Many LGBT communities centre their support around cisgender gay, lesbian and bisexual people and neglect to include proper support for transgender people. The same 2020 literature review analyses the social, emotional and physical experiences of pregnant transgender men. A common obstacle faced by pregnant transgender men is the possibility of gender dysphoria. Literature shows that transgender men report uncomfortable procedures and interactions during their pregnancies as well as feeling misgendered due to gendered terminology used by healthcare providers. Outside of the healthcare system, pregnant transgender men may experience gender dysphoria due to cultural assumptions that all pregnant people are cisgender women. These people use three common approaches to navigating their pregnancy: passing as a cisgender woman, hiding their pregnancy, or being out and visibly pregnant as a transgender man. Some transgender and gender diverse patients describe their experience in seeking gynaecological and reproductive health care as isolating and discriminatory, as the strictly binary healthcare system often leads to denial of healthcare coverage or unnecessary revelation of their transgender status to their employer.
Many transgender people retain their original sex organs and choose to have children through biological reproduction. Advances in assisted reproductive technology and fertility preservation have broadened the options transgender people have to conceive a child using their own gametes or a donor's. Transgender men and women may opt for fertility preservation before any gender affirming surgery, but it is not required for future biological reproduction. It is also recommended that fertility preservation is conducted before any hormone therapy. Additionally, while fertility specialists often suggest that transgender men discontinue their testosterone hormones prior to pregnancy, research on this topic is still inconclusive. However, a 2019 study found that transgender male patients seeking oocyte retrieval via assisted reproductive technology (including IVF) were able to undergo treatment four months after stopping testosterone treatment, on average. All patients experienced menses and normal AMH, FSH and E levels and antral follicle counts after coming off testosterone, which allowed for successful oocyte retrieval. Despite assumptions that the long-term androgen treatment negatively impacts fertility, oocyte retrieval, an integral part of the IVF process, does not appear to be affected.
Biological reproductive options available to transgender women include, but are not limited to, IVF and IUI with the trans womans sperm and a donor or a partners eggs and uterus. Fertility treatment options for transgender men include, but are not limited to, IUI or IVF using his own eggs with a donors sperm and/or donors eggs, his uterus, or a different uterus, whether that is a partners or a surrogates.