Transgender

Not a doctor. But YMMV! Talk to an endocrinologist if you can but they will probably tell you that you need to freeze sperm if you want to be 100% sure to preserve fertility. That's what I did and I kinda regret it because it took freaking ages and delayed my HRT date, and I was only able to afford it due to the cushy union healthcare plan covering it through Progyny. It's still going to cost me freaking $800 a year to keep jizz on ice and I have to save for it throughout the year. It's really important for my partner to have bio kids, otherwise I probably wouldn't have done this. If you are able to, you can pay out of pocket for sperm banking and it will be like $1500 supposedly.

You probably don't need to bank before trying HRT. The fertility effects take a while. Lower doses tend not to affect it. If I got a sperm analysis right now I bet they'd tell me I still have swimmers.

Anecdote: A lady I know went off E in order to have a kid with her partner (who went off T to do so as he is a trans guy) and she was able to conceive after going off for a couple months.

This website has a lot of info: https://transfemscience.org/

I'd also see if you can get a consult with an endocrinologist, especially one who prescribes HRT already, they might be able to discuss the level of detail you are looking for better than a GP. You should be able to look up endocrinologists on the UHC website, some will even have the tag "LGBTQ friendly" or something like it, I would start there!

This resource has a comprehensive overview of the effects of HRT:

https://genderdysphoria.fyi/en/hormones

I would start with your primary care physician to be honest. In a lot of cases (far from most, but still), PCs can at least make referrals to the right people. Plus if it’s your PC and assuming your PC is covered, then they’d likely also suggest providers in network.

If you feel safe then they should at least be brought into the conversation at an early stage. If you do t feel safe then time for a new PC.

Good luck. It can be overwhelming, but certainly not insurmountable.

Also to add that, while I’m not a doctor, HRT will affect your fertility in nearly all cases. If one day having biological children is something important to you, you should look into freezing sperm before starting.

I would see if you could get a referral to an endocrinologist that your local trans community recommends, and then ask them your questions. Unfortunately doctors are generally clueless about trans healthcare, though, so educating yourself first is a necessity.

I think most doctors will tell you that estrogen will make you permanently infertile, but you should take this with a grain of salt. I'm not sure how many will know that trans women have regained fertility when pausing HRT.

Give folxhealth.com a try, they do entirely online HRT services. You should be able to set up a consultation with them. I recommend writing down any specific questions you have and asking them at the end, it can be a lot of information to process.