21 interviews were conducted among 5 healthcare affiliates, 5 parents of TNB youth, and 11 non-minor youth aged 18–26 years old (6 transgender men, 3 transgender women, and 2 non-binary individuals). Healthcare affiliates included 3 physicians (an adolescent medicine specialist, a pediatric endocrinologist, and a pediatric primary care physician), a licensed clinical social worker, and a patient advocacy leader on the community advisory board for SCGC. All parents interviewed were cisgender women, 4 of whom were parents of young transgender men and 1 parent of a non-binary child, whose children’s ages ranged from 14–24 years old. All parent and youth participants were white. See Table 2 for additional demographics.

Concerns about online sources’ accuracy and bias were mentioned by healthcare affiliates, parents, and youth, with varying degrees of trust and skepticism expressed by participants. Healthcare affiliates were ubiquitously concerned about inaccurate information online. One healthcare affiliate noted that “for better or for worse, our teen patients tend to be more trusting of the things that they read online.” Downsides of this included inapplicable information “because the person that might be sharing information is doing it from an adult perspective” or creating unrealistic expectations about aesthetic outcomes after HRT. Another healthcare affiliate noted their role in “directing [youth] to more appropriate educational forums.” In line with these healthcare affiliate concerns, 1 youth described Tumblr as “pretty accurate,” and another perceived pervasiveness as equivalent to accuracy: “Whenever I have a question, I will basically do a Google search and just go through different forums and different links that pop up to see what seems to be the most common response, and then that's what I take away from it. Because if it's the most common one, it's most likely the one that's the truth.” —Transgender man, age 18

However, many still struggled to find information that answered their sexual health questions and was transgender inclusive: “Normally, if you look up stuff for trans men, you basically have to look up stuff for women, and that doesn't feel good. Also, if you're on hormones, it's different, so it's not that helpful.” —Transgender man, age 18

Some participants specifically sought online sources that included personal narratives and stories of other TNB people. A healthcare affiliate noted, “I can’t tell you how much I hear about YouTube…particularly a lot of queer and trans YouTubers that people look to.” A parent of a 17-year-old transgender man similarly explained, “They can find somebody that's gone through the same experience as them… and follow that person's story and feel like… they're not alone. That someone else understands.” “Before I came out, I found a trans community on YouTube and was like, ‘Oh, wow, that's me. That person's like me. I didn't know this was a thing.’" —Transgender man, age 18

Many TNB youth and parents used online resources for information on TNB sexual health. Generic online searches were most commonly discussed, although myriad specific sites were also mentioned. 1 youth searched for related medical articles online, as did a few parents looking for credible sources to educate their child. Others turned to hospital websites or to niche subgroups of larger websites like Tumblr, Reddit, YouTube, and Instagram. Youth also cited more specific websites providing TNB-inclusive sexual health information, including a website with the tagline “sex ed for the real world,”an online community for “lesbian, bisexual, & otherwise inclined ladies,”an online magazine “for and by teenagers,”a webcomic about a transgender girl,and vendor websites for sex toys.

For another youth, sex was a mystery until the very moment of their first sexual experience: “I had sex for the first time without knowing what was going to happen… and then I learned it all through doing.” At the same time, youth reflected on the intense vulnerability inherent in learning about sex through one’s first romantic partner (as opposed to coming in with one’s own baseline knowledge), especially given the evanescence of most people’s early relationships. “I think also trans and gender non-conforming kids and queer kids really latch onto that first romance and those first couple romances as like, ‘You're my person!’ Somebody finally understands me and loves me in that, and sees me in that. And that's really, really dangerous…because 2 learners who are learning together are expecting perfection out of each other. They're expecting each other to be perfect and keeping each other feeling safe and loved.” —Non-binary youth, age 26

Conversations with romantic partners were a primary source of sexual health information for some youth. Some learned from partners’ descriptions of past sexual experiences. A 20-year-old transgender woman recalled learning about relationships and sex through “really intimate relationships” with “the people I was in love with” and then in turn passing along that knowledge to their future partner: “I helped him want to learn more, and we basically did it together.” Multiple youth participants described feeling unprepared for their initial sexual experiences because they did not realize that there are other types of sex in addition to penile-vaginal sex. One youth’s school-based sex education curriculum had ingrained in them that “sex was defined as a penis and a vagina inserting into each other,” which left them unprepared for the emotional vulnerability that may accompany the other types of sex they were engaging in: “For a very long time, the [sexual] stuff I was doing, I didn’t think about it as sex…. But meanwhile I was doing these things that were very emotionally risky. And not really dealing with it because, well, I’m not having sex.” —Non-binary youth, age 19

Whether peers were an accurate source of information was a topic of debate. A few youth recalled fumbling through puberty together with their peers: “I wouldn't say that I got education from my friends, but there was definitely a, like, ‘Is this happening to you? This is happening to me, too.’" Others cited peers as a source of misinformation about pregnancy (eg, from “kissing,” “any kind of foreplay,” or “just by giving someone a blowjob”) and sexual acts (“I thought that masturbating meant putting carrots and other vegetables up a vagina… because someone in my class was joking about that”). 1 youth admonished themselves as a propagator of “really dumb stuff that my friends apparently believed for years.”

Peers were a commonly cited source of information about puberty and sex for TNB youth, but the perceived validity of their input varied widely. For some, peers’ lived experience made them a trusted source of information and support and “the most comfortable group” with whom to broach these intimate conversation topics. One healthcare affiliate opined, “the greatest depth of support… is the peer-to-peer aspect,” and a parent noted that their child’s “peers are even more comfortable sharing this information than my partner and I can be.” 1 youth valued TNB peers’ perspectives specifically because “there’s no glossary” for what relationships and sex will be like after starting hormone replacement therapy (HRT), and another commented “you know that you’ll have each other’s backs.”

An 18-year-old transgender man discussed seeing doctors who avoided discussing sex with teens (“In [my county] it’s actually very, very rare for [those conversations] to happen…if anything, it would be a conversation they had with my parent”), as well as the inconvenience of contacting his doctor when questions about sex arose (“…[T]here were questions that I would think of when I wasn’t around [my doctor] that I didn’t want to have to call him with all the time”). Healthcare affiliates, conversely, discussed encouraging patients to reach out to them between clinic appointments if needed, and the balance of nonjudgmentally normalizing sexual behavior while simultaneously promoting risk reduction. “I just put it out there [for my patients]…I know that the world of queer and trans sex and dating can be exciting, and confusing, and just kind of a whole new thing. So if you have questions at any point, you can always call or e-mail us, and we’re always happy to discuss that stuff with you, even if it’s between appointments or you just don’t want to talk to your mom about it.” “…[W]e had a patient who... [was] having an unsafe masturbation issue with foreign objects… [T]his kid was like… ‘I don’t like talking to strangers at all. I 1,000% don’t want to talk to you about sex.' And that was one where we were like, ‘Okay, How can we do this safely?’… Sometimes it’s about saying, ‘Let’s just provide you with the information and supplies you need, and we’ll leave it at that.’”

Whereas parents hoped that youth would turn to medical practitioners for sex education questions, only one youth participant cited healthcare affiliates as their top sex education resource. Some youth did describe medical practitioners as a trusted information source specifically for gender-affirming medical interventions. For one youth participant, distrust of healthcare affiliates around the topic of sex stemmed from prior stigmatizing experiences: “I had just had sex with a new person… After [the doctor] came back from doing the rapid [HIV] test, [they] said: ‘If you were my [kid] and you were doing these things I would tell you not to do this…’ essentially just stop being such a [expletive] slut.” —Non-binary youth, age 26

As a result of feeling that the content was not applicable to their experience or identity, or because they were experiencing psychosocial distress, youth often tuned out during most of the sex education curriculum. Therefore, most youth believed that the sex education they were exposed to in school did not prepare them for puberty, their gender transition and “coming out,” or their early sexual encounters. All youth felt they lacked sexual health knowledge compared with their cisgender peers, and many expressed uncertainty about where to turn to fill in their gaps: “My heterosexual cisgender classmates got this set of information… But, [I felt] that my box was open, and I would never know when it was full, or when I had the right things in it. Or, even if the right things were true… I still feel kind of incomplete about it.” —Non-binary youth, age 26

In lieu of LGBTQ content, multiple youth described receiving excessively detailed information about the menstrual cycle, fetal development, and STI symptoms, leaving little opportunity to ask “any of the actual questions and concerns I had once I started having sex” (Non-binary youth, age 19). An 18-year-old transgender man described that it felt futile to ask about TNB identities or same-sex relationships: “It was just for cis[gender], straight people… if you asked about it, you tended to be ignored.” That same youth recalled the curriculum “creating fear” about STIs without “mention[ing] that a lot of those are either curable or at least treatable.”

All participants discussed school-based sex education as something either they, their child, or their patients had experienced. A few participants recalled school-based sex education experiences in which content covered was thorough and applicable to gender-diverse populations. Most participants, however, described school sex education programs as either inadequately addressing or completely omitting content on gender and sexual orientation. Exclusion of these topics was upsetting and othering to participants. “…[G]ender issues, homosexuality... They did not even touch on. It's almost like it did not even exist, and [my child] was kind of disgusted about that.” —Parent of 17-year-old transgender man “…I went to a public school…for the most part, they just show you a video, and it was super heteronormative…No mention of anyone remotely like me…. I was just sort of like, ‘Well, is that really applicable?’ It doesn’t feel applicable.” —Transgender man, age 18

To understand the landscape of recent sex education content received by TNB youth, all participants were asked about prior sex education that they, their TNB child, or their TNB patients had experienced. Top sources mentioned included school curricula, medical practitioners, peers, romantic partners, online media, and parents. Analysis of parent-child sex education dynamics, as well as specific language preferences of TNB youth, providers, and families, will be explored in depth in separate analyses. Of note, these sources of information are not necessarily unique to TNB youth. Although some themes presented below specifically apply to the experiences of TNB people (eg, exclusion of transgender identities in school-based sex education), other themes may be commonly experienced by LGBTQ and all youth (eg, misinformation about sex from peers).

Recommended Sex Education Content for TNB Youth

When asked what content they would recommend for a sex education curriculum for TNB youth, participants’ responses fell into 8 categories: puberty-related gender dysphoria, non-medical gender-affirming interventions (eg, binders), medical gender-affirming interventions (eg, HRT), consent and relationships, sex and desire, STI prevention, contraception and fertility, and accessing healthcare.

Puberty-Related Gender Dysphoria Youth and healthcare affiliates noted that puberty can be distressing for many TNB adolescents. One youth recalled, “I saw changes that didn’t match my brain… it just didn’t feel right”; another described puberty as “really traumatic”; and a third stated with regard to puberty, “The only common experience trans youth have is that they’re in pain.” Youth emphasized the importance of talking to kids early about puberty to normalize dysphoria as a valid feeling. Although not all youth were interested in medical interventions to delay puberty, some thought it was important to inform young people about options such as puberty blockers or other gender-affirming steps. Some youth and healthcare affiliates mentioned menstrual suppression as an important intervention option for menstruating youth with gender dysphoria to be aware of.

Non-Medical Gender-Affirming Interventions Youth and parents recommended including information about non-medical gender-affirming intervention options, such as binders, packers, stand-to-pee devices, tucking, bras, make-up, attire, and other choices. The ability of these modalities to empower youth was emphasized; 1 youth explained that “updating gender expression” can help “maximize comfort and personal well-being.” Suggested topics for discussion included safety concerns associated with these items (especially binding and tucking), vendor options, and cost. Although 1 youth perceived binding safety as universally understood—“I’ve never met a trans kid with breasts who didn’t know how to bind safely”—others desired recommendations on potential safety pitfalls when binding. One parent explained, “We didn’t realize until we went to speak with the doctors at the gender clinic…that some kids wore their binders 24 hours a day”; another youth lamented, “There is a lot of issues with people using whatever they can find as a binder, and not realizing that that is incredibly unhealthy and unsafe for your body and that that can damage not only your ribs but your lungs as well.” Ace bandages, duct tape, and kinesiology tape were mentioned as binding strategies that TNB youth should be aware are unsafe. The benefits of binders in minimizing dysphoria was universally acknowledged, as was the distress experienced by some youth when they did not have access to binding: “Even just the amount of the anxiety my son can have over not having a clean binder available… that's enough that you might not be able to go to school” (Parent of 14-year-old transgender man). Practical safety related to tucking (“There should absolutely be a resource on what kinds of tape are safe to use around your genitals”), hygiene of stand-to-pee devices, cost, and where to buy packers were also mentioned.

Medical Gender-Affirming Interventions Pubertal blockers (eg, gonadotropin-releasing hormone agonists), HRT, and gender-affirming surgeries were discussed at length by all participants as important for inclusion in a TNB sex education curriculum. Youth participants wished they had known about puberty blockers at an earlier age and would have pursued this option if they had had access to it: “I know personally that that would’ve helped me a lot with my body image if I had those hormone blockers before” (Transgender man, age 18). Participants noted that a sex education program would be a helpful avenue by which to alert TNB youth to the availability of this therapy. Participants also identified youths’ questions and knowledge gaps in understanding the basics of HRT—including side effects and realistic expectations for achievable body changes—and suggested that sex education touch on the following topics related to HRT: voice changes, breast tissue changes, facial and body hair growth, menstrual cessation, “bottom growth” (ie, enlargement of the clitoris), acne, sex drive, and permanency of changes. Youth described difficulty finding accurate information about gender-affirming surgeries and realistic outcomes to expect, which made navigating risks and benefits of surgery murky. 1 youth reiterated, “if you’re wanting…surgery but you have no idea what it looks like, it’s going to be hard for you to make a decision to actually go through with that” (Transgender man, age 20). Youth particularly desired information about how gender-affirming interventions may impact sexual function and relationships with partners. Although top (chest) surgery and bottom (genital) surgery were both discussed among participants, sexual function was of higher concern when considering bottom surgery. Desire to pursue surgery was considered alongside questions about sex drive, ability to generate arousal, and mechanics of sex, especially if a person has an existing partner during transition. One youth noted, “[M]ost people don't want to have [genital] surgery, because they think, ‘If I'm not going to feel anything, I don't want it just for the looks’" (Transgender man, age 20). Others emphasized the importance of anticipating changes in sexual function and planning ahead to address them with a partner: “One thing that I've heard is that…when you go on hormones if you have vulva, then you lose the ability to self-lubricate. So [discussing with your partner] what that would mean. Do you use a lube?” —Transgender man, age 18 1 healthcare affiliate described talking to patients about the emotional component of changing sexual practices alongside a partner’s changing body, asking, “How might your sex life change when you transition?…[W]hether it's about sexual function or not. And are there other kinds of sex you can have?”

Consent and Relationships Most participants deemed consent, as well as the emotional aspect of romantic relationships, to be key topics for a sex education program. Segregating the preventive health topics that dominate most sex education curricula from the relationships that underlie why people want to have sex seemed unrealistic to most participants. 1 youth explained, “I guess with the [typical] sex ed they teach you [what] to or what not to do, but they don't teach you the emotional part of it.” Participants lamented the exclusion of TNB persons from depictions of relationships in traditional sex education programs, resulting in feelings of shame, disconnectedness, or unworthiness of romantic affection. The social rejection and isolation faced by many TNB youth was described as putting them at higher risk for intense emotional vulnerability. Participants also discussed risks of dating as a TNB person, including high rates of sexual assault, interpersonal violence, and manipulation. Parents and healthcare affiliates of TNB youth especially feared these outcomes. Teaching TNB children that their identities and bodies are valid and worthy of respect was viewed as 1 way to empower youth to avoid romantic and sexual relationships rooted in unhealthy power dynamics. Youth recommended that consent and boundary setting should be a key part of sex education for TNB youth: “So I think basically telling people…that it's okay to have boundaries, and don't settle for less than you deserve and what's healthy for you” (Transgender woman, age 20). Participants recommended defining and modeling consent, especially that “anything less than a yes is a no” and that “consent must be given every time versus one time to span all times.” Youth also emphasized that consent can be taught and practiced across many developmentally appropriate ages: “[T]he way that you teach kids how to have healthy relationships, it's the same skills as having great sex... Being able to say no. Knowing what to do when things don't feel right or feel scary.” —Non-binary youth, age 26 “I think a lot of kids don't know that you can say, ‘No,’ or they get nervous, or whatever, and they don't put up their boundaries. And I think there needs to be a lot of education on respecting yourself, and then knowing what your boundaries are, and conveying them to whoever the partner is.” —Parent of a 14-year-old transgender man “What you're okay with, what you're not, making sure that your partner knows that before you engage in anything. And it can be really difficult to stop yourself too, once you're too excited to care and then something goes wrong.” —Transgender man, age 18 Participants stressed the importance of teaching communication skills between partners. Effective communication was exalted as critical to “how to build a relationship with people, and how to build a future and a foundation.” Youth, parents, and healthcare affiliates all prioritized not only personal predetermination of physical boundaries, but also discussion with one’s partner about boundaries ( Figure 1 ). Figure 1 Artistic rendering by Rue Maia Oliver of a parent particpant's quote. Figure 1 is available in color online at www.jsm.jsexmed.org For many youth, how to begin this conversation with a partner was the biggest hurdle, more so than what they wanted to say once the conversation was underway. Boundaries around language were also discussed. This included discussing what words a person is okay with a partner using for their body parts (“This is what I call my genitals; this is stuff I don't want you to call my genitals”), recognizing verbal abuse, and decisions about answering invasive questions from people whom you don’t know well (“…[M]ake sure to lay out your boundaries and say, ‘Hey, you aren’t entitled to my story’”). Disclosure of one’s TNB identity while dating was raised as unique challenge this population faces. Maintaining agency over when and how to disclose was described as “very, very important, even if it's not like a romantic or a sexually intimate relationship” (Transgender man, age 18), but anticipation of sexual intimacy complicated the matter: “Coming out to your sexual partner can be difficult. And I think there should be a little more conversation on how to have that conversation. Be like, ‘Hey, I want to be in a sexual relationship with you, but I need to tell you I don't have what I present to be.’ Especially with youth that are too young to get surgery.” —Another transgender man, age 18 Some youth feared being rejected after disclosure of their identity. But hearing of other TNB peers’ relationships inspired hope; according to 1 healthcare affiliate, “It says possibility rather than impossibility.”

Sex and Desire Normalizing diversity in sexual attraction and desires was a recommended topic. Participants desired content that affirms a range of sexualities and sex acts and that destigmatizes desire. A subtheme that arose was the desire to validate those who are asexual or choose not to have sex: “Sexuality is natural. People can have a healthy sexual life. Also, you don't have to have a sexuality. It's okay not to have sex” (Healthcare affiliate). Youth also sought candid information on the mechanics of sex acts: “A lot of people don't know how sex works between two trans people, or a trans and a cis person” (Transgender man, age 18). Most youth felt that resources on transgender sexuality are either fetishized (“Our youth struggle in that they're getting a lot of the negative parts of being sexualized, where people are often hypersexualizing the idea of queer people or trans people”), or completely absent. Youth craved realistic and affirming representations of transgender bodies and sexuality: “Something that I still struggle with is just finding resources… In general [there is] not really anything about non-binary individuals and how we might be relating to our bodies. So I've really kind of hit a wall… I still feel totally unsupported as a trans person and as a queer person. I really can't find anything out there that isn't just explaining to cis people that non-binary people have sex. I haven't really been able to find myself celebratory or positive.” —Non-binary youth, age 19 Sex toy use and safety were discussed as taboo in previous sex education experiences (“This is an area that I really feel like I never really got any sex ed on”), and youth noted confusion on effective and safe use. At the same time, sex toys were described as “very important” and “a really big deal for trans people… especially because a lot of transgender people use toys in sexual situations to simulate the parts that they may or may not have on their own body” (Transgender man, age 18). Youth desired information about how to find affordable but hygienic prostheses and sex toys. There was general concern that cheaper products “could carry bacteria” or contain harmful chemicals. Lubrication, cleaning, and safe storage of these items were also discussed, as were questions of how to initiate conversations with partners about use of toys during sexual activity. 1 youth elaborated on the difference sex toys had on his ability to advocate for the type of sex he wanted: “Keeping [toys] clean is important and making sure that you're using it properly and you don't end up hurting each other is important. I didn't know what I was going to need. I just ended up always being a bottom, and that wasn't what I wanted. But it was kind of what I thought was what I was doomed to because I didn't have the tools that I needed… Sex was really awkward for me because I didn't want to have penetrative sex on my end. But, eventually, years after I started to transition, I found resources on sex toys.” —Transgender man, age 18

STI Prevention All participants desired discussion of STIs in a sex education course for TNB youth. Some clarified that they do not want excessive detail about each STI, but rather, general knowledge about risks and the knowledge that STIs are preventable and treatable: “[One] sex ed class was just like, ‘Let's look at all these pictures of STDs.’ And we were just kind of like, ‘Oh, gross. I can't retain all this information. There are too many STDs to memorize.’” —Transgender man, age 18 2 youth participants mentioned the importance of discussing STIs in a nonjudgmental way. “When people talk about STIs, they assume that no one they're speaking to actually has one yet. But there's a lot of various experiences that people hold that it's best to assume that those people are there because they also deserve comprehensive sex ed.” —Non-binary youth, age 19 “I feel like there has to be a lot done to remove the stigma, because that doesn't really—it's counter-productive. … I don't know if normalizing it is the right word, but humanizing that experience. And making sure to talk about it in a way that strikes the balance between sort of clinical and non-judgmental.” —Transgender man, age 18 STI testing, particularly HIV testing, was emphasized, including locations offering testing and destigmatizing testing (“It’s a totally normal thing to want to make sure that you have not caught anything”). Healthcare affiliates and youth thought that pre-exposure prophylaxis and post-exposure prophylaxis were important topics to include. “The HIV prevention pill. I feel like queer youth should definitely have access to that and should know about it…There's a lot more people that are HIV positive …in the transgender community than in the ciscommunity…Again, not a lot of people know it because not a lot of people get tested.” —Transgender man, age 18 A few youth had not heard of pre-exposure/post-exposure prophylaxis before this study but, on hearing about it, thought that it was critical to share knowledge about these medications: “Wow. That's amazing. Especially if you’re in a relationship… from what I learned about HIV is that you can't have sex with someone who does … That makes a big difference if there's still a possibility that people can be together.” —Transgender man, age 20 Youth and healthcare affiliates also desire discussion about the importance of consistent use of barrier protection (“I’ve regularly had people say, [they use condoms] ‘most of the time’ when they mean less than 1 in 4 times”) and the different types of barrier protection available for various sex acts and body parts involved: “Especially how to put on a condom properly. Or how to properly put on a dental dam or anything like that. Those are very, very handy things that aren't generally taught, and those need to definitely be included in a proper sex ed curriculum, especially one for LGBT youth.” —Transgender man, age 18

Contraception and Fertility Youth and healthcare affiliates cautioned that a curriculum should clarify that decreased fertility rates after gender-affirming medical interventions does not preclude the possibility of unintended pregnancy. Participants believed that the risk of pregnancy, as well as the importance of contraception, should be conveyed in a sex education course. A 19-year-old transgender woman explained: “I don’t know 100% certain either way, but I’ve heard that some people think that if you’re [male] to [female] and you’re on hormones, you can’t get someone pregnant. Or if you’re [female] to [male] and you’re on hormones you can’t get pregnant. So I feel like that’s something that doesn’t get talked about a lot, and I think that should be included.” Healthcare affiliates emphasized the importance of contraception counseling, due to the current limited knowledge of how HRT impacts fertility: “If you are someone with a uterus that is interested in having sex with people with a penis, you can still get pregnant even on testosterone… birth control is a very important option for you.” —Healthcare affiliate “Also, even though estrogen has effects on fertility with the trans females, we don’t know how much of an exposure that is, so they could still get someone pregnant.” —Another healthcare affiliate Youth were also interested in learning about a variety of contraception options beyond oral contraceptive pills, such as long-acting reversible contraception, which has the advantage of not increasing secondary sex characteristics that may cause dysphoria. “[I wish I knew earlier] how quick and easy the IUD [intrauterine device] is…The pill is what most people think of when they think of birth control, but it's not the only option. And it's, arguably, kind of the worst option. It's really hard for a human being to do the same thing every single day and not miss it, even once. And the NuvaRing, and the Depo shot, and the IUD, things that you only have to do every once in a while… but the IUD was really big for me because I could just get it removed when I get SRS [sex reassignment surgery]. And it's not something I have to think about, pretty much ever.” —Transgender man, age 18 Youth, parents, and healthcare affiliates thought discussion of fertility was important for TNB youth considering HRT or surgery. Healthcare affiliates and parents worried that urgency to combat dysphoria with gender-affirming interventions leads youth to be less concerned with the long-term fertility repercussions of those interventions. “Definitely, fertility questions are huge for parents and not as much for the youth themselves. They wave their hand and say, ‘If I want a family, I'll make a family. I can figure that one out.’ But still being able to provide them with some understanding of fertility preservation options because that's a moving field. There's lots happening there, and knowing that they can be attentive in that way to what are our options if they think they might want produce a child with their own body.” —Healthcare affiliate Recommended talking points included preservation options (eg, egg and sperm banking) and adoption.