Let trans men freeze eggs on NHS, say fertility experts  

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Women seeking to change sex should be allowed NHS funding to freeze their eggs, the British Fertility Society has said.

Transgender people born female but transitioning to male should be no less eligible for free treatment than those left infertile by cancer drugs, the doctors’ group believes.

The BFS has published the first guidance on fertility preservation which includes people changing sex.

It says transgender men should retain their chance of becoming a ‘genetic or biological parent’, and be offered the chance to freeze their eggs as soon as possible during their treatment.

Every year, almost 600 girls under 18 in Britain are estimated to have hormone-blocking treatment to halt puberty, meaning they change sex before their bodies fully develop the reproductive system of an adult woman.

These young people, as well as adults having sex change surgery, will then become infertile.

The cost of freezing eggs – to have a baby later in life using a surrogate mother – is £5,000, with storage costs amounting to £300 a year. The process is already available for free in Scotland and Wales, but health trusts have varying policies on whether to fund it in England.

The BFS says people transitioning from female to male should be eligible for egg freezing on the NHS, as are cancer patients who may be left infertile by chemotherapy. 

Professor Adam Balen, BFS chairman, said: ‘Infertility is a real disease, recognised as such by the World Health Organisation, that requires treatment because of the direct and indirect burden of ill health on the NHS and wider society.

‘In principle, the reason for infertility should not affect the decision to consider treatment.

‘For many people undergoing gender transition, it is the medical treatment they receive that causes infertility – we do not consider this any differently than we do infertility as a consequence of, for example, life-saving cancer treatment.’

The BFS guidelines, which will become the standard for doctors and nurses, say female cancer patients should be spoken to about fertility preservation as soon as possible.

This can mean egg or embryo freezing, removing ovarian tissue which can be re-implanted later in life, or ‘ovarian transposition’ to move their ovaries away from the area being blasted by cancer drugs. The guidelines say the options should also be discussed with people changing sex from female to male.

They say transgender people should receive counselling, adding: ‘If appropriate, fertility preservation should be performed as early as possible in the treatment pathway.’

Dr James Barrett, of Charing Cross Gender Identity Clinic in London, said the clinic discusses future fertility with patients but ‘they are not always able to self-fund’.

He added: ‘Infertility is a real disease and it is hugely frustrating that the whole NHS is not always able to help our patients with that part of their lives.’

NHS Clinical Commissioners, the body representing clinical commissioning groups (CCGs), said the NHS ‘does not have unlimited resources’ adding: ‘On a daily basis [CCGs] are forced to make difficult decisions that balance the needs of the individual against those of their entire local population … tough choices that have to be made, which we appreciate can be difficult for some patients.’

 

 

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