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  • Michael Costa

"Gender Affirming Care" is Destroying Children's Fertility

Puberty Blockers and Fertility Preservation: Irreversible, Harmful, and Leads to More Medicalization

Puberty blockers, or GnRH agonists, the same drugs used to chemically castrate sex offenders (Clinical, 2018), are not a "pause button for puberty." They have devastating effects, especially when used on prepubertal boys. Dr. Marci Bowers (she/her) who serves on the board of WPATH is on record saying that all children who take puberty blockers and cross-sex hormones are completely sterile and will never have sexual function or sensation. Their reproductive systems will never develop and forever be stunted. These short peptide analogues of GnRH "cause a profound inhibition of estrogen and androgen synthesis and are used predominantly as androgen deprivation therapy of advanced prostate cancer … When used to suppress gonadotropin release, GnRH agonists can lower sex hormone levels by 95% in both sexes (Gonadotropin, 2018)." This is creating major issues when discussing fertility preservation because not enough development has taken place to yield anything significant. When puberty blockers are followed by cross-sex hormones [which is the case nearly 100% of the time], then it is virtually impossible to preserve any fertility.

According to the available data, the most accurate indicator of male fertility in this transgender demographic is testicular volume. Interestingly enough, a study examining puberty-blocked natal males as young as eleven years old who identify as transgender

showed a significant decrease in testicular volume (median Tanner stage 4 (range: 2–5), median age 13.6 years (range: 11.6–17.9)) just from puberty blockers alone.

Graph analyzing testicular volume and stages of spermatogenesis


Overview of Evidence and Studies About Puberty Blocking Drugs

Fertility Preservation and Informed Consent for Children

Information about how many of these patients know what they are getting themselves into is not widespread. "The current lack of high-quality medical data specific to Fertility Preservation counseling practice for this population means there is a reliance on expert opinion and extrapolation from studies in the cisgender population. (Baram et al., 2019 [Systematic review])"

However, the available data does provide at least a little insight. In 2018, one study investigated the extent to which children were informed about the effects "Gender Affirming Care" will have on their fertility or were made aware that Fertility Preservation exists before starting treatment.

80% of these children in the sample reported never discussing fertility with a health care provider whatsoever. Only 14% discussed how hormones can affect one's fertility (Chen et. al, 2018).

"Low Fertility Preservation Utilization Among Transgender Youth," a study published in the Journal of Adolescent Medicine about Fertility Preservation awareness had very surprising results. In this case, nearly all participants (98.6%) went through fertility counseling before they were able to go on hormones. But for some reason, only two of the participants attempted Fertility Preservation (Nahata, 2017). A contributing factor could be that fertility preservation (FP) for children receiving "Gender Affirming Care" is experimental and therefore not covered by insurance, in most cases.

Reasons Fertility Counseling for TNB Youth is Complex

Another study (Chen, 2017) found low rates of Fertility Preservation in teenagers prior to castration and cited cost, invasiveness of the procedure, and desire to not delay medical transition as the main reasons. "This is probably important, given an unwillingness to delay hormone treatment is a common reason for forgoing Fertility Preservation (2017)."

Not looking into fertility services before being sterilized in order to not "delay medical transition" says a lot about how children are being rushed onto a conveyor belt to lifelong medicalization. Not only are they encouraged at school and online to go down this path, but they are told that they will die without it. The narrative that children will hurt themselves (or worse) if they do not receive "Gender Affirming Care" is a manipulative lie that is doing nothing but scaring children and their parents. The saddest part is that trans activists are pushing for these kids to undergo pediatric transition younger and younger, despite never being on puberty blockers themselves. They claim that "trans kids" need early medical intervention in order for them to "pass" better as the opposite sex by suppressing natural puberty, We are affirming insecure and confused children into an identitarian cult that prioritizes a child's physical appearance over physical health. It discourages true integrity and promotes superficial notions of sex stereotypes and selfhood. And your gender can change based on what you are wearing and more importantly: what others perceive you as.

Male Fertility Preservation & Testicular Biopsy

When going about fertility-preserving procedures for males, the most common way to harvest sperm cells is through semen analysis. However, this method is not going to work for children whose reproductive development has already been blocked (Sterling, 2019-2020) at the age of ten. In trans-identified adolescents, the only other possible method would be to remove a portion of the testicle, freeze it, and hope that some stem cells are available in there.

This immature testicular tissue (ITT) cannot and will never be able to make sperm cells, since it has not started development. A germ cell or gametogonium is a stem cell that is undifferentiated and will develop into gametes during puberty via gametogenesis. In human males, spermatogonia or spermatogonial stem cells (SSCs) give rise to mature

sperm cells via meiotic cell division and spermatocytogenesis.

Males are born with these stem cells but they remain rather dormant until pubertal development begins (Goossens, 2013).

They require specific hormones (LH and FSH) to activate and become mature sperm cells (Galuppo, 2015). The entire spermatogenic process takes 61 days to turn an SSC into functional male gametes, producing 100 million sperm cells in one day (Zeng, 2015). When puberty is blocked with synthetic hormones that hinder LH and FSH secretion, they will remain dormant.

If a child is not even mature enough to produce gametes, then they are most definitely not mature enough to remove part of their testicle. No child can consent to such grotesque experimentation.

Testicular Biopsy for Fertility Issues

According to the available research, every single fertility-related procedure that utilizes a testicular biopsy on children is considered extremely experimental. It is not a fun surgery, especially for an 11-year-old. There is no proof whatsoever that it will work. Using spermatogonial stem cells (SSC) to create mature spermatozoa in vitro has not been accomplished in humans. The only successful attempts have been observed in mice, all of which had reached sexual maturity, unlike this cohort of children (Wyns et al., 2021). So far, the mouse model does not seem to be applicable to humans, but young boys are being put through this surgical procedure anyway. Despite treating our children like lab rats, human beings are not rodents. And this is not a human experiment worth indulging in (2021). In prepubertal boys, there are not enough spermatogonial stem cells (SSC) in the immature testicular tissue (ITT) to generate any meaningful results (Zeng et al., 2015) or information. In order to possibly utilize them, it would require in vitro copying first, which puts the resulting cells at a high risk for containing genetic abnormalities.

Artificially generated gonads from stem cells are being created in laboratories in order to experiment on children. And this is somehow considered "progressive." It is nothing but evil.

In a recent study about this phenomenon, a sample of boys were put through this testicular procedure (mean [SD] age, 13.9 [1.5] years; P = .003) and the majority of them were still not capable of creating mature sperm cells. A similar study specifically collected data from boys who were taking puberty blockers, have not started cross-sex hormones, and received the testicular biopsy surgery. Only one of the participants was able to produce mature sperm cells. The rest of them were not.

Sperm count and GnRH dosage (graph)

The Aftermath: Fertility and Trans Regret

Gays Against Groomers always says that children cannot consent to being sterilized. As it turns out, 80% of these kids didn't properly consent. They were not even given the option. Not only do kids lack the foresight to make extreme medical decisions, but they are being lied to about what will happen to them down the line if they go through with this process. If a minor is sterilized without proper education or awareness about fertility, and they eventually regret their decision, they deserve legal compensation from the people who did this to them without offering true informed consent or transparency. Right is right and wrong is wrong.

"Research demonstrates a negative psychosocial impact of infertility among otherwise healthy adults, and distress among adolescents facing the prospect of future infertility due to various medical conditions and treatments that impair reproductive health. Guidelines state that providers should counsel transgender youth about potential infertility and fertility preservation (FP) options prior to initiation of hormone therapy." A study by Vyas & Steril (2021) looked at regret in pursuit of fertility preservation among transgender and gender-diverse individuals.

Stem cell concentration in natal males who take exogenous hormones vs. those who do not

They found that 37% stated that their family planning goals were not adequately addressed. Those who had made a firm decision to pursue or not pursue fertility treatment had mild decisional regret. Moderate-to-severe decisional regret was noted in those who were undecided regarding the pursuit of fertility perseveration before transition (2021). If this is how adults feel, then imagine what these kids are going to feel like in a few years…or a few decades. The new pediatric cohort of "trans kids" are left in the dark about fertility, sterilized without giving proper consent, and then left to fend for themselves if they realize that transitioning was a mistake overall.

Medicalizing Society’s War on Children

Society is creating unrealistic health demands that require more treatments for treating non-diseases that are part of the normal human experience. In this way, the medicalization of life can lead to cultural harm as people lose their autonomous coping skills (Barnet, 2003). Society used to encourage people to make their own decisions and overcome their insecurities organically, regardless of what other people think. But the cult of gender ideology relies on the exact opposite. It promotes the worldview that your self-worth is completely dependent on what others think of you. If you do not "pass" well enough, then you should worry about the opinions of everyone around you and how they assume your gender. If somebody calls you by the wrong pronoun, then it ruins your day. It is a vicious cycle of emotional turbulence and unnecessary distress. We are living in a time where a child's fertility is seen as something disposable and irrelevant. Children are not notified of their fertility options and they are sometimes receiving a testicular biopsy for experimental stem cell collection. This is not the way to help kids. Instead of caring about child wellness, boys and girls are viewed as collateral damage in order to validate the gender affirmative model and the sadistic medical professionals who enable it. This is only going to get worse until we ban it completely. Gays Against Groomers will not rest until no minor is put through this torture and it is prohibited for good.

More Abstracts and Full-Texts Available in RADAR Studies

Baram, S., Myers, S. A., Yee, S., & Librach, C. L. (2019). Fertility preservation for transgender adolescents and young adults: a systematic review. Human Reproduction Update, 25(6), 694–716.

Barnet, Robert (2003). "Ivan Illich and the Nemesis of Medicine". Medicine, Health Care and Philosophy.

Chen, D., Simons, L., Johnson, E. K., Lockart, B. A., & Finlayson, C. (2017). Fertility Preservation for Transgender Adolescents. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 61(1), 120–123.

Chen D, Matson M, Macapagal K, et al. Attitudes toward fertility and reproductive health among transgender and gender-nonconforming adolescents. J Adolesc Health.2018;63(1):62-68.

Galuppo A. G. (2015). Spermatogonial stem cells as a therapeutic alternative for fertility preservation of prepubertal boys. Einstein (Sao Paulo, Brazil), 13(4), 637–639.

Goossens, E., Van Saen, D., & Tournaye, H. (2013). Spermatogonial stem cell preservation and transplantation: from research to clinic. Human reproduction (Oxford, England), 28(4), 897–907.

Mattawanon N, Spencer JB, Schirmer DA 3rd, et al. Fertility preservation options in transgender people: A review. Rev Endocr Metab Disord 2018;19:231-42.

Nahata, L., Tishelman, A. C., Caltabellotta, N. M., & Quinn, G. P. (2017). Low Fertility Preservation Utilization Among Transgender Youth. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 61(1), 40–44.

Sterling J, Garcia MM. Fertility preservation options for transgender individuals. Transl Androl Urol 2020


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