I loved this talk a lot! It was presented by Dr. Matrika Johnson, a 2002 Davidson alum, who now owns and runs her own fertility clinic. Instead of simply talking about the care she provides for her transgender patients, she structured this event more like a discussion where she would give us case studies and have us consider possible treatment options. Before we continued on with treatments, she gave us the definitions of top surgery, IVF, IUI, and reciprocal IVF. Initially, I had never heard of top surgery in this implication; I knew that the general idea was to have the physical body match more of what the gender typically looks like (e.g. transgender male removing breast tissue to look more like a “real man”). However, I never considered the fact that if both partners were to go onto hormones and/or become pregnant, any remaining breast tissue could be stimulated and grow. This seems like such a conflicting decision because, with top surgery, this individual took great lengths to have their outer appearance match how they truly feel and the fact that could be reversed would be nerve-racking. Pregnancy is already a mental toll due to the physical changes one undergoes; but, the addition of having a significant gender-related body part change as well can be a difficult decision.

Regardless, I greatly appreciated Dr. Johnson’s approach to this fertility care. She seems to not only value the patients themselves (such as through open insurance conversations), but also the status of their fertility. What I mean by insurance conversations is, in some cases, Dr. Johnson has to refer to her patients by their birth sex on paperwork despite their transition. For instance, if a transgender male received a mammogram, he’s charted as a female because no insurance codes exist for a male getting checked for breast cancer. While not being Dr. Johnson’s fault, this is definitely something that insurance companies need to become more understanding about in the future for all their transgender clients. 

The only aspect of this presentation that I questioned the most was the recommendation for all transgender females to store their sperm before making the transition. Essentially, after taking estrogen for a long time, the production of sperm stops and thus any future genetic reproduction abilities. While this recommendation is good in theory, my issue with it is the fact that, if you’re transitioning from male to female, the last thing that’d be on my mind would be to save some of my sperm– the very identifier I’d want to leave behind of the male sex. And, especially since transitioning is occurring around younger age groups, reproductive options may not even be thought about. Unless further counseling concerning this option is done, this recommendation may seem a little insensitive to the struggles a transgender female had to go through.