Fertility Considerations for Gender-Diverse People.

Individuals pursuing gender-affirming care should receive comprehensive counseling regarding their reproductive options and be offered fertility preservation prior to medical or surgical transition. All fertility preservation and infertility treatment modalities available to cisgender individuals are also available to transgender individuals. Fertility preservation should prioritize methods with the highest potential for future live birth, particularly mature oocyte or sperm cryopreservation. Gender-affirming hormone therapy may reduce spontaneous fertility, though this effect is incomplete and should not be relied upon for contraception. Temporary cessation of hormone therapy can facilitate spontaneous conception; this decision should be made collaboratively.