A 15 year old pre op trans gender is thankful her fertility can be held for the day she may want a family.

When she was 15, a girl deposited her sperm at an Auckland fertility clinic. It was somewhat impersonal and medical, but the staff were kind and she didn't feel judged. The sample was taken away and frozen, in case she needs it again.

Now she's 16. She's into her image, and clothes, and going out with her friends. She doesn't often think about that sample, left in a freezing unit in Greenlane. Like most teenagers, she doesn't give much thought to the idea of having children.

But this girl is transgender. She is taking hormones to help her live as a female, and if she doesn't think about fertility now, the opportunity to have genetic children may be left behind with her memories of life in a male body.

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She heard about the option to preserve her sperm in her first session with nurse practitioner Mo Harte. The girl was there with her mother, discussing transition options with Harte. "Transitioning" is the process of becoming recognised as transgender and living as a gender other than that which was assigned at birth.

READ MORE: What it's like to be transgender in New Zealand

"I felt a sense of relief. Because I was transgender and I was going to transition, I felt like it gave me sort of hope for maybe being a parent one day, like, when I'm older."

IAIN MCGREGOR/ FAIRFAX NZ Ashlin Lunardi says he's happy to treat his cats as his children, but he wishes there was more fertility information for transgender people in Canterbury.

She had other things on her mind, but presented with the options, she found it empowering to be have the opportunity to have genetic children one day in the future.

"I wasn't really focusing on thinking about being a parent, since I am 16. I'm just focusing on me now," she says.

The girl is Maori, and her whanau is important to her. She considers the whanau concept when talking about her own fertility.

BEVAN READ/ FAIRFAX NZ A transgender teen has preserved her fertility before undergoing hormone therapy.

"In the Maori culture... family and whanau goes beyond just your own kids. It goes beyond, to your sisters and brothers' kids, and your cousins' kids and all that stuff."

Her mum is ecstatic that she might one day have grandchildren if a little concerned that the sperm sample will only be stored for 10 years.

"It was a big thing for me and to have that available was amazing. It meant the world to me because I just love kids," says the girl's mother. "Not that she's thinking much about having kids, but to have that as an option was just the best thing."

MARK TAYLOR/FAIRFAX NZ Jaimie Veale is a transgender woman who researches transgender health at the University of Waikato psychology department.

Harte, who has been working with transgender youth for 15 years, says families are a big factor in the discussion.

"One of the biggest senses of loss for families is that loss of grandchildren or the next generation," she says.

Harte was one of two people instrumental in making fertility preservation possible for transgender youth in Auckland. She began working with transgender kids at the Youth One Stop Shop in Palmerston North, where the staff were attempting to provide barrier-free services.

Then Harte moved to Auckland, where she discovered a growing demand for services for transgender people. She worked in a Counties-Manukau clinic alongside Dr John Newman, a youth specialist known as a pioneer in transgender health.

Four years ago, she started searching for someone who would help her transgender patients preserve their fertility. It wasn't an easy search. She spent six months approaching fertility services, with little luck. Then she came across Margaret Merrilees, scientific director at Fertility Plus.

"It took a long time to find Margaret, but as soon as I did she was very welcoming," she says, and after one conversation, wheels started turning. "I take my hat off to Margaret for being so open. She had the ability to just open up doors."

Talking to transgender teenagers about fertility and reproduction is touchy business. "It takes very skilled and crafted conversations," Harte says.

But between Harte, the patients, and their families, decisions are made. And if the decision is to preserve gametes - sperm or eggs - then the service can be publicly funded.

Public funding for gamete preservation is available to anyone who doesn't already have children, and will undergo treatment that may permanently impair fertility. This is usually used for cancer patients whose treatment might leave them infertile. Merrilees interpreted that transgender people undergoing hormone treatment qualified for funded treatment under those guidelines as well.

"We felt, well, they are going to undergo treatment that may impair their fertility," she says.

Fertility Plus now takes care of fertility services for transgender people in the Northern region of New Zealand: everywhere from Counties Manukau upwards.

"The reason that we started doing that is they were told that 'oh it's your choice to have that'... but it's who they are. That's where they felt they were being discriminated against at other clinics."

The clinic has frozen sperm for 35 transgender people in the last couple of years. Most of them were around 16 or 17 years old, and some as young as 14.

"We have no idea if this is going to be used or how often. They won't even know themselves. But at least the chance is there," says Merrilees.

Of the 35 preservations Fertility Plus has done for transgender people, none of them were freezing eggs for females transitioning to males. There may be a few reasons for this. Collecting eggs is a very invasive process, and involves doing an entire IVF cycle. It also has a higher failure rate than freezing sperm.

Also, some people born female choose to live as a males without having gender reassignment surgery, which means they can decide to have children later on. Merrilees expects that a request to preserve eggs for a transgender person will come one day, and the clinic is prepared for that

"Under our public contract we need to do it really, if they're properly informed."

Unfortunately, in other places around the country, the information and services don't seem as readily available.

Christchurch 23-year-old Ashlin Lunardi has been undergoing hormone treatment for nearly three years, taking testosterone to help his transition to living as a man. He was born female but identifies as male, and earlier this year had a hysterectomy as part of his gender reassignment.

Nobody, Lunardi says, gave him information about preserving his eggs in case he wants to have genetic children in the future. But fertility preservation is available, it's publicly funded, and a transgender health researcher says people have a right to know their fertility options.

There are known cases of transgender people regretting not being able to parent genetic children after hormone treatment or gender reassignment surgery.

Lunardi says the information might not be well-known in other parts of the country. He says in Canterbury the transgender community is smaller and the health sector isn't up to speed on transgender issues.

"We don't have many professionals who specialise in transgender care or know a lot about us."

He only knows of one psychologist in Christchurch who is able to certify a person as transgender, and other specialists are hard to come by.

"So I can see why not many people would know about the fertility stuff as well, when it comes to transgender people, because it's just not available here."

Lunardi doesn't especially want children at this stage, and if he changes his mind later, he'll adopt. "But it would have been nice to know that it actually existed."

He says without knowing about public funding, many young transgender people simply wouldn't consider paying for gamete preservation.

"If it's not publicly available, being someone with a low income such as myself, it's just not something that I could afford."

Dr Jaimie Veale says transgender people are entitled to all of the relevant fertility information before making an informed choice about treatment or surgery. Veale is a psychology lecturer at the University of Waikato, teaching and researching transgender health. She is also a transgender woman and closely associated with several transgender community organisations.

"It was quite a while ago when I was a youth and going through this process myself. And one thing is that those [fertility] options weren't actually spelt out for me."

Veale began to transition in her late teens, and says it was only through the transgender community that she learned about freezing sperm. She isn't sure whether public funding was available, but as far as she knew at the time - around 2002 - it would have cost roughly $20 per month out of her own pocket to store frozen sperm. Every transgender person that Veale knows of who has decided to preserve gametes has paid to do it privately.

"There might have actually been some availability but nobody actually knew about it."

She says it is possible the health professionals themselves don't know fertility preservation can be publicly funded for people transitioning gender. But that is changing.

"Slowly people are recognising that more, and slowly it's being talked about in the academic literature more as well," says Veale.

"Transgender people have the right to be informed of all the information, all the possibilities for reproductive technology available for them."

As well as being made aware of fertility preservation options, she says kids have a right to be informed of the costs and benefits of taking hormone blockers before puberty. There needs to be informed consent.

"There are the benefits of being able to take the blockers and you won't have to go through the puberty of a gender which is not who you are, which is obviously distressing and discomforting for a lot of people.

"While there is that advantage, on the other hand there is the disadvantage of not being able to preserve gametes. That's all part of being able to give people the fully-informed choices."

Another issue, Veale says, is that transgender people may be put off visiting a fertility clinic out of fear it won't be a friendly service.

"Transgender people in general, we can be somewhat wary of health professionals who aren't expecting or aren't understanding of us."

She says some people have bad experiences coming out to their family doctor. Many transgender people find an accepting doctor - often by recommendation from other transgender people - and stick with them. One thing that can make transgender people feel uncomfortable in a fertility clinic is the use of incorrect pronouns. People generally assume that anyone preserving sperm is a man.

Merrilees agrees this can be an issue.

"It gets quite difficult for a scientist to say 'you're banking sperm for a woman'."

The Northern district health boards are trying to put together a transgender service for the region, and are consulting Veale along with other experts.

"That's something that's really exciting and an opportunity for some improvement," says Veale. But not every transgender person lives in a big city or an area with those options.

In Veale's ideal world, transgender people would be able to visit any health professional without fear of judgement.

"Hopefully we can get to a point where people don't have to go to the 'trans doctor', so to speak."

Lynda Whitehead is a transgender woman living in Christchurch. She's a leader in the transgender community, and the spokesperson for Tranzaction NZ, a transgender advocacy and support group. She says public funding for gamete preservation isn't widely understood, and in practice not many transgender people take advantage of it.

"I'm not aware of any young people that I know of that are doing anything like this."

And without public funding, Whitehead says, most young transgender people "haven't got the bloody money" for the process.

"There would be very few trans people that I know that would be living a particularly financially, fiscally successful life," she says, "Many of them, if they're not studying, are trying to find work - which is hard enough as it is if you're not transgender."

She also said transgender people might not consider the option of having genetic children until they were older.

"Their minds are mainly on transition. The fact that they may want to one day be in a position to genetically have children I don't really think actually crops into it. I think the main thing is that they're more concerned about their own situation. I mean, they're living in the wrong body for crying out loud."

Stewart Jessamine, director of protection, regulation and assurance at the Ministry of Health says funding has been available for eligible transgender people to preserve gametes and embryos since July 2014. She says the service is available nationwide and transgender people can go to any fertility clinic for fertility preservation and advice. Some clinics need a referral from a health practitioner.

The only fertility clinic in Christchurch with access to public funding is Fertility Associates, a nationwide chain. John Peek, the organisation's general manager of quality, information and science, says it's unlikely any transgender people in Christchurch have received publicly funded fertility preservation services.

He says that's because the document that outlines the criteria for publicly funded treatment, the Service Coverage Schedule, didn't specifically mention transgender people until the start of July this year.

"Until that it was pretty undefined, so I don't think many people got referred."