A new type of family: Transmen as fathers thanks to donor sperm insemination. A 12-year follow-up exploratory study of their children

TLDR: The “therapeutic alliance” with these couples is now good enough to allow for research beyond pure observation – with a protocol and standard measures to appreciate the mental health, gender identity and quality of life of these children as they become adolescents.

Abstract: Objective In France, female-to-male transsexuals who have obtained a change of civil status have the right to request donor sperm insemination (DSI) for the woman with whom they live. Because this was met with some reluctance, a trial program with a follow-up study was devised with the agreement of the ethical committee. The aim was to check the quality of parenthood and the development and quality of life of the children. Patients and methods These couples were considered to be similar to any couple requesting medical assistance to procreate. There is always an interview with a specialist in psychology before gametes are given. In these cases, there was a second one with a professional who worked with transsexuals. Usually parents are left free to choose to disclose or not the gift of gametes; but in this situation, since everybody in the father's environment as a child was aware of his background history, these parents were advised to tell the truth about the DSI and the father's transsexual past. A follow-up was proposed every second year. Parents and children were not volunteers participating in a research program; they came for a consultation from which they expected some help in their particular situation. The parents had interviews with a psychiatrist and two psychologists, the children were observed in their playing and drawing, and one standard measure (the Brunet-Lezine Scale) was used. Results Forty-two children born to 32 couples were followed up from 2000 to 2012 and the program is still on-going. Though without a penis, the transmen are considered by their wives as men; the wives are not homosexual; the couples are stable (there have been only three separations); the children are very well cared for and have good relationships with their fathers, they seem normal, happy, without any major difficulty, without any gender identity variant. Fathers (with one exception) spoke easily of the DSI, but had some difficulty with their transsexualism – although willing to talk about it, they found it hard to put into appropriate words. They were helped by one father, who wrote and illustrated a booklet, telling of his childhood experience in simple words. The children coped well with this disclosure. Conclusion This trial program brought positive results. It may continue and others may be set up in spite of persistent prejudices. The “therapeutic alliance” with these couples is now good enough to allow for research beyond pure observation – with a protocol and standard measures to appreciate the mental health, gender identity and quality of life of these children as they become adolescents.