This article examines the state of gamete preservation for trans people in Switzerland. While it has become an international standard of care for trans people undergoing medical transition, we highlight, via a sociological study based on interviews with 25 legal experts, doctors and LGBTQ+ organization members, that health care providers are confronted with four major challenges: grappling with an uncertain legal framework; reconciling the temporality of fertility preservation with the temporality of transition; making medical infrastructures inclusive; and dealing with the funding of gamete preservation at both the individual and institutional levels. The article concludes by discussing the role medical institutions play in the development of trans reproductive rights