Fertility Options for Trans and Non-Binary People in Portugal

Transgender and non-binary individuals have unique fertility considerations. Whether you're planning transition, already transitioned, or exploring your options, Portugal offers pathways to biological parenthood.

Key Takeaways

• Preserve before hormones: Egg or sperm freezing before starting hormone therapy is the most straightforward path
• Reversibility varies: Fertility effects of hormone therapy may be reversible, especially after shorter-term use
• Legal in Portugal: Trans individuals, single or partnered, can legally access fertility treatments
• Find inclusive care: Not all clinics have experience with trans patients, so look for explicit LGBTQ+ inclusion
• Your family is valid: However you build your family, trans and non-binary parents create loving homes

Understanding Your Options

Before Hormone Therapy

If you haven't started hormones yet:

Birth Assignment	Preservation Option
AFAB (assigned female)	Egg freezing
AMAB (assigned male)	Sperm freezing

This is the most straightforward path to preserving fertility.

During/After Hormone Therapy

Effects vary and may be reversible:

Therapy	Fertility Effect	Reversibility
Testosterone (AFAB)	Suppresses ovulation	Often reversible after stopping
Estrogen (AMAB)	Reduces sperm production	Sometimes reversible
Longer-term use	Greater impact	Less predictable

Important: Individual responses vary significantly. Consult with specialists about your specific situation.

After Surgery

Surgery	Impact
Hysterectomy	Cannot carry pregnancy
Oophorectomy	Cannot produce eggs
Orchiectomy	Cannot produce sperm
Phalloplasty/vaginoplasty	May not affect gamete production (depends on specific surgery)

Fertility Preservation Options

Egg Freezing (AFAB Individuals)

Process:

• Hormonal stimulation (10-14 days)
• Egg retrieval procedure
• Vitrification (freezing)
• Storage

Considerations:

• Requires temporarily stopping testosterone (if on it)
• May trigger dysphoria (hormonal effects)
• Can be emotionally challenging
• Discuss with trans-competent provider

Cost in Portugal: €2,500-4,500 per cycle + annual storage

Sperm Freezing (AMAB Individuals)

Process:

• Semen sample collection
• Analysis and processing
• Cryopreservation
• Storage

Considerations:

• Ideally before starting estrogen
• If already on estrogen, may need to stop temporarily
• Multiple samples recommended

Cost in Portugal: €300-500 + annual storage (€100-200)

Building Your Family: Treatment Options

Trans Men/AFAB Non-Binary People

If you've preserved eggs:

Option	How It Works
Partner carries	Your eggs + donor sperm → partner's uterus
Surrogate carries	Your eggs + partner or donor sperm → surrogate
You carry	Possible if uterus intact and comfortable

If you haven't preserved:

Option	Possibility
Egg production after stopping T	Sometimes possible
Donor eggs	Using partner's or donor eggs
Adoption	Non-biological option

Trans Women/AMAB Non-Binary People

If you've preserved sperm:

Option	How It Works
Partner carries	Partner's eggs + your sperm
Donor eggs + surrogate	Donor eggs + your sperm → surrogate
Donor eggs + partner	If partner can carry

If you haven't preserved:

Option	Possibility
Sperm production after stopping E	Sometimes possible
Donor sperm	Using partner's eggs or donor
Adoption	Non-biological option

Portugal-Specific Considerations

Legal Framework

Situation	Portugal Law
Trans individuals accessing treatment	Legal
Single trans people	Legal
Trans couples	Legal
Surrogacy	Not legal (must go elsewhere if needed)

Finding Inclusive Care

Not all clinics have experience with trans patients. Look for:

• Explicit LGBTQ+ inclusion in communications
• Experience with trans patients
• Willingness to use correct pronouns/name
• Understanding of trans-specific needs

Nestiva's Approach

We work with clinics that:

• Welcome all gender identities
• Have trans patient experience
• Provide sensitive, respectful care
• Understand unique considerations

Navigating Dysphoria During Treatment

For AFAB Individuals

Fertility treatment may involve:

• Gynecological exams
• Hormonal changes (stopping T, taking estrogen)
• Monitoring via transvaginal ultrasound
• Physical changes during stimulation

Coping strategies:

• Communicate boundaries with clinic
• Bring support person
• Use affirming self-talk
• Remember: this is temporary for a long-term goal
• Consider therapy support

For AMAB Individuals

Fertility treatment may involve:

• Producing samples
• Potentially stopping hormones
• Medical examinations

Coping strategies:

• Discuss privacy needs with clinic
• Have support available
• Frame as temporary step toward family

Working with Your Healthcare Team

Before Starting

Discuss:

1. Your gender identity and pronouns
2. Your family-building goals
3. Current hormone therapy
4. Comfort levels with examinations
5. Any past challenging experiences in healthcare

Questions to Ask

• Have you worked with trans/non-binary patients before?
• How will you address me?
• Can I have a support person present?
• What accommodations can you make for dysphoria?
• What are my realistic options given my situation?

Financial Considerations

Costs to Plan For

Item	Approximate Cost
Egg freezing	€2,500-4,500/cycle
Sperm freezing	€300-500
Annual storage	€100-350
IVF cycle (when ready)	€4,000-6,000
Donor gametes (if needed)	€300-5,000

Planning Ahead

If you're early in transition, consider:

• Preserving gametes before hormones (if possible)
• Budgeting for preservation now
• Long-term storage costs

Frequently Asked Questions

Can I produce eggs/sperm after being on hormones?

Possibly. Many people regain some fertility after stopping hormones, but it's not guaranteed and depends on duration of therapy and individual factors.

Will fertility treatment affect my transition?

Temporarily. Stopping hormones or taking stimulation medications has temporary effects. You'll resume your transition afterward.

Do I need to "detransition" to have a baby?

No. You may need to pause certain treatments temporarily, but this doesn't change your identity.

How do I explain my family structure to my child?

Honestly and age-appropriately. Trans-parented families are increasingly common. Resources and communities exist to help.

What if the clinic isn't respectful?

Find another clinic. You deserve respectful care. Don't accept misgendering or disrespect.

Resources

• WPATH (World Professional Association for Transgender Health): Guidelines on fertility
• Family Equality: LGBTQ+ family-building resources
• Local trans support groups: Peer support and recommendations

Your Family Is Valid

However you build your family, it's valid. Trans and non-binary parents create loving homes. Don't let anyone tell you otherwise.

Contact us for compassionate guidance on your fertility journey.

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Nestiva provides inclusive support for all people building families, including transgender and non-binary individuals.