Irrespective of the place you might be on the gender spectrum, you may select to make use of contraception if there’s an opportunity you possibly can get pregnant and also you don’t wish 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 case you do, needless to say gender-affirming hormone remedy isn’t made for contraception, so that you shouldn’t depend on it for that goal.
Some individuals may also take into account sure sorts of hormonal contraception for different causes. For instance, gender dysphoria – misery when your gender doesn’t match the intercourse assigned to you at delivery – can worsen if you happen to determine as male however have been assigned feminine at delivery and get your interval. Some contraception choices can reduce or cease your interval.
Contraception just isn’t designed for any specific gender id. Something that cisgender individuals may select is obtainable for everybody. The kind of contraceptive that’s finest for you depends upon your scenario.
“If it’s for a affected person with no different threat elements, any choice is obtainable,” says Beth Cronin, MD, an obstetrician-gynecologist in Windfall, RI. Issues that will have an effect on your choice embody your well being, household planning objectives, and what uncomfortable side effects you’re keen or capable of dwell with.
Contraceptive counseling can assist you resolve which choice finest matches your objectives, says Adam Bonnington, MD, an obstetrician-gynecologist in San Francisco. (Contraceptive is one other phrase for contraception.)
In case your purpose is to keep away from being pregnant, you might wish to take into account contraception if:
- You will have ovaries and a uterus, you haven’t gone via menopause, and you’ve got vaginal intercourse with somebody who has testicles and a penis.
- You will have testicles and a penis, and you’ve got vaginal intercourse with somebody who has ovaries and a uterus who hasn’t been via menopause and doesn’t wish to get pregnant.
You and your associate might wish to talk about what you every need and what the choices are.
Trans males and nonbinary individuals: In case you take testosterone remedy (T) to curb female traits and produce out masculine ones, it is going to cease your durations. Some individuals assume meaning they will’t get pregnant. However whereas a being pregnant for somebody on this scenario is unlikely, it’s not unimaginable, Cronin says.
“We usually 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 case you take testosterone as a part of your gender-affirming care, and also you wish to get pregnant, you’ll need to cease taking it.
Trans ladies and nonbinary individuals: Some trans ladies and nonbinary individuals take estradiol remedy as a feminizing hormone. That remedy received’t work as contraception. Neither will hormonal remedy that curbs masculine traits, as a result of it doesn’t utterly cease sperm manufacturing.
In case you haven’t had a vasectomy (when a health care provider 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 associate, ensure they use contraception in the event that they don’t wish to get pregnant. You may also use a barrier technique, corresponding to a condom, however condoms don’t work in addition to different types of contraception.
Different sorts of hormonal therapies that aren’t contraception strategies embody:
- Cyproterone acetate
- Finasteride
- Gonadotropin-releasing hormone (GnRH) analogues
There are a number of sorts of contraception. The sort that’s best for you won’t be proper for another person.
Issues that may have an effect on your choices embody:
- How straightforward it’s to make use of
- Price
- Doable uncomfortable side effects
- Misconceptions you will have about it
- Issues that make it arduous to get contraception
- Discrimination or bias
- Your relationship together with your physician
Discuss to your physician in case you have questions on your choices.
Condoms
Condoms will assist shield you from sexually transmitted illnesses (STDs). However to keep away from being pregnant, you must also use one other type of contraception.
If condoms are the one type of contraception you employ – and you employ them completely, each time you will have vaginal intercourse – there’s a couple of 2% probability that you possibly can get pregnant. However most individuals don’t all the time use them accurately, driving up the chances of getting pregnant to about 13% if you happen to’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 wish to ensure you’re comfy with that.
There are 5 sorts of IUDs permitted within the U.S. 4 of them launch very small quantities of the hormone progestin, which is not going to trigger any feminizing results. The fifth kind is a nonhormonal copper intrauterine system (you may hear these known as Cu-IUDs).
Unwanted effects can embody vaginal recognizing (the place there’s solely a little bit little bit of blood) and bleeding. Some individuals additionally get cramps associated to their IUD. However most individuals stick to the IUDs, based on a 2021 examine revealed within the Journal of Midwifery and Girls’s Well being. That examine was primarily based on a survey of 105 trans males and gender various individuals with IUDs who had been assigned feminine at delivery. The IUDs have been “properly tolerated,” the researchers wrote, with few individuals looking for to take away them due to uncomfortable 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 embody some IUDs (levonorgestrel intrauterine techniques), implants, photographs, or drugs. Discuss to your physician about it first.
Pictures or IUDs may enable you to cease or reduce bleeding out of your vagina. To keep away from bleeding, you might wish to select a way just like the progestin-only implant, IUD, or shot, Bonnington says.
Mixed hormonal contraceptives (CHCs)
Mixed hormonal contraceptives (CHCs) embody 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 case you’ve had high surgical procedure (surgical procedure to take away breast tissue to create a extra masculine chest), drugs with estrogen – corresponding to contraception drugs, patches, or the ring – may make your breasts really feel tender or sore. “Some individuals word some bloating and issues like that, but it surely’s actually going to rely upon the individual,” Cronin says.
Extra everlasting choices
There are additionally extra everlasting types of contraception. Both associate can get a vasectomy or tubal ligation (surgical procedure to chop, tie, or block the fallopian tubes). Each procedures will assist stop 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 best ways to search out LGBTQ-friendly suppliers is thru phrase of mouth from household or pals, Cronin says. Native LGBTQ organizations typically have a listing of suppliers they refer individuals to, Bonnington says.
Indicators the supplier is LGBTQ-friendly can embody:
- A posted signal with nondiscrimination insurance policies that embody 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 types that ask in your appropriate title, pronouns, gender id, and intercourse assigned at delivery
- Suppliers who’ve their pronouns on their title badges
Nonetheless, he says, these aren’t ensures {that a} supplier or clinic is LGBTQ-friendly.
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