An Analysis of Fertility Preservation Offerings for Transgender Youth on United States Pediatric Hospital Websites

Purpose: To survey United States (U.S.) pediatric hospital websites for information about fertility preservation (FP) for transgender patients. Secondarily, to identify hospital characteristics associated with higher likelihood of publishing transgender-specific FP content on websites. Methods: This cross-sectional study included all U.S. pediatric hospitals from Children's Hospital Association excluding specialty hospitals. From September-December 2023, 2 independent researchers surveyed websites for: geographic location, academic affiliation, religious affiliation, presence of general and transgender-specific FP information, and specialties of FP providers. Fisher's exact and Pearson's Chi-square tests were used. Results: Of 177 websites surveyed, 41% (n = 73) published FP information, largely targeted to oncology patients (90%, n = 66). Only 8% (n = 15) of all websites mentioned FP for transgender youth. Based on website information, most fertility programs included a medical oncologist (80%, n = 53); fewer included a urologist (32%, n = 21), pediatric gynecologist (27%, n = 18) or reproductive endocrinologist (RE, 21%, n = 14). About half (n = 31) referred to affiliate REs. Presence of transgender-specific FP website content ranged from 0% to 5% in Southern divisions to 20% in New England (median = 10%). Secular (p < .001) and academic (p = .04) hospital websites were significantly more likely to include FP content. Discussion: Our findings highlight a gap in access to FP information for transgender youth on U.S. pediatric hospital websites. Few websites identify FP teams that include an RE or pediatric gynecologist, who specialize in FP for patients with ovaries. Access to FP information is critical to transgender youth who may desire genetically related children later in life. Strategies to assure this information is widely available are needed.