Transgender individuals who were assigned female at birth and have undergone hormone replacement therapy (HRT) may still have the ability to conceive and carry a pregnancy if they have preserved their reproductive organs, such as the uterus and ovaries. Here are two possible scenarios for transgender individuals to become pregnant:

  1. Pre-Transition Fertility Preservation: Some transgender individuals choose to undergo fertility preservation procedures before starting hormone therapy or undergoing gender-affirming surgeries. This may involve the extraction and freezing of eggs, sperm, or embryos for future use. With preserved eggs or embryos, a transgender woman (assigned male at birth) can choose to have a surrogate carry the pregnancy or may consider gestational surrogacy.
  2. Post-Transition Pregnancy: If a transgender man (assigned female at birth) has retained their uterus and ovaries, and has stopped hormone therapy or temporarily paused it, they may be able to conceive naturally or with the assistance of assisted reproductive technologies. This would involve stopping testosterone therapy to allow for the return of menstrual cycles and ovulation. However, each person’s fertility journey is unique, and it is recommended to consult with a fertility specialist who has experience working with transgender individuals to explore available options.

It’s important to note that not all transgender individuals have the desire or opportunity to pursue pregnancy, and family-building options can vary based on individual circumstances, access to healthcare, and personal preferences. Consulting with a healthcare provider who specializes in transgender healthcare or a fertility specialist can provide personalized guidance and information based on individual needs and goals.