Before they transition, some transgender youth preserve fertility by banking sperm or eggs

The summer after high school, Kacey Cabanban came out as transgender and was about to begin the transition to live as a man.

But first the teen who grew up in north suburban Wauconda, Ill., faced one more weighty choice: whether to preserve his fertility - having his eggs harvested and frozen - prior to starting hormone therapy.

"The idea of having my own kids with my own eggs was, I guess, a pretty easy decision," said Cabanban, now 21 and a junior at Michigan State University. "Even just having the option available ... I knew I wanted to do that."

Historically, many transgender people simply accepted potential loss of biological fertility as the price they paid to live according to their gender identity, which can involve hormone regimens and surgeries that might damage or destroy fertility.

But this mindset is shifting with advancements in assisted reproductive technology, many rooted in cancer treatment, said Diane Chen, a pediatric