Regardless of the place you might be on the gender spectrum, you may select to make use of contraception if there’s an opportunity you can get pregnant and also you don’t need to.
Not all people who find themselves transgender, nonbinary, or gender expansive select to get gender-affirming care. However some individuals do take hormone remedy as a part of their medical care to assist align their intercourse traits with their gender id. In the event you do, understand that gender-affirming hormone remedy isn’t made for contraception, so that you shouldn’t depend on it for that function.
Some individuals may also contemplate sure varieties of hormonal contraception for different causes. For instance, gender dysphoria – misery when your gender doesn’t match the intercourse assigned to you at start – can worsen for those who determine as male however had been assigned feminine at start and get your interval. Some contraception choices can reduce or cease your interval.
Contraception isn’t designed for any explicit gender id. Something that cisgender individuals may select is out there for everybody. The kind of contraceptive that’s finest for you is dependent upon your state of affairs.
“If it’s for a affected person with no different danger elements, any possibility is out there,” says Beth Cronin, MD, an obstetrician-gynecologist in Windfall, RI. Issues which will have an effect on your resolution embrace your well being, household planning objectives, and what unwanted side effects you’re keen or capable of reside with.
Contraceptive counseling might help you determine which possibility finest matches your objectives, says Adam Bonnington, MD, an obstetrician-gynecologist in San Francisco. (Contraceptive is one other phrase for contraception.)
In case your aim is to keep away from being pregnant, chances are you’ll need to contemplate contraception if:
- You could have ovaries and a uterus, you haven’t gone by menopause, and you’ve got vaginal intercourse with somebody who has testicles and a penis.
- You could have testicles and a penis, and you’ve got vaginal intercourse with somebody who has ovaries and a uterus who hasn’t been by menopause and doesn’t need to get pregnant.
You and your accomplice might need to focus on what you every need and what the choices are.
Trans males and nonbinary individuals: In the event you take testosterone remedy (T) to curb female traits and produce out masculine ones, it’s going to cease your durations. Some individuals assume meaning they will’t get pregnant. However whereas a being pregnant for somebody on this state of affairs is unlikely, it’s not unattainable, Cronin says.
“We typically counsel sufferers that in the event that they’re on T and are having that kind of intercourse, they may get pregnant and they need to be utilizing contraception,” she says.
In the event you take testosterone as a part of your gender-affirming care, and also you need to get pregnant, you’ll should cease taking it.
Trans ladies and nonbinary individuals: Some trans ladies and nonbinary individuals take estradiol remedy as a feminizing hormone. That therapy received’t work as contraception. Neither will hormonal remedy that curbs masculine traits, as a result of it doesn’t fully cease sperm manufacturing.
In the event you haven’t had a vasectomy (when a physician cuts and seals the tubes that carry sperm) or orchiectomy (surgical procedure to take away the testicles), and you’ve got vaginal intercourse together with your accomplice, ensure that they use contraception in the event that they don’t need to get pregnant. You can even use a barrier technique, resembling a condom, however condoms don’t work in addition to different types of contraception.
Different varieties of hormonal therapies that aren’t contraception strategies embrace:
- Cyproterone acetate
- Finasteride
- Gonadotropin-releasing hormone (GnRH) analogues
There are a number of varieties of contraception. The sort that’s best for you may not be proper for another person.
Issues that may have an effect on your selections embrace:
- How straightforward it’s to make use of
- Value
- Potential unwanted side effects
- Misconceptions you have got about it
- Issues that make it laborious to get contraception
- Discrimination or bias
- Your relationship together with your physician
Speak to your physician in case you have questions on your choices.
Condoms
Condoms will assist shield you from sexually transmitted ailments (STDs). However to keep away from being pregnant, you also needs to use one other type of contraception.
If condoms are the one type of contraception you utilize – and you utilize them completely, each time you have got vaginal intercourse – there’s a couple of 2% likelihood that you can get pregnant. However most individuals don’t at all times use them accurately, driving up the percentages of getting pregnant to about 13% for those who’re not utilizing a second type of contraception.
IUDs
Intrauterine gadgets (IUDs) are formed like a T. A health care provider inserts an IUD into your uterus for long-term, extremely efficient contraception. It’s a fast course of, however you’ll need to ensure you’re comfy with that.
There are 5 varieties of IUDs permitted within the U.S. 4 of them launch very small quantities of the hormone progestin, which won’t trigger any feminizing results. The fifth kind is a nonhormonal copper intrauterine gadget (you may hear these referred to as Cu-IUDs).
Unintended effects can embrace vaginal recognizing (the place there’s solely a bit little bit of blood) and bleeding. Some individuals additionally get cramps associated to their IUD. However most individuals keep on with the IUDs, in keeping with a 2021 examine printed within the Journal of Midwifery and Girls’s Well being. That examine was based mostly on a survey of 105 trans males and gender numerous individuals with IUDs who had been assigned feminine at start. The IUDs had been “properly tolerated,” the researchers wrote, with few individuals searching for to take away them due to unwanted side effects.
Progesterone-only strategies
Progesterone is a hormone that your physique makes. Progestin is an artificial model of it.
Progesterone-only strategies of contraception embrace some IUDs (levonorgestrel intrauterine methods), implants, photographs, or drugs. Speak to your physician about it first.
Photographs or IUDs may assist you cease or reduce bleeding out of your vagina. To keep away from bleeding, chances are you’ll need to select a way just like the progestin-only implant, IUD, or shot, Bonnington says.
Mixed hormonal contraceptives (CHCs)
Mixed hormonal contraceptives (CHCs) embrace patches, drugs, and the vaginal ring. They comprise estrogen and progestogen. There isn’t sufficient feminizing hormone in these contraceptives to have an effect on testosterone remedy.
In the event you’ve had high surgical procedure (surgical procedure to take away breast tissue to create a extra masculine chest), drugs with estrogen – resembling contraception drugs, patches, or the ring – may make your breasts really feel tender or sore. “Some individuals notice some bloating and issues like that, nevertheless it’s actually going to rely on the individual,” Cronin says.
Extra everlasting choices
There are additionally extra everlasting types of contraception. Both accomplice can get a vasectomy or tubal ligation (surgical procedure to chop, tie, or block the fallopian tubes). Each procedures will assist forestall conception.
Many transgender and nonbinary individuals say they’ve been discriminated towards or in any other case not handled respectfully in well being care settings.
Typically one of the simplest ways to seek out LGBTQ-friendly suppliers is thru phrase of mouth from household or mates, Cronin says. Native LGBTQ organizations typically have a listing of suppliers they refer individuals to, Bonnington says.
Indicators the supplier is LGBTQ-friendly can embrace:
- A posted signal with nondiscrimination insurance policies that embrace gender id and expression protections
- A ready room with academic brochures, magazines, or posters about transgender well being
- A toilet labeled for all-gender use
- Consumption kinds that ask to your appropriate identify, pronouns, gender id, and intercourse assigned at start
- Suppliers who’ve their pronouns on their identify badges
Nonetheless, he says, these aren’t ensures {that a} supplier or clinic is LGBTQ-friendly.
