An obvious consequence of male
transsexualism is infertility due to absent
sperm production. The following information is
offered to couples pursuing parenthood despite
this challenge.
Across the general population, infertility is
quite common. About 15% of couples have
difficulty conceiving - roughly a third of cases
being related to the male partner, another third
related to the female partner and the final
third a combination of both.
There are various causes of male infertility,
including testicular injury or disease,
blockages, varicocele (swollen veins), sperm
disorders, genetic disorders, hormonal problems,
other medical disorders, problems with erection
or ejaculation, use of certain drugs and
environmental toxins or radiation. In many cases
these causes can be overcome but a number of
men, including men of transsexual history, will
never be able to biologically father
children.
Alternative parenting options can be
considered in terms of either conceiving a
child through assisted conception techniques
using donated sperm, or parenting a child
already born (eg fostering or adoption).
I. ASSISTED CONCEPTION —
'Assisted conception' is a
general term that covers the range of medical
treatments that are used with the aim of
achieving a successful pregnancy. Conception can
be assisted by donor insemination (either by
private arrangement or through a fertility
clinic, with or without hormones to stimulate
ovarian function), In Vitro Fertilisation
(IVF) and Embryo Transfer (ET), or
Gamete Intra-Fallopian Transfer (GIFT).
The treatment option chosen will depend on
individual circumstances.
Conceiving children or assisting someone else
have children with the help of donated gametes
or embryos is a complex and lifelong decision.
There are many factors that need to be
considered, including potential long term
psychosocial, legal and health issues.
Donors, recipients and people born from
donated sperm all have rights and
responsibilities, though these may vary between
different states/territories of Australia and
may change over time. It is important to learn
about these rights and responsibilities, and
take these into account, even if you know the
donor. Thought needs to be given to guaranteeing
parental rights and responsibilities of the
non-biological parent, lest misfortune or
relationship breakdown occur (particularly if
the couple are not legally married).
Eligibility criteria may also vary from state
to state, for example Victorian laws forbid
assisted reproductive technologies to single
women, or women in same-sex relationships,
unless it can be shown that the woman has
"medical infertility". Similarly different
fertility clinics will have different
guidelines, which may pose challenges for
couples seeking to conceive.
Couples affected by transsexualism are on par
with other infertile couples. Should you believe
you are being unfairly discriminated against,
there is usually a social worker attached to
every clinic whom you may wish to consult with.
You may even wish to seek legal advice, however
it may be easier and less stressful to seek
another clinic more willing to assist.
In Melbourne, a clinic at the Royal
Women's Hospital Reproductive Services
conducts a self-insemination programme to assist
women in screening their known sperm donors to
ensure that the self-insemination procedures can
be carried out with maximum safety and
efficiency. Melbourne IVF <http://www.mivf.com.au/>
is also willing to assist couples seeking
artificial insemination treatment
interstate.
For more information regarding the use of
donated sperm see the website of Donor
Conception Support Group of Australia http://www.dcsg.org.au/
II. ADOPTION —
Adoption is a process whereby legal
rights and responsibilities are permanently
transferred from birth parents to adoptive
parents. There are several different avenues of
adoption: local adoption and permanent care
programs, special needs adoption and
intercountry adoption programs.
The process moves in stages to determine that
adoption matches your life circumstances to
ensure the best interests of the child, both in
childhood and later life. The first step when
approaching an agency is learning more about
their specific eligibility criteria.
All adoptions must comply with relevant
state-based legislation, which in some cases may
challenge couples affected by transsexualism.
For example according to the NSW Adoption Act
2000 adoption orders may be made solely by
or on behalf of one person or jointly by or on
behalf of a couple. A couple is defined by the
NSW Adoption Act as "a man and a woman
who are married or have a defacto relationship"
and therefore does not recognise same sex
partners as couples. This may prove an obstacle
for a man who has transitioned and is in a
relationship with another man, or for someone
who has not changed their birth record to "male"
and is in a relationship with a woman.
Information about adoption is offered here
somewhat hypothetically - FTM Australia is
not aware of specific couples affected by
transsexualism who have adopted children. We
make the assumption that, since a man of
transsexual history (fully transitioned with a
male birth certificate) can be legally married
to a woman in Australia, then it would follow
that he would also be recognised as a male
partner in the adoption process. At the time of
writing FTM Australia was seeking
clarification on this matter and would be keen
to hear from couples who have successfully
applied to adopt.
III. FOSTERING
Foster care is provided to children and
young people who, for a range of reasons, are
unable to live with their own families. To
foster, you take on the responsibilities of a
parent for a period of time, to provide a safe,
nurturing and secure family environment.
Foster care is only arranged after options
within the child's own family and community have
been explored, the aim being to reunite children
with their parents as soon as possible. Most
children and young people are in foster care
because they are at risk of harm or neglect or
because their parent or carer needs periodic
relief. Foster care could be short term or long
term - for one or two nights, a few weeks or
months, or even years. In cases where serious
abuse or neglect has occurred, or parents can't
guarantee the safety of their child, children
may need to remain in foster care until the age
of 18.
For more information contact child welfare
agencies in your state or territory.
MANAGING STRATEGIES—
Coping with infertility, undergoing
fertility procedures, applying to adopt or
foster, experiencing pregnancy, and becoming a
new parent can be all-consuming, stressful and
expensive.
For these reasons many men complete their sex
affirmation treatment or the majority of the
process in advance so as to more confidently
present to a clinic or agency fully and legally
male (undoubtedly, couples will judge for
themselves when this stage has arrived).
Similarly it may be wise to resolve any other
major issues or recover from other major life
events, before pursuing parenthood.
For many people the unfulfilled desire to
have a child can be hard to bear. Efforts to
conceive, adopt or foster - even if the outcome
is successful - can impose a considerable
emotional burden at various stages along the
way. Plans for coping may help, such as:
- Setting limits in regard to time frames
and expense
- Considering all options and determining
alternatives (which may include not having
children)
- Locating support groups or counselling
services in advance, and making use of
them
- Expressing yourself (eg any feelings of
grief, guilt, anger)
- Staying in touch with loved ones
- Exploring therapies for stress management
and relaxation.
IN SUMMARY—
This information sheet outlines
parenting possibilities for couples who
experience infertility due to male
transsexualism. There is an enormous amount of
published material "out there" about assisted
conception, adoption and fostering, and many
service providers available to inform interested
couples. The good news in a nutshell is that
couples affected by transsexualism can and do
become parents.
Resources and Services—
Inclusion of
any resources or services should not be viewed
as recommendations or endorsements. They are
included here to offer further information for
your own enquires into this complex
subject.
IVF Australia
Ph: 1800 111 483
http://www.ivf.com.au/
Melbourne IVF
Ph: (03) 9473 4444
http://www.mivf.com.au/
IVF Queensland
Ph: (07) 5476-3111
http://www.ivfq.com.au/
Repromed (SA)
Ph: (08) 8333 8111
http://www.repromed.com.au/
Sydney IVF
Ph: (02) 9229 6420
http://www.sydneyivf.com/
The Donor Conception Support Group of
Australia
Ph: (02) 9793 9335
http://www.dcsg.org.au/
Sydney IVF
Ph: (02) 9229 6420
http://www.sydneyivf.com/
Fertility Plus
http://www.fertilityplus.org/
National Health and Medical Research
Council's information of the regulation of
Assisted Reproductive Technology (ART).
http://www.nhmrc.gov.au/embryos/information/art.htm
Books
Building a Family - has been
written for parents who have used donor
insemination to build their families and for
those considering whether donor insemination is
the right option, by Prof. Ken Daniels.
Published by the Donor Conception Support Group
of Australia.
Experiences of Donor Conception: Parents,
Offspring and Donors through the Years -
Drawing on the experiences of parents, offspring
and donors and including her own and her
family's story, Caroline Lorbach explores the
process of donor conception from finding out
about an infertility problem, to considering
whether - and how - to tell the children about
their conception, and how those children feel as
the adult offspring of a donor. Published by the
Donor Conception Support Group of Australia.
Also see http://www.dcsg.org.au/dcsg/resources/books.html
Same-Sex Relationships
If you and your partner both have
"female" birth certificates, or
both have "male" birth
certificates, then it is likely that
you will be deemed to be in a same-sex
relationship.
In this case it may be wise to seek
specific advice regarding parenting
options and/or parental rights and
responsibilities in your state or
territory of Australia.
The following resources may be of
help—
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* where a male partner was identified
female at birth and has subsequently
undergone masculinising sex affirmation
procedures
— Also
see Parenting and Family Resources
—
Citation
— FTM Australia (2006). Can we have
children?
Family
Section
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