Dados do Trabalho

Title

Comparative report of psychological care of two cases of transgender men undergoing assisted reproductive techniques

Objective

To evaluate the history and experiences of two cases of transgender men in
an assisted reproduction treatment.

Methods

Psychological follow up two couples, with
transgender men married with cisgender women, who sought treatment at a private
reproductive medicine clinic in Belo Horizonte/Brazil, in January 2021.

Results

Cases report:
First case: Transgender man (34 years) in a relationship with a cisgender woman (36
years). She looked for a treatment in 2020, when single, and she was diagnosed with
low ovarian reserve. She reported her anguish at this diagnosis, so she did not do the
treatment. After that, she met an old friend (a transgender man) and they had been
together ever since. He started the reassignment process seven years ago and he has
been using testosterone since then. He underwent a mastectomy and was preparing to
have his uterus and ovaries removed, when the Covid pandemic came and he had to
postpone the surgical procedure. He spoke about his desire to have children, but that it
was not in their plans to carry out the treatment, which changed given the situation of his
partner. In 2021, they did a treatment with ovulatory induction on him. He said that the
treatment was intense, as he had to stop testosterone and use female hormones, which
brought intense symptoms. He was very irritated; in addition, it greatly affected his
physical strength, which reflected in his work. He had two blastocysts and they had two
transfers into his wife’s uterus, with an anembryonic pregnancy and another a negative
result. They decided not to continue the treatment, as he revealed was not willing to
undergo hormone treatment again. Second case: Transgender man (37 years) married
a cisgender woman (43 years) with altered karyotype and low ovarian reserve. She did
treatment when single with donor semen with anembryonic pregnancy and negative
result. She returned in 2021, in a relationship with a transgender man. He transitioned
eight years ago, but ever had a strong desire to be a father. He did intend to remove the
uterus, tubes and ovaries, but first he was willing to perform the ovulation induction
treatment. He did need double stimulation and said that the use of the hormone was less
impactful than he had imagined and his desire to have a child was bigger than that. He
had an embryo transferred to his wife with a positive result. The couple's daughter was
born in 2022. The question in this case was she has not told anyone that he is a
transgender man and they are in therapy.

Conclusion

The psychological approach in
these cases was before starting treatment, with follow-up during the treatment and all
the implications of the technical demand on the transgender patient's body and emotion
and follow-up after the result - grieving the negative outcome and decisions about the
way forward and the experience of pregnancy and childbirth. This made it possible to
provide the necessary support in view of the psycho-emotional demands of each couple.

Keywords

Psychology, Transgender, Assisted Reproductive Techniques

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