What You Must Know About Beginning Management if You’re Transgender or Nonbinary

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 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 identification. Should 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 additionally contemplate sure varieties of hormonal contraception for different causes. For instance, gender dysphoriadistress when your gender doesn’t match the intercourse assigned to you at start – can worsen in case you establish as male however had been assigned feminine at start and get your interval. Some contraception choices can reduce or cease your interval.

Contraception is just not designed for any explicit gender identification. Something that cisgender individuals may select is offered for everybody. The kind of contraceptive that’s greatest for you relies on your scenario. 

“If it’s for a affected person with no different danger components, any choice is offered,” says Beth Cronin, MD, an obstetrician-gynecologist in Windfall, RI. Issues which will have an effect on your resolution embody your well being, household planning targets, and what unwanted side effects you’re keen or capable of dwell with.

Contraceptive counseling will help you resolve which choice greatest matches your targets, 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, chances are you’ll wish to contemplate contraception if:

  • You’ve ovaries and a uterus, you haven’t gone by means 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 means of menopause and doesn’t wish to get pregnant.

You and your accomplice could wish to talk about what you every need and what the choices are.

Trans males and nonbinary individuals: Should you take testosterone remedy (T) to curb female traits and produce out masculine ones, it should cease your durations. Some individuals assume which means they will’t get pregnant. However whereas a being pregnant for somebody on this scenario is unlikely, it’s not inconceivable, Cronin says.

“We usually 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. 

Should 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 therapy gained’t work as contraception. Neither will hormonal remedy that curbs masculine traits, as a result of it doesn’t utterly cease sperm manufacturing.

Should 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 along with your accomplice, be certain that they use contraception in the event that they don’t wish to get pregnant. You may as well use a barrier technique, equivalent to a condom, however condoms don’t work in addition to different types of contraception.

Different varieties of hormonal therapies that aren’t contraception strategies embody:

  • Cyproterone acetate
  • Finasteride
  • Gonadotropin-releasing hormone (GnRH) analogues

There are a number of varieties of contraception. The sort that’s best for you won’t be proper for another person. 

Issues that may have an effect on your selections embody:

  • How straightforward it’s to make use of
  • Value
  • Attainable unwanted side effects
  • Misconceptions you’ve about it
  • Issues that make it laborious to get contraception
  • Discrimination or bias
  • Your relationship along with your physician

Discuss to your physician you probably have questions on your choices.


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’ve vaginal intercourse – there’s a couple of 2% probability 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% in case you’re not utilizing a second type of contraception. 


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 be sure you’re comfy with that.

There are 5 varieties of IUDs authorised within the U.S. 4 of them launch very small quantities of the hormone progestin, which won’t trigger any feminizing results. The fifth sort is a nonhormonal copper intrauterine system (you may hear these referred to as Cu-IUDs). 

Unintended effects can embody vaginal recognizing (the place there’s solely slightly little bit of blood) and bleeding. Some individuals additionally get cramps associated to their IUD. However most individuals persist with the IUDs, in keeping with a 2021 research printed 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 individuals with IUDs who had been assigned feminine at start. The IUDs had been “effectively tolerated,” the researchers wrote, with few individuals looking 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 embody some IUDs (levonorgestrel intrauterine programs), implants, pictures, or capsules. Discuss to your physician about it first. 

Photographs or IUDs may show you how to cease or reduce bleeding out of your vagina. To keep away from bleeding, chances are you’ll wish to select a technique just like the progestin-only implant, IUD, or shot, Bonnington says.

Mixed hormonal contraceptives (CHCs)

Mixed hormonal contraceptives (CHCs) embody patches, capsules, 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.

Should you’ve had prime surgical procedure (surgical procedure to take away breast tissue to create a extra masculine chest), medicines with estrogen – equivalent to contraception capsules, patches, or the ring – may make your breasts really feel tender or sore. “Some individuals notice some bloating and issues like that, but it surely’s actually going to depend 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 individuals say they’ve been discriminated towards or in any other case not handled respectfully in well being care settings.

Generally the easiest way to search 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 embody:

  • A posted signal with nondiscrimination insurance policies that embody gender identification and expression protections
  • A ready room with instructional brochures, magazines, or posters about transgender well being
  • A rest room labeled for all-gender use
  • Consumption kinds that ask to your right title, pronouns, gender identification, and intercourse assigned at start
  • Suppliers who’ve their pronouns on their title badges

Nonetheless, he says, these aren’t ensures {that a} supplier or clinic is LGBTQ-friendly.