Dr. Garofalo, Dr. Finlayson, Jennifer Leininger and Dr. Lawson brought their respective expertise to generate a stimulating, thought-provoking discussion on fertility preservation in gender dysphoria patients at this year’s Oncofertility Consortium 2015 Conferece . Dr. Garofalo, MD/MPH and Director of the Center for Gender, Sexuality and HIV Prevention at Lurie Children’s Hospital, set the stage by reviewing definitions then highlighted barriers to access and care in this population. Pediatric endocrinologist Dr. Finlayson shared valuable lessons on the medical treatment of pubertal gender dysphoria patients, including pubertal suppression, and emphasized the need for additional investigation to establish threshold values at which hormonal therapies negatively impact fertility. Jennifer Leininger, Program Coordinator for Gender Dysphoria Clinic at Lurie, continued by discussing how to create gender-affirming spaces and reproductive psychologist Dr. Lawson discussed key issues in how we can provide the overall best care for these patients, including setting realistic expectations through frank conversations. Specifically, Dr. Lawson called attention to the need to discuss anticipated costs associated with treatments both in the short and long-term and to review future necessary treatments to permit use of cryopreserved gametes, including gestational surrogacy when appropriate.