You are transgender or non-binary
Wondering if you need birth control?
Regardless of whether you identify as trans or non-binary, or relate to any other part of the gender spectrum, you might need birth control. Like for everybody else, it very much depends on your individual needs. Pregnancy can happen with vaginal sex if you have a uterus and ovaries, and your partner has a penis and testicles. So if you are having vaginal sex and you do not plan to get pregnant, you should consider birth control. All birth control options available to cis people are available to you.
Birth control on hormone treatment?
Short answer – yes! Because gender-affirming hormones (like testosterone) are not reliable as birth control. Better consult with your doctor first before going on a new birth control. Here are a few tips to get you started:
IF YOU ARE A TRANS MAN OR NON-BINARY
If you are a trans man or non-binary who has vaginal sex and has not had surgery to remove their uterus (hysterectomy) or ovaries (oophorectomy), or surgery to block the tubes that carry eggs to the uterus (tubal ligation), you should consider birth control.
Testosterone can limit estrogen production over time and stop your period within one to 12 months, but this is not enough to avoid pregnancy. Even if you have been taking testosterone for long, it is still possible to get pregnant. This is particularly important as testosterone can cause defects in an unborn child.
Which method is right?
As a trans man or non-binary person who is taking hormones, you can use all the birth control methods available to cis females. Having said that, it is not fully understood if estrogen-containing combined hormonal methods may or may not interfere with the masculinizing effects of testosterone. So you might prefer to consider these last if the other options are acceptable to you. Talk to your doctor about your birth control and fertility needs!
The patch, the vaginal ring, and some pills also contain estrogen in addition to progestogen. It is not fully understood if estrogen may or may not interfere with the masculinizing effects of testosterone. So for those on testosterone treatment, you may prefer to consider non-estrogen methods first if they are acceptable to you.
The patch, the vaginal ring, and some pills also contain estrogen in addition to progestogen. We are still learning if estrogen may or may not interfere with the masculinizing effects of testosterone. So for those on testosterone treatment, you may prefer to consider non-estrogen methods first if they are acceptable to you.
If your partner is a trans woman
If you have vaginal sex with your partner, and they are a trans woman who has not had surgery to remove their penis (penectomy) or testicles (orchiectomy), or surgery to cut or block the tubes that carry sperm (vasectomy), you should consider birth control. Estrogen treatment in trans women who are transitioning does not completely stop sperm production, and none of the anti-androgenic treatments are effective as birth control.
FINDING A DOCTOR
Discussing your fertility needs with a doctor is an important step in your health and fertility planning. Choosing the right doctor, who is empathetic and understands your needs, can help smooth the process.
Tips for the appointment:
- Ask loved ones to join you.
- Communicate your pronouns and names for body parts.
- Consider potential physical examinations of the vagina, uterus or ovaries.
- Change your doctor if you don’t feel comfortable with them.
Ask around in your community of friends or check out the resources below to find a doctor: