Nearly all hormonal and surgical treatment in a gender identity clinic will remove the potential for fertility. This must be made clear to patients, who may wish to consider gamete banking.1 The Human Fertilisation and Embryology Authority has not given specific consideration to the position of transsexuals or those living in an acquired gender role with regard to assisted conception treatment. However, the authority states that there is nothing in principle that would prohibit either the storage of gametes from an individual prior to gender reassignment or the provision of treatment to the female partner of a transsexual or someone living in an acquired gender, either with the previously stored gametes (sperm or eggs) of that person, or using gametes donated by a third party (or donor gametes combined with the gametes of that person). Likewise, there is nothing in principle to prohibit a surrogacy arrangement where a pregnancy is carried by a third party using embryos created with eggs or sperm of a person who has acquired a new gender identity.