Photo/Illutration Miho Sugie, left, and Hiroshi Okada at the Reproduction Center at Dokkyo Medical University Saitama Medical Center in Koshigaya, Saitama Prefecture. (Yuki Nikaido)

KOSHIGAYA, Saitama Prefecture--An outpatient clinic for transgender patients considering fertility preservation is now offered at Dokkyo Medical University Saitama Medical Center, the nation's first facility to provide such care.

The specialized clinic opened in July and is part of the Reproduction Center. As certain gender-affirming procedures can majorly impact the ability to have children, trans individuals can explore options with professionals before starting such treatment.

Appointment slots are available once a month on a Saturday morning and are not covered by public health insurance.

While it currently caters to male-to-female patients, the clinic also welcomes trans men. 

However, it currently does not have a system in place to freeze female-to-male patients’ eggs.  

“I hope it will become a standard process for transgender patients to preserve their fertility, just like cancer patients,” said Hiroshi Okada, a project professor specializing in male infertility at the Reproduction Center.

Since opening in 2015, the Reproduction Center has offered fertility preservation for cancer patients who want to store their sperm or unfertilized and fertilized eggs before starting chemotherapy or radiation therapy. Both types of treatment are known to affect fertility.

The availability of fertility preservation also attracted transgender women planning to medically transition.

So far, eight individuals ranging from their teens to their 30s have preserved their sperm at the center, according to officials.

When trans women start hormone therapy—one type of gender-affirming care—their sperm count and efficacy typically decrease, while those who have bottom surgery can no longer have biological children. 

During consultations, the outpatient clinic provides detailed explanations on effects that may accompany surgery and hormonal therapy. It also covers legal matters concerning Japan’s trans population.

The outpatient clinic’s opening is a result of the Supreme Court’s ruling in June that recognized a transgender woman as the father of a child conceived using her frozen sperm that was stored before her transition.

The landmark decision has opened doors to more options for trans individuals who want biological children.

In a related case, the top court ruled in October 2023 that the mandatory sterilization of transgender people seeking to legally change their gender was unconstitutional.

Despite these recent victories, the reality is that few medical facilities actually offer reproductive health care for trans patients.

The Reproduction Center hopes its new outpatient clinic specifically for the transgender community will increase accessibility.

Miho Sugie, an assistant professor of reproductive care at the clinic, encouraged trans youth to visit so that they are well-informed about their options.

“Teenagers and people in their 20s may not think about whether they want to have a family in the future, but I recommend that they come here to learn that they can keep their options open,” she said.

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