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Objective:To explore the desires and barriers to fertility preservation among transgender women and gender diverse people assigned male at birth in Thailand. Material and methods:This study is a cross-sectional study in clinic-based setting. The data was obtained from a questionnaire. Three hundred and three participants visiting the Gender Care Clinic at Chiang Mai University Hospital and Mplus clinics between April 2019 and December 2019 were included. Of these, 199 were transgender women and 104 were gender diverse people assigned male at birth. Results:The overall parental desire was 30.4% which was similar across the 2 groups (p = 0.897). A genetically related child was preferred in 40.9% of transgender women and 50.5% of gender diverse group (p = 0.115). Factors impacting a parental desire were a good relationship with family (OR 2.905, 95%CI 1.315–6.420, p = 0.008), being in a stable relationship (OR 4.183, 95%CI 1.738–10.069, p &lt; 0.001) and belief in a positive attitude of society toward LGBTQ parenting (OR 2.572, 95%CI 1.207–5.479, p = 0.014). Access to fertility preservation services was low. The majority of transgender women (75.3%) and gender diverse people (95.2%) never received a consultation regarding fertility. The utilization rate of fertility treatments was 5.3% in our study. Conclusion:Transgender women and gender diverse people assigned male at birth have parental desires for a genetically related child. However, access to reproductive information, consultation and services were very limited. Social support along with competent health services might increase access to reproductive services in transgender and gender diverse populations.

Reproductive desires in transgender and gender diverse adults: A cross-sectional study in Thailand