Regardless of the place you’re on the gender spectrum, you would possibly select to make use of contraception if there’s an opportunity you may 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 folks 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, take into account that gender-affirming hormone remedy isn’t made for contraception, so that you shouldn’t depend on it for that goal.
Some folks may also contemplate sure forms of hormonal contraception for different causes. For instance, gender dysphoria – misery when your gender doesn’t match the intercourse assigned to you at beginning – can worsen in case you establish as male however have been assigned feminine at beginning and get your interval. Some contraception choices can reduce or cease your interval.
Contraception shouldn’t be designed for any explicit gender id. Something that cisgender folks would possibly select is on the market for everybody. The kind of contraceptive that’s greatest for you relies on your state of affairs.
“If it’s for a affected person with no different danger elements, any possibility is on the market,” says Beth Cronin, MD, an obstetrician-gynecologist in Windfall, RI. Issues that will have an effect on your determination embody your well being, household planning targets, and what unwanted effects you’re prepared or in a position to stay with.
Contraceptive counseling can assist you determine which possibility greatest matches your targets, says Adam Bonnington, MD, an obstetrician-gynecologist in San Francisco. (Contraceptive is one other phrase for contraception.)
In case your objective is to keep away from being pregnant, you could need to contemplate contraception if:
- You’ve ovaries and a uterus, you haven’t gone by way of menopause, and you’ve got vaginal intercourse with somebody who has testicles and a penis.
- You’ve testicles and a penis, and you’ve got vaginal intercourse with somebody who has ovaries and a uterus who hasn’t been by way of menopause and doesn’t need to get pregnant.
You and your accomplice might need to talk about what you every need and what the choices are.
Trans males and nonbinary folks: In case you take testosterone remedy (T) to curb female traits and produce out masculine ones, it would cease your intervals. Some folks assume which means they’ll’t get pregnant. However whereas a being pregnant for somebody on this state of affairs is unlikely, it’s not not possible, Cronin says.
“We typically counsel sufferers that in the event that they’re on T and are having that sort 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 need to get pregnant, you’ll must cease taking it.
Trans ladies and nonbinary folks: Some trans ladies and nonbinary folks take estradiol remedy as a feminizing hormone. That remedy gained’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 accomplice, be certain that they use contraception in the event that they don’t need to get pregnant. You can even use a barrier methodology, comparable to a condom, however condoms don’t work in addition to different types of contraception.
Different forms of hormonal therapies that aren’t contraception strategies embody:
- Cyproterone acetate
- Finasteride
- Gonadotropin-releasing hormone (GnRH) analogues
There are a number of forms of contraception. The kind that’s best for you won’t be proper for another person.
Issues that may have an effect on your choices embody:
- How simple it’s to make use of
- Value
- Attainable unwanted effects
- Misconceptions you could have about it
- Issues that make it arduous to get contraception
- Discrimination or bias
- Your relationship together with your physician
Speak to your physician when you have questions on your choices.
Condoms
Condoms will assist defend you from sexually transmitted ailments (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 could have vaginal intercourse – there’s a couple of 2% probability that you may get pregnant. However most individuals don’t at all times use them accurately, driving up the chances of getting pregnant to about 13% in case you’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 be sure you’re snug with that.
There are 5 forms of IUDs accredited 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 sort is a nonhormonal copper intrauterine machine (you would possibly hear these referred to as Cu-IUDs).
Unwanted side effects can embody vaginal recognizing (the place there’s solely slightly little bit of blood) and bleeding. Some folks additionally get cramps associated to their IUD. However most individuals keep on with the IUDs, in keeping with a 2021 research revealed within the Journal of Midwifery and Ladies’s Well being. That research was based mostly on a survey of 105 trans males and gender numerous folks with IUDs who had been assigned feminine at beginning. The IUDs have been “nicely tolerated,” the researchers wrote, with few folks in search of to take away them due to unwanted 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 methods), implants, photographs, or tablets. Speak to your physician about it first.
Photographs or IUDs may enable you cease or reduce bleeding out of your vagina. To keep away from bleeding, you could need 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, tablets, and the vaginal ring. They include 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), medicines with estrogen – comparable to contraception tablets, patches, or the ring – would possibly make your breasts really feel tender or sore. “Some folks be aware some bloating and issues like that, however it’s actually going to rely upon 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 folks say they’ve been discriminated in opposition to 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 associates, Cronin says. Native LGBTQ organizations usually have an inventory of suppliers they refer folks 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 varieties that ask on your right title, pronouns, gender id, and intercourse assigned at beginning
- 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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