P-581 Family of origin cohesion and intention to pursue fertility preservation in transgender and non-binary people
Authors: Moura-Ramos M , Pinto A , Reis J 
Published: June 2023

Abstract

Study question
Is the relationship with the family of origins associated with parenthood plans and fertility preservation of transgender and non-binary people?

Summary answer
Family of origin characteristics, namely family cohesion, is associated with the transgender and non-binary people intention to undergo fertility preservation.

What is known already
Few studies have explored parenting intentions and decision to undergo fertility preservation (FP) in transgender and non-binary people. Most studies have focused on the barriers and facilitators of this decision, focusing on the procedures involved in FP, but no studies have assessed the role or psychological (namely relational) variables in the decision making regarding FP. Previous research indicates that family closeness is an important factor in the psychological adjustment of transgender people. Similarly, research indicates that more favorable family relationships were associated with parenting intentions. No studies have examined how relationship with family of origin may affect fertility preservation intentions.

Study design, size, duration
This is a cross-sectional study. Participants were surveyed online from January to April 2022. Dissemination of the study was performed through the social networks of LGBTQIA+ associations.

Participants/materials, setting, methods
Participants were 69 transgender and non-binary people, aged 18-39. The assessment protocol included a questionnaire assessing childbearing intentions, importance of genetic and non-genetic parental connectedness and intention to pursue FP. A validated measure assessing family relationships (Fertility Environment scale, Moos & Moos, 1976) was used, evaluating family cohesion (degree of commitment and support family members provide for one another) and family expression (the extent to which family members are encouraged to express their feelings directly).

Main results and the role of chance
Participants were 40 transgender men (58%), 8 transgender women (11,6%) and 21 non binary (30.4). About 55,1% participants had already initiated hormonal therapy. Almost half of the sample (47,8%) considered having children in the future, while 13 (18.8%) were sure about not wanting children. Genetic connection was not very important (M = 19.51, from 0 -100). A total of 48,1% indicated that that would envision undergo FP in the future.
A mediational model examining indirect effects were tested to examine whether family of origin relationship (cohesion and expression) would be associated with fertility preservation intention.
A significant indirect effect was found, suggesting that family cohesion is associated with the intention to undergo fertility preservation through the effect on the importance of genetic parenting (estimate: 0.56, bootstrap bias-corrected 95% confidence interval 0.052; 1.199) That is, participants with high family cohesion in their family of origin highly valued genetic parenting and this was positively associated with the intention to undergo fertility preservation.
The same indirect effects was tested regarding family expression, but no significant effects were found, that is, the expression of the family of origin is not associated with the intention to undergo PF (estimate: 0.604, bootstrap bias-corrected 95% confidence interval -0.077; 1.366).

Limitations, reasons for caution
The dissemination of the study and participants recruitment was throughout LGBT+ associations, so it is possible that some transgender people that are less prone to be involved in these associations were not reached.

Wider implications of the findings
The importance of the relationships with the family of origin may be an important factor to consider when counselling transgender and non-binary people regarding fertility preservation This may be markedly important when lower family cohesion may be limiting patients’ future options.

Trial registration number
Not applicable