Contraceptive Pearl: Birth Control Across the Gender Spectrum
When providing contraceptive counseling to LGBTQ+ patients, clinicians must take care to establish rapport and use patients’ self-identified name and gender pronouns. Clinicians should ask transgender or gender non-conforming patients what they call their body parts and employ that same language.
Reproductive health care should focus on behavior rather than identity. Specific sexual behaviors may result in unplanned pregnancy, with no regard for categories/groups. For example, patients taking gender-affirming hormones such as testosterone may still be able to conceive. Patients with a penis and testes who are taking estrogen can get someone pregnant.
Estrogen interacts with testosterone, but progestins do not. Progestin-only methods and non-hormonal methods are great contraceptive options for patients who take testosterone and do not wish to become pregnant. Estrogen has no interactions with contraceptives, so patients taking estrogen (and their partners) can use any indicated method.
Resources
Birth Control Across the Gender Spectrum
Taking Routine Histories of Sexual Health: A System-Side Approach for Health Centers
The National LGBT Health Education Center at the Fenway Institute
UCSF Center for Excellence for Transgender Health
Sources
Saewyc E, Bearinger L, et al. Sexual Intercourse, Abuse and Pregnancy Among Adolescent Women: Does Sexual Orientation Make a Difference? Family Planning Perspectives. 1999; 31(3).
Pharma-free
The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or products. The information in the Contraceptive Pearls is unbiased, based on science alone.
