Navigating Pregnancy Risks: Insights from Testosterone Therapy in Transgender Individuals

In a recent study involving transgender men and gender-diverse individuals undergoing testosterone treatment, researchers discovered that one-third of participants continued to ovulate, increasing the possibility of pregnancy. While testosterone therapy is commonly chosen to induce male secondary sex characteristics and suppress menstruation, the study revealed that some individuals may still ovulate despite not experiencing periods.

The study, which included 52 transmasculine individuals, analyzed ovarian tissue following oophorectomy, a surgery to remove one or both ovaries. Despite testosterone use for at least a year prior to the procedure, signs of ovulation were present in 33% of participants. These signs included fluid-filled sacs indicative of egg development or the presence of the corpus luteum, which supports potential pregnancy.

Published in the journal Cell Reports Medicine, the study underscores the importance of contraception for transmasculine individuals on testosterone therapy to avoid unwanted pregnancies. Joyce Asseler, a co-senior author of the study, emphasized the significant physical and mental consequences of unplanned pregnancies and urged awareness among both patients and healthcare providers.

While previous research hinted at the possibility of pregnancy in individuals on testosterone therapy, this study provides direct evidence of ovulatory activity. Further research is necessary to understand why ovulation occurs in some individuals but not others and its implications for pregnancy risk.

Asseler stressed the importance of addressing this issue due to limited access to reproductive healthcare for transgender and gender-diverse individuals globally. Considering the potential impact of testosterone on fetal development, reproductive counseling is crucial. Additionally, transmasculine individuals who discontinue testosterone can still conceive if they choose to bear children, highlighting the complexity of transgender healthcare.