..

The Conversation

  • Written by Damien Riggs, Associate Professor in Social Work, Australian Research Council Future Fellow, Flinders University

For any person needing medical care, informed consent is vital. Yet for transgender people, informed consent may be hindered by how medical professionals share information. This is especially the case in the context of reproductive health, where speaking about reproductive materials is often highly gendered.

Both the World Professional Association for Transgender Health Standards of Care and the Royal Children’s Hospital’s Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents emphasise the importance of discussing fertility preservation as an option for transgender people.

Yet little guidance is given on how to do so in ways that are inclusive.

Read more: Rethinking how we represent transgender children in the media

Barriers to informed consent

How medical professionals share information about fertility preservation can be distressing for some transgender people. This is because the terms typically used may be seen as referencing gender.

Sperm are typically associated with men. Eggs are typically associated with women. For women who produce sperm, or men who produce eggs, these terms can be distressing. Such distress can mean disengagement from information.

Further compounding issues of terminology are assumptions about people’s desire to reproduce. In countries such as Australia, population growth is considered important. This places an expectation on all people to reproduce. This is especially true for people who are assigned female at birth.

Informed consent, individual care vital to ensure reproductive rights of transgender Australians Role of professionals in fertility discussions. Damien Riggs, Author provided

As a result, transgender men in particular may feel pressured to preserve their fertility. In our recent study of Australian transgender and non-binary people and fertility preservation, some of our trans masculine participants reported they had been told, in essence, that “if you have a uterus, you should want to use it”.

Certainly growing numbers of transgender men are bearing children. It is heartening that Medicare now treats pregnancy and birth-related items as non-gender-specific. But this does not mean that all men want to bear children, nor that they should be expected to do so.

Read more: Commercial surrogacy in Australia: rethinking notions of 'natural'

Some of our participants also reported that medical professionals insisted they preserve their fertility. This was an especially concerning form of gatekeeping. Gatekeeping occurs when access to medical care is restricted to transgender people who conform to a standard narrative of what it means to be transgender.

Facilitating informed consent

In our work on sexuality education for transgender young people, we highlighted the importance of gender-neutral language. We suggested that speaking about gametes, rather than sperm and eggs, is one way of ensuring that transgender young people do not experience distress. This does not prevent making distinctions between different types of gametes, and how they come together in the process of conception.

In the context of fertility preservation, it is also possible to speak about gametes or reproductive organs. As noted above, it is also important not to presume that all people want to reproduce. Many of our participants reported that, should they wish to become parents in the future, they might do so through adoption or foster care.

Discussions about fertility preservation are important for any person whose fertility may be compromised by particular forms of medical care. But this does not mean that agreeing to fertility preservation should be mandatory in order to access particular forms of medical care.

Read more: Transgender kids get their own health-care guidelines

Particular care is indicated with regard to young people. Parents of transgender children may hope to have grandchildren. They may encourage a young person to preserve fertility when that is not necessarily the young person’s desire. For young children unable to give consent, medical professionals should ensure that the family receives adequate counselling prior to a decision being made so as to ensure that children’s voices are heard.

Informed consent, individual care vital to ensure reproductive rights of transgender Australians Experiences with clinics when undertaking fertility preservation. Damien Riggs, Author provided

Transgender people’s reproductive rights

The area of fertility preservation represents an important aspect of reproductive rights for transgender people. Transgender people should absolutely have the right to undertake fertility preservation. This should be provided in a timely and affordable manner, mindful of how informed consent may be undermined if medical professionals do not approach the topic in an inclusive way.

At the same time, however, assumptions are not helpful. It should not be assumed that all transgender people want to preserve their fertility. It should also not be assumed that all transgender people want to access forms of medical care that might negatively impact their fertility (i.e., not all transgender people will wish to commence hormone therapies or undertake gender affirming surgeries).

Read more: More Australian trans stories on our TV screens, please

Conversely, it is important to acknowledge that some transgender people might experience infertility unrelated to gender transition, and may wish to access reproductive services – as is true for any person who experiences infertility.

For transgender people who do choose to have children, their rights as parents must be protected. This includes as a society challenging the discrimination that many transgender parents face. More broadly, ensuring transgender people’s reproductive rights must include access to services related to reproductive health (such as pap smears for transgender men), and access to abortion services.

Transgender communities are diverse, and there is no one right outcome for medical care other than ensuring that the individual’s needs are met. Medical professionals must acknowledge the diverse desires and needs of transgender people. This means opening up conversations about reproduction, but also respecting when people do not wish to reproduce.

The author is presenting Futurity and fertility in transgender people’s lives at the 2018 Adelaide Festival of Ideas, Sunday 15 July 2018 (free entry).

Authors: Damien Riggs, Associate Professor in Social Work, Australian Research Council Future Fellow, Flinders University

Read more http://theconversation.com/informed-consent-individual-care-vital-to-ensure-reproductive-rights-of-transgender-australians-99589

Politics

Prime Minister interview with Alan Jones

Good morning Alan.   ALAN JONES: Thank you for your time. Could I just begin by saying that politicians rarely get praise. I have been speaking to farmers during the course of the weekend. You wen...

Alan Jones - avatar Alan Jones

Scott Morrison on Shorten's Border Protection backdown

Border Protection   PRIME MINISTER: Less than 24 hours ago, I warned Australia that Bill Shorten would make Australia weaker and the Labor Party would weaken our border protection. That they could...

Scott Morrison - avatar Scott Morrison

Funding to support women and children escaping domestic violence

Hundreds more women and children escaping domestic and family violence will have a safe place to sleep with a $78 million investment by the Morrison Government.   This investment includes a $60 mi...

Scott Morrison - avatar Scott Morrison

Business News

Why Branding is vital to your family owned business

Once available only to large corporations, branding is now more accessible and vitally important to every size (and type) of family business, including yours. But what is branding and how does it ...

Stella Gianotto - avatar Stella Gianotto

Statewide Super announce Tony D’Alessandro as CEO

Tony D’Alessandro Tony D’Alessandro will be the new Chief Executive Officer of Statewide Super, effective 1 March 2019. Mr D’Alessandro will replace Richard Nunn, who in January announced his ...

Media Release Service - avatar Media Release Service

Why ‘Handover Culture’ Doesn’t Exist in Australia – And Why It Should

Handing over a business to the next generation might seem like something that can wait, but Australian business is largely unprepared for succession – and that’s a problem.   Handover culture is t...

Andrew Williams - avatar Andrew Williams

Travel

Fun Things You Must Do In Perth

Perth: Sun, sand and 19 beaches might seem to sum up the city, but not quite. The sunniest capital city in Australia offers so much more for you to do. Regardless of what your idea of fun is, you wi...

News Company - avatar News Company

ex-HMAS Tobruk dive site Fraser Coast

Fraser Coast Has a New Sunken Treasure for Divers to Explore A rush of scuba divers from around Australia is expected to begin exploring the underwater wonderland created by the ex-HMAS Tobruk after...

Tracey Joynson - avatar Tracey Joynson

3 Steps to Make Your Dream of Working Abroad Come True This Year

Oh, the New Year. The time of year when anything seems possible and everything seems doable. For some people, nothing will change over the course of the next 12 months. For others, everything may. I...

Bevan Berning - avatar Bevan Berning

You might also like