January 14, 2014 — Although the Affordable Care Act (PL 111-148) ensures that "'transsexualism' can no longer be considered a pre-existing condition," the desire and ability of transgender people to have children has "been left out of the spotlight," author Sarah Richards writes in a New York Times opinion piece.
She highlights the case of Andy Inkster, a transgender man who decided to keep his female reproductive organs intact when he transitioned so he could later become pregnant. Inkster was denied fertility treatment at Baystate Reproductive Medicine, which argued that "it didn't have enough expertise to treat transgender patients," Richards writes, noting that he later obtained care elsewhere, eventually gave birth and sued Baystate for sexual discrimination.
Richard continues, "The issue [of pregnancy for transgender people] brings up unprecedented questions," such as how hormone therapy could affect eggs and sperm. She notes that one study that found 54% of transgender men wished to have children, while another found that 40% of transgender women wished to be parents.
"[T]hese issues aren't likely to get the attention they deserve until transgender people succeed in getting basic health care first," Richards writes, citing a separate study that found that 19% of transgender participants reported having been denied medical treatment because of their gender identity.
"Discomfort over difference isn't an excuse to refuse compassionate care to a transgender person in an emergency room or a fertility clinic, or for insurance companies to refuse to cover that care," Richards writes, adding, "Gender identity has nothing to do with a desire to have children -- or with who will make a good parent" (Richards, New York Times, 1/12).