International journal of transgender health · 2024
The impact of tucking on fertility among transgender women: A systematic review.
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Manafi Ethan, Belarmino André R, Mills Jesse N, Eleswarapu Sriram V, Ng Gladys Y
Аннотация
INTRODUCTION: Tucking involves maneuvering the testicles into the inguinal canal and compressing one's penis and scrotum posteriorly for a smoother pelvic area. A study based in Baltimore reports that 74.7% of transgender women engage in this practice.
OBJECTIVES: Fertility preservation is a significant concern for many transgender women, however, the implications of tucking on fertility remain underexplored. This review aims to bridge this knowledge gap.
METHODS: Using PRIMSA guidelines, a systematic search across various databases was conducted to identify studies evaluating the impact of genital tucking on fertility. Keywords related to tucking, transgender identity, and fertility were utilized.
RESULTS: In total, 127 manuscripts were identified, of which 11 satisfied the inclusion and exclusion criteria. Four studies noted significant differences in semen parameters between cisgender men and transgender women prior to gender-affirming hormone therapy suggesting tucking as a potential factor. Two studies documented tucking prior to semen analysis but did not establish a definitive link between tucking and lower semen parameters in transgender women. One study, with a larger sample size of 113 transgender women, discovered an odds ratio of 7.95 between extensive tucking and low total motile sperm count. One year-long study on daily tucking reported a decline of up to 98% in total motile sperm count, and a complementary paper noted an increase in abnormal sperm morphology. Two case reports observed that after a 3-4 month cessation from tucking, semen parameters returned to normal.
CONCLUSION: The review highlights the prevalence of tucking among transgender women and the negative impact on fertility it may have. Temporary cessation of tucking may improve semen parameters for fertility preservation. A harm reduction approach should be implemented to balance fertility aspirations with the management of gender dysphoria.
OBJECTIVES: Fertility preservation is a significant concern for many transgender women, however, the implications of tucking on fertility remain underexplored. This review aims to bridge this knowledge gap.
METHODS: Using PRIMSA guidelines, a systematic search across various databases was conducted to identify studies evaluating the impact of genital tucking on fertility. Keywords related to tucking, transgender identity, and fertility were utilized.
RESULTS: In total, 127 manuscripts were identified, of which 11 satisfied the inclusion and exclusion criteria. Four studies noted significant differences in semen parameters between cisgender men and transgender women prior to gender-affirming hormone therapy suggesting tucking as a potential factor. Two studies documented tucking prior to semen analysis but did not establish a definitive link between tucking and lower semen parameters in transgender women. One study, with a larger sample size of 113 transgender women, discovered an odds ratio of 7.95 between extensive tucking and low total motile sperm count. One year-long study on daily tucking reported a decline of up to 98% in total motile sperm count, and a complementary paper noted an increase in abnormal sperm morphology. Two case reports observed that after a 3-4 month cessation from tucking, semen parameters returned to normal.
CONCLUSION: The review highlights the prevalence of tucking among transgender women and the negative impact on fertility it may have. Temporary cessation of tucking may improve semen parameters for fertility preservation. A harm reduction approach should be implemented to balance fertility aspirations with the management of gender dysphoria.