# Fertility options for trans and non-binary people

> Thinking ahead before hormones or surgery

Category: Fertility & TTC · 3 min read · Written by the Splash team · Sources checked October 2026
URL: https://splash.care/learn/fertility-ttc/fertility-options-lgbtq

## Quick answer

- Hormone therapy can reduce fertility, sometimes permanently.
- Freezing eggs or sperm before treatment is an option to ask about.
- Testosterone is not contraception, so you can still get pregnant.
- Funding varies by area, so start with your GP.

If you might want biological children one day, it helps to know your options before starting [hormone](https://splash.care/learn/cycle-basics/hormones-explained) therapy or having surgery. The HFEA, the UK fertility regulator, says it may be a source of regret to have treatment without preserving fertility and later find it is harder to have a biological family. Thinking it through now helps you decide.

- Hormone therapy suppresses fertility and over time can lead to a complete loss of it. Fertility may return after stopping, but this is not guaranteed, and the longer you take hormones, the more likely the effects are to be permanent.
- If you have been through puberty you may be able to freeze eggs or sperm. Egg freezing involves fertility drugs and a procedure under sedation. The HFEA says it is mostly very safe, but there is a risk of ovarian hyperstimulation, which can need hospital treatment.
- Genital surgery such as removal of the womb, ovaries or testes means you cannot have biological children without stored eggs, sperm or embryos, or a surrogate.
- Stopping hormones usually lets [ovulation](https://splash.care/learn/glossary/ovulation) or sperm production restart over a few months, but a fertility specialist can advise on your own situation.
- Since 1 July 2022 you can store eggs, sperm or embryos for up to 55 years, as long as you renew your [consent](https://splash.care/learn/glossary/consent) every 10 years.
- NHS funding depends on where you live. In England your local integrated care board decides, so ask [your GP](https://splash.care/learn/conditions/talk-to-your-doctor) first.

> Hormone therapy is not an effective form of birth control. The NHS says it may be possible to get pregnant while taking testosterone, so it is important to use contraception if you have sex that could lead to pregnancy. Testosterone is not recommended in pregnancy. Do not stop testosterone before talking with your prescriber, and contact them straight away if you think you might be pregnant. Testosterone and hormone treatment also do not protect against STIs.

Whatever you decide, it is your decision. A GP can refer you to a fertility specialist, and you can ask your gender service about preserving fertility. If you do get [pregnant](https://splash.care/learn/fertility-ttc/early-pregnancy-signs), the NHS says it can trigger feelings of gender dysphoria, and the LGBT+ helpline Switchboard can talk it through.

### When to see a doctor

Speak to a GP or your gender service early if you want to talk about fertility. The NHS says you can ask for a referral to preserve eggs or sperm.

## Sources

1. [HFEA: Information for trans and non-binary people seeking fertility treatment](https://www.hfea.gov.uk/treatments/fertility-preservation/information-for-trans-and-non-binary-people-seeking-fertility-treatment/)
2. [NHS: Testosterone and pregnancy (also covers what testosterone does to periods)](https://www.nhs.uk/pregnancy/having-a-baby-if-you-are-lgbt-plus/testosterone-and-pregnancy/)
3. [NHS: Gender dysphoria and incongruence](https://www.nhs.uk/conditions/gender-dysphoria-and-incongruence/)
4. [NHS Cumbria, Northumberland, Tyne and Wear: Information about treatment with testosterone](https://www.cntw.nhs.uk/wp-content/uploads/2022/10/Information-about-treatment-with-testosterone-v1.4.pdf)

This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US).