Parenting intentions in transgender and gender-nonconforming adults.

OBJECTIVE: To assess parenting intentions, knowledge and attitudes regarding fertility preservation, and barriers to achieving parenthood in an adult transgender population. METHODS: This was a multi-center online cross-sectional study conducted at three university-affiliated and 15 community-affiliated clinics within a major US city. Inclusion criteria included being aged 18 years and older and self-identification as transgender, gender non-conforming or non-binary. Eighty respondents completed a 36-question survey regarding their transition and plans to achieve parenthood. We compared demographic characteristics to plan for transition using Chi-Square analysis. We compared options to achieve parenthood to plans for transition using ANOVA, Spearman's rho correlation coefficient, and a Kruskal Wallis H test. RESULTS: The mean desire to become a parent was 59.9 on a scale of 1-100. There was no significant association between plan for gonadectomy and reduced preference for the use of autologous gametes for parenting [H(2) = 1.309, P = 0.520]. The desire to have children was correlated with an increasing willingness to pause cross-sex hormones (rs  = 0.40, P < 0.01). Cost was identified as the largest barrier to fertility preservation (54.1%). CONCLUSION: The majority of transgender adults surveyed desire parenthood and this could be correlated with plan for transition including willingness to suspend cross-sex hormones.

Multiple pathways mediate luteinizing hormone regulation of cGMP signaling in the mouse ovarian follicle.

Luteinizing hormone (LH) regulation of the epidermal growth factor (EGF) network is critical for oocyte maturation and the ovulatory process. Recent studies have indicated that C-type natriuretic peptide (CNP) and its receptor natriuretic peptide receptor B (NPR2) play an important role in the control of meiotic arrest. Here, we investigated the involvement of the EGF network in the LH-dependent regulation of the CNP/NPR2 axis and cGMP accumulation. LH/hCG treatment causes a major decrease in both cGMP and the CNP precursor (natriuretic peptide precursor C [Nppc]) mRNA accumulation in vivo and in vitro. However, the cGMP downregulation precedes the decrease in Nppc mRNA by more than 1 h. Amphiregulin, an EGF-like factor, suppresses Nppc mRNA levels in cultured follicles to the same extent as LH, and this effect is completely prevented by the EGF receptor (EGFR) kinase inhibitor AG1478. However, the LH-dependent suppression of Nppc is insensitive to AG1478. Similarly, Nppc suppression by LH occurs in follicles from EGFR null mice. These findings document that EGFR signaling is sufficient to downregulate CNP, but is not necessary for LH action. When cGMP concentration in the follicle is measured, the short-term, but not long-term, LH effects on cGMP are prevented by AG1478, suggesting that ligand availability may be responsible for the late response. Human CG decreases the CNP-dependent cGMP synthesis in wild-type and EGFR knockdown cumulus-oocyte complexes. These findings demonstrate that redundant pathways are involved in the regulation of cGMP. EGFR-dependent events are involved in the short-term regulation of cGMP, whereas the long-term effects may involve regulation of the CNP.