Can phalloplasty affect fertility or the ability to father children?

Yes, phalloplasty can affect fertility and the ability to father children. Phalloplasty is a complex surgery that involves the creation of a penis from tissue from other parts of the body. The tissue used for the phallus does not contain sperm, so it is not possible to father children through natural means.

In addition, phalloplasty can also damage the nerves and blood vessels that are necessary for erections. This can make it difficult or impossible to have penetrative sex.

If you are considering phalloplasty and want to preserve your fertility, you should talk to your doctor about fertility preservation options. These options may include sperm cryopreservation or testicular tissue cryopreservation.

Here are some of the fertility preservation options for transgender men:

• Sperm cryopreservation: This involves collecting and freezing sperm so that it can be used to fertilize an egg later.
• Testicular tissue cryopreservation: This involves removing a small piece of testicular tissue and freezing it. The tissue can then be transplanted back into the body later to produce sperm.

Phalloplasty itself does not typically affect fertility or the ability to father children because it primarily involves the reconstruction of the external genitalia. However, it’s important to consider the broader context of gender-affirming treatments and their potential impact on fertility.

Here are some key points to consider regarding fertility and phalloplasty:

1. Primary Impact on External Genitalia: Phalloplasty focuses on the creation of a neophallus (new penis) and related structures. It does not involve the removal or alteration of reproductive organs such as the testes, which are responsible for sperm production.
2. Hormone Therapy Considerations: Many transgender individuals undergo hormone therapy as part of their gender-affirming journey. Hormone therapy can impact fertility by reducing or eliminating sperm production. If fertility preservation is a concern, individuals may opt to bank sperm before starting hormone therapy.
3. Potential for Future Parenting: Phalloplasty itself does not affect one’s ability to become a parent through methods such as adoption or assisted reproductive technologies, including in vitro fertilization (IVF) or the use of a gestational surrogate.
4. Individual Variation: Fertility and reproductive options are highly individual. It’s essential for individuals to discuss their specific fertility goals and concerns with healthcare providers and specialists in transgender healthcare to explore options and make informed decisions.
5. Timing of Procedures: Some individuals choose to undergo phalloplasty and related surgeries before addressing fertility preservation, while others may prioritize fertility preservation first. The timing of these procedures should align with the individual’s goals and medical advice.
6. Alternative Options: If an individual’s fertility has been impacted by hormone therapy or other gender-affirming treatments, they may consider alternative family-building options, such as adoption, sperm or egg donation, or surrogacy.