children in the future. Conversely, prior to taking testosterone, trans men can explore procedures such as egg freezing or ovarian tissue preservation to secure their reproductive potential before starting hormone therapy. These proactive measures are essential, as hormone treatments can significantly affect fertility. By understanding and utilizing these preservation techniques, transgender people can make informed choices about their reproductive futures, ensuring they have the opportunity to build families that align with their identities and desires, regardless of the path they choose. Ultimately, fertility preservation empowers them to navigate their journeys with confidence and hope, knowing that parenthood remains a possibility.
For Transgender Women (MtF)
Transgender women, or MtF people, often seek fertility preservation options before beginning hormone therapy or gender-affirming procedures. Understanding these options is crucial for those who wish to maintain the possibility of biological parenthood or birth sometime in the near future.
Sperm Freezing

Cryopreservation of sperm (sperm freezing) is one of the main fertility preservation methods that trans women use. A trans woman may choose to ejaculate and have the sperm frozen to use later if she does not undergo hormone therapy beforehand, which can cut sperm production to practically nothing and severely reduce sperm quality. With this method, trans fertility still has the ability to conceive a child down the line, whether that be to artificial insemination or other assisted reproductive techniques. Trans women can preserve sperm, meaning they can become parents and raise children with a partner.
Pre-Hormone Therapy Considerations
It is essential for trans women to consider more research on their fertility options before starting hormone therapy that introduces testosterone into their bodies. Hormone medications alter the body’s natural hormone levels, which can significantly impact fertility and may reduce the chances of producing viable sperm. Planning ahead allows people to take proactive steps toward parenthood and understand the meaning of their reproductive choices in the context of their transitioning journey.
For Transgender Men (FtM)
Transgender men, or FtM people, also face unique challenges regarding fertility preservation. As they undergo hormone therapy and embrace their identities, understanding their reproductive options is just as critical for those patients looking to maintain their ability to have biological children.
Egg/Embryo Freezing

- Egg Freezing: This option allows transgender men to preserve their fertility before starting testosterone therapy, which can suppress ovarian function.
- The process involves:
- Undergoing assisted reproductive techniques to retrieve eggs.
- Freezing the eggs for future use.
- The process involves:
- Embryo Freezing: Suitable for those who have a partner and wish to conceive, embryo freezing allows people to create and store embryos.
- This involves:
- Fertilizing the retrieved eggs with a partner’s sperm.
- Freezing the resulting embryos for potential future pregnancies.
- This involves:
Ovarian Tissue Freezing
- Ovarian Tissue Freezing: An innovative technique that holds promise for transgender men.
- This method includes:
- Surgical removal of ovarian tissue before starting hormone therapy.
- Preservation of the tissue for future use.
- Later, the tissue can be:
- Transplanted back into the body to restore fertility.
- Used to aid in the retrieval of eggs, especially for individuals unable to undergo traditional egg retrieval procedures.
- This method includes:
Pre-Hormone Therapy Considerations
Transgender men must consider several key points before starting hormone therapy:
- Impact of Testosterone: Understand how testosterone can lead to:
- Changes in physical appearance, typically resulting in a more masculine look.
- Alterations in reproductive organ function and fertility.
- Awareness of Fertility Status:
- It is crucial to be informed about how testosterone therapy affects the chances of getting pregnant if one wishes to maintain reproductive capabilities.
- Informed Decision-Making:
- Understanding these options empowers transgender men to make well-informed decisions about their bodies and future reproductive health while navigating their gender identity journey.
Reproductive Options
There are now many reproductive options for transgender women, from a variety of ways to become parents that are adapted to the particular circumstance and desire. Though transgender women are unable to carry a pregnancy biologically, a number of methods exist to help families grow, including conception through partner insemination, surrogacy, and the very promising field of uterine transplant clinical trials. Trans women are presented with a range of possible options, including being able to collaborate with partners, use assisted reproductive technologies, or the very revolutionary option of uterine transplantation. The more we become aware and accepting, the more we must accept these reproductive possibilities and support trans people on their journeys to parenthood.
For Transgender Women
Transgender women have various reproductive options available to them, despite the absence of female reproductive organs at birth. Each option caters to a person who may meet the desire for parenthood, allowing the first trans woman to explore ways to have children and start families, regardless of who they are attracted to.
Conception via Partner Insemination
Partner insemination is one of the main reproductive options for trans women. The method uses previously frozen sperm or sperm from a donor for fertilization. This route is more personal and direct for trans women who put sperm away before hormone therapy and is the fastest and most direct way to start a family. Trans women can’t experience periods or the physical signs that come along with pregnancy, but that doesn’t mean they can’t participate actively in the process of conception; they might be able to assist their partner while pregnant and possibly breastfeed if they choose to induce lactation.
Surrogacy Options
There are other avenues for transgender women who want to have children: surrogacy. In this arrangement, the trans woman becomes a parent, but without having to actually carry the child—the pregnancy is instead carried by a surrogate. Some of the ways surrogacy can work involve using the trans woman’s previously frozen sperm, donor sperm, or the sperm of her partner. This option opens up a special possibility to become parents for trans women, close to the child in a surrogacy journey. This method is appealing to many because it allows for kids without the pregnancy risks of bearing a child.
Uterine Transplants

Uterine transplants are a cutting-edge but developing reproductive option for transgender women. A trans woman would have the uterus relocated into her body in this surgical procedure and would potentially be able to give birth and conceive. Uterine transplants are still in the experimental stages and have given trans women who want a first-hand experience of pregnancy hope. Carrying a pregnancy after uterus transplants would be a personal dream of parenthood, but would also add to the knowledge of fertility and reproductive health in the transgender community. These options are a hopeful sign of a future in which more trans people can have their dreams of family building come true as medical technology continues to advance.
For Transgender Men
Transgender men have a variety of reproductive options available to them, enabling them to explore different pathways to parenthood. Whether through natural conception, advanced fertility techniques, or adoption, each option allows trans men to create families that reflect their unique journeys and identities.
Natural Conception
Many transgender men who have not had extensive hormone therapy or surgical interventions that impact fertility may be able to conceive naturally. Sexual intercourse with a partner can cause a person to become pregnant if they retain their ovaries and uterus. Trans men need to know their fertility status and how taking testosterone or therapy might affect their chances to conceive. The prospect of natural conception has much to offer the many trans men who enjoy dating and relationships as well as exploring their desire to have children.
Assisted Reproductive Technologies (ART)

Assisted Reproductive Technologies (ART) offer transgender men alternative methods to achieve pregnancy, especially for those who may have undergone hormone therapy and have concerns about fertility. Options such as intrauterine insemination (IUI) or in vitro fertilization (IVF) utilize either the woman or transgender man’s preserved eggs or the eggs of the transgender man’s partner, coupled with donor sperm, to facilitate conception. ART can be especially empowering for trans men who desire to have biological children, as these techniques are designed to overcome common fertility challenges, ultimately allowing them to navigate their family-building journeys with hope and agency.
Adoption and Surrogacy
Transgender men also have other ways of becoming parents, adoption and surrogacy. Adoption is when people can give a child in need a loving home and make a family without being related biologically. In particular, many trans men find fulfillment in this inclusive choice if there are fertility challenges. The other option, if you want to have a deeper connection with your children, is surrogacy. Through surrogacy, transgender men can enjoy the parenting journey while navigating the complications of reproductive health. Adoption and surrogacy are both ways that trans men can parent, and both ways of parenthood affirm trans men’s own gender identity and contribute to the lives of the children they bring into their families.
Medical and Ethical Considerations
Navigating the reproductive options available to transgender people involves careful medical and ethical considerations. Understanding the impacts of hormone therapy, surgical interventions, and ethical dilemmas is crucial as individuals make informed decisions about their reproductive futures.
Hormone Therapy and Fertility Impact

Transgender people depend on hormone therapy, especially in relation to fertility. For transgender men on testosterone therapy, the treatment commonly halts ovarian function, and as a result, fertility may be reduced or, in some cases, temporarily lost. It is important for people considering starting hormone therapy to understand how testosterone use may affect their ability to conceive before starting. However, transgender women retain fertility until they undergo surgical procedures or hormone therapy that can reduce sperm production. Consequently, fertility preservation methods such as sperm freezing for trans women and egg freezing for trans men should be included in all pre-transition medical counseling to empower people to make decisions about their reproductive health.
Surgical Interventions
Additional medical considerations are present for the transgender community through surgical interventions, including gender-affirming surgeries. Hysterectomy or oophorectomy (removal of ovaries) in transgender men will render their chances of natural conception and childbirth impossible. On the other hand, transgender women may also consider vaginoplasty and other procedures that may hinder them from conceiving by traditional means. Clear communication between people and healthcare professionals is critical and they need to have an in-depth discussion about the benefits and risks of these procedures in the setting where they have reproductive goals. For transgender patients, it is important to have a good understanding of what implications surgical choices will have for them and for future planning around sex and family building.
Ethical Dilemmas
As with the landscape of reproductive options for transgender people, important ethical dilemmas arise. For example, other questions raised by the use of assisted reproductive technologies, including sperm donation or surrogate parenting, involve consent, the rights of biological parents, and the interests of the child. Moreover, the access of reproductive healthcare to the transgender community cannot be overlooked, along with issues associated with equitable access to reproductive healthcare. The medical community has an ethical responsibility to provide that same inclusive, affirming care that takes into consideration the identities and reproductive choices of transgender people. With the ongoing development of society’s more nuanced understanding of gender and family building, these ethical dilemmas need to be openly discussed so that all can receive respectful and supportive reproductive healthcare.
Psychological and Social Support
Navigating the reproductive landscape can be both exciting and challenging for transgender people. Psychological and social support play critical roles in ensuring that individuals have the necessary resources to make informed decisions, cope with the emotional aspects of parenthood, and foster a sense of community as they move forward in their journeys.
Counseling for Fertility Preservation
Counseling for fertility preservation is an essential step for transgender people considering their reproductive options. Access to knowledgeable mental health professionals who understand the unique challenges faced by trans people can help individuals navigate the complex emotions associated with decisions around fertility. To be able to discuss infertility fears and the impact of hormone therapy or surgical interventions on future parenthood, it helps to have a supportive counselor who can provide a safe space.
Additionally, counseling can guide individuals in exploring their options, setting realistic expectations, and developing coping strategies to manage the potential emotional stress involved in fertility preservation and family-building. The need for multidisciplinary care, including psychological support, has been highlighted in reports emphasizing comprehensive approaches to transgender healthcare.
Support During Pregnancy and Community Resources
Support during pregnancy is crucial for transgender individuals who choose to carry a child or partner with someone who does. Trans men who experience pregnancy may face unique challenges, including navigating healthcare systems and addressing societal stigma. Support networks, including their healthcare providers and professionals experienced in transgender care, can provide affirming environments for prenatal visits, labor, and postpartum care. It’s important for transgender people to find healthcare providers who are knowledgeable and sensitive to their needs to ensure a supportive and affirming experience during pregnancy.
Gabrielle Union says:
“You don’t know how strong you are until being strong is your only choice,” which resonates with those who are navigating the complexities of pregnancy and parenthood.
Partners can also benefit from support as they navigate their roles during pregnancy and parenting. Emotional and practical support from friends, family, and the community can enhance the overall transgender pregnancy experience, helping to foster resilience and confidence in the journey to parenthood. To further aid this journey, consider downloading the Fiorry app, which offers tailored resources and support networks specifically designed to meet trans women. By leveraging community resources, such as support groups and educational materials, transgender people can connect with others who share similar experiences, reducing feelings of isolation and fostering a sense of belonging. Access to this network is invaluable for building a strong foundation of support and knowledge throughout the family-building process.
Community resources play a vital role in offering support to transgender people and couples looking to build families. Organizations dedicated to serving the LGBTQ+ community often provide educational materials, support groups, and workshops focused on reproductive health, family planning, and parenting. These resources can help individuals connect with others who share similar experiences. Additionally, advocates within these communities work to address disparities in access to healthcare and support, ensuring that all trans people can pursue their family goals without facing discrimination or barriers. By leveraging community resources, transgender people can find the encouragement and knowledge needed to navigate their unique paths to parenthood.
For easier access to these valuable resources and community support, be sure to download the Fiorry app, a platform designed to empower and inform transgender people and their families.
FAQ
In this section, we provide answers to frequently asked questions about reproductive health and options for transgender individuals.
1. What options are available for transgender people who wish to preserve their fertility?
Transgender people have several fertility preservation options, including sperm banking for transgender men and egg freezing for transgender women. Additionally, some may consider embryo freezing if they have a partner. People need to discuss these options with a healthcare provider who specializes in reproductive health.
2. In what ways does hormone therapy influence fertility among transgender people?
Hormone therapy can have a significant impact on fertility. For transgender men, testosterone can suppress ovarian function, which may reduce fertility potential. Conversely, transgender women undergoing estrogen therapy may experience diminished sperm production. People are encouraged to explore their fertility status before initiating hormone therapy.
3. Is it possible for transgender women to become pregnant through a uterine transplant?
While uterine transplants are an emerging field of reproductive medicine, they have not yet become a standard option for transgender women. Some advancements have been made, and the possibility is being researched, but these procedures are still in experimental stages and come with numerous medical and logistical challenges.
4. What are the potential risks and difficulties faced by transgender men during pregnancy?
Transgender men may face a range of risks during pregnancy, including psychological challenges related to gender identity and societal stigma. There may also be medical complications due to prior surgeries or hormone therapy. Support from healthcare providers familiar with transgender health is essential to address these challenges.
5. How do surgical procedures impact future reproductive possibilities for transgender people?
Surgical interventions, such as chest or genital surgeries, can affect reproductive options. For transgender men, removal of the ovaries during gender-affirming surgery will eliminate the ability to conceive. People need to consider their reproductive goals and discuss them with their healthcare team prior to surgery.
6. What ethical issues arise in relation to reproductive technologies for transgender people?
Ethical concerns surrounding transgender reproductive technologies include issues of access, informed consent, and the long-term implications of fertility preservation methods. The need for equitable healthcare access and the potential for coercion in making reproductive choices also raise important ethical considerations.
7. What types of psychological support can be accessed by transgender people contemplating pregnancy?
Transgender people considering pregnancy can find various forms of psychological support, including counseling and support groups that cater specifically to transgender and non-binary experiences. Mental health professionals can provide guidance on navigating the emotional complexities of pregnancy, as well as support through the challenges related to identity and social acceptance.
Time to read: 17 min.
PR manager
Olena Kosonogova
Support systems are essential for transgender people as they navigate complex decisions regarding their reproductive health and family planning