Fertility was not a priority for d'Arcy Kenobi when he began his transition. At that time, he was single and had no plans for a family. However, his perspective shifted after he fell in love. "Once I met my partner, I realized this is actually someone I want to spend the rest of my life with and potentially want to start a family with," Kenobi said.

Living on the Sunshine Coast, Kenobi began exploring the option of freezing his eggs. He noted the challenges of adoption, stating, "It's incredibly difficult to adopt a kid; the foster system is horrendous." He believed that freezing his eggs would simplify the process of starting a family with his partner, but he faced significant obstacles.

The costs associated with fertility treatments were high, and Kenobi encountered reluctance from fertility providers to treat him. Even clinics that specialized in supporting rainbow families suggested he consult mental health services or a gender clinic first. "They were just like, 'Look, I think you should consult mental health support or the gender clinic first so that you're clear on what you want because clearly you're having second thoughts about transitioning' — which wasn't the case," Kenobi explained. He clarified, "I want to take a break in my transition to harvest my eggs and store them in a facility for whenever I'm ready. And then I want to jump straight back onto [testosterone] and continue to live my life. I was pretty clear on what I wanted."

Kenobi's experience is not unique. Oskar Reedy, a 19-year-old from a rural town in Western Australia, faced similar challenges. After identifying as non-binary in their mid-teens, Reedy sought to explore microdosing testosterone. However, they felt unsafe discussing their needs with their local general practitioner. "He had very conservative values and views of medicine," Reedy said. "He would kind of be dismissive to people who … seemed to be queer. I didn't feel like I could talk about what I wanted to do with my body."

Healthcare access for transgender individuals often involves significant hurdles. Sav Zwickl, a researcher at the Trans Health Research Group at the University of Melbourne, highlighted the discrimination faced by transgender people in medical settings. "It can range from being misgendered to a complete denial of care, where a doctor is actually unwilling to treat that person — even for something really, really basic — because they are trans," Zwickl said. A 2023 study co-authored by Zwickl found that over 50% of transgender Australians reported negative experiences when seeking medical care.

Zwickl noted that these challenges are particularly pronounced for trans individuals in rural areas. "Even if there is a local doctor in their local town, that person might not know much about trans people, they might have been discriminatory against them in the past. So people are sharing these stories of having to travel two, three, up to even six hours to see a healthcare professional that they feel safe with."

The Royal Australian College of General Practitioners (RACGP) emphasizes the importance of gender-supportive care. Michael Clements, the RACGP rural chair, stated that it is a core part of training for doctors. "We have very clear legislation, very clear ethical, moral and legal guidelines in place that means that every trans patient and every other patient … do get treated in a respectful way," he said.

Despite these guidelines, Zwickl pointed out that medical professionals often receive minimal training on transgender health. They advocate for increased education in medical curricula and upskilling existing healthcare workers. Clements advised patients seeking gender-affirming care to gauge their doctors' responses. "If it's not the response that gives you the support you need … consider either looking for some of those online [health] services or using the online support groups to find out where [people] have received good, supportive care," he said.

Reflecting on his fertility treatment journey, Kenobi expressed frustration with healthcare workers who did not fully understand his needs as a trans man. He supports calls for more education and greater representation of LGBTQIA+ individuals in healthcare. Reedy, who moved to the Sunshine Coast six months ago for better healthcare access, described the impact of support services like Headspace as life-changing. "Knowing that I have a place and a medical professional who is there to help me, I honestly feel like I've died and gone to heaven or something," they said. "It just does not feel real."