Table 6.

Content analysis of decision making about fertility preservation

Question	Theme	N	Examples
How did you make a decision to undertake fertility preservation?	Individual’s desire to have the option	11	“I decided to undertaken fertility preservation in case I still want to have children in the future” “I wanted to have children one day. I knew that soon my window would close and that my only option was to store sperm”
	Encouraged by medical professionals	4	“Recommended by health carers prior to starting HRT” “I started seeing an endocrinologist at a children’s hospital who brought up the prospect of fertility preservation”
	Encouraged by partner	3	“Wife wanted kids” “I was neutral on the issue and my partner felt strongly about having the option”
	Encouraged by family members	4	“My parents thought the procedure would be a good idea” “My mother is insistent on having grandchildren”
How did you make the decision not to undertake fertility preservation?	Cost was prohibitive	44	“It was not available to me due to the sheer cost of it” “I was not going to be able to afford it”
	Not interested in genetic relationships and/or children	35	“Don’t want genetic children, therefore fertility preservation is a non issue to me” “Never wanted children”
	Thought of children as dysphoria inducing	34	“I do not want children that are made through my genes. I do not want to bear children myself. The idea of childbirth adds to my dysphoria” “Conceiving and birthing a child sickens me and would humiliate me as a man”
	Have enough children already	20	“Nine children is enough” “I already have two children”
	Did not want to delay transition	11	“I wanted to begin my transition immediately as my priority was to treat the dysphoria. Future children were not a consideration” “Postponing hormones for possibly years until I was at the stage of my life to consider children was never an option”
	No genetic material available	11	“I can’t have children anymore due to a genetic disorder” “I had cancer and chemo early which meant that I had no material to store regardless of transition”