What you need to know about birth control whether you are transgender or not binary


It doesn’t matter where you are on the gender spectrum (whether it’s transgender (trans), non-binary, genderqueer, or gender nonconformist). Birth control, especially if there is any possibility get pregnant and don’t try.

Even if you do gender-affirming hormone therapy (a type of treatment that helps align your sexual characteristics with your gender identity), it won’t work very well as a birth control. If you have ovaries and a uterus and you have vaginal intercourse with someone who has testicles and a penis, you could get pregnant.

However, there are other reasons why you may be taking birth control (you may feel this way contraception). For example, gender dysphoria – the feeling that your gender does not match the sex you were assigned at birth – may get worse if you are not binary or are a trans man and start the period. Some birth control options may shorten or stop the period.

All the options for birth control that cisgènere the people they use are available to non-binary and trans people. However, some are better than others, depending on other medications you may be taking.


“If it’s for a patient with no other risk factors, there are some options available,” says Beth Cronin, MD, obstetriciangynecologist in Providence, RI. It depends on what your goals are and the side effects you want or can experience.

This is where contraceptive advice can help.

If you want to avoid pregnancy, contraceptive counseling can help you match your contraceptive with your family planning values ​​and reproductive goals, says Adam Bonnington, MD, a San Francisco obstetrician-gynecologist.

Who needs birth control?

Not all transgender people choose to make a transition through gender-affirming surgery or hormone treatments. Before discussing parenting and fertility decisions with your partner.

Doctors recommend birth control for most trans and non-binary men and women who have vaginal sex and do not want to get pregnant.

Transmasculine people

If you are a transgender or non-binary man, you have vaginal sex and have not had any hysterectomy or a bilateral oophorectomy (where your doctor removes your fallopian tubes and ovaries), you should use birth control. Testosterone (T) therapy, a treatment that slows down female characteristics and evidences male ones, does not prevent pregnancy.


People often think that if she doesn’t have a period she can’t get pregnant. It’s unlikely, but it’s not impossible, Cronin says. “We generally advise patients that if they are in T and have this type of sex, they could get pregnant and should use contraceptives.”

If you are transmasculine, take testosterone and want to get pregnant, you should stop taking it.

Transfeminine people

Some transgender women or non-binary people succeed estradiol therapy: a treatment that causes changes in the body caused by female hormones. It can help align your body’s physical characteristics with your gender identity, but it won’t work as a birth control if you have vaginal sex. Neither is hormone therapy, because it doesn’t completely stop the sperm you produce.

Types of hormonal therapies that are not birth control methods include:

  • Cyproterone acetate
  • Finasteride
  • Gonadotrophin Releasing Hormone (GnRH) Analogs

If you have not had a vasectomy (when a doctor cuts and seals the tubes they carry sperm) or orchidectomy (when a doctor removes your testicles), make sure your partner uses birth control if you have vaginal sex and don’t want to get pregnant.

Types of birth control and how to use them

How you use birth control depends on the method you and your partner choose.

The type that suits you best may not be right for you.

The aspects that can affect your decisions are:

  • How easy to use
  • How much is it
  • Possible side effects
  • The misconceptions you have about it
  • Things that make birth control difficult
  • Discrimination
  • Your relationship with your doctor

Always talk to your doctor before adding anything new to your diet.


Condoms they are a popular form of birth control, but they are not 100% effective in preventing pregnancy. If you use condoms, keep in mind that you may still be pregnant. If you use them the right way every time, there is a 2% chance they can fail. The typical failure rate of the people they use condoms around 18%. You can use birth control condoms to protect yourself ARE YOU.



Another option is non-hormonal copper intrauterine devices (they may hear them called Cu IUDs). These are completely safe to use and will not interact with any hormonal treatment you may get if you are not binary or are a trans man. But there may be side effects you don’t want, such as vaginal blemishes (where there’s only a little blood) and bleeding.

Methods with progestogens only

If you want to use birth control methods only with progestogens, such as levonorgestrel Intrauterine systems (IUS), implants, injections, or pills: Talk to your doctor first. Some doctors don’t think it affects the hormonal treatments you might get if you’re trans or non-binary, but others don’t recommend it.

Given the lack of data on potential risks, side effects, and specific benefits for transgender and non-binary people who use testosterone that claims gender in combination with estrogen-containing contraceptives, Bonnington says it’s best to avoid these products unless there is a benefit. clear or strong preference.


Injections or IUS can help you stop or decrease bleeding vagina.

If you want to prevent bleeding, you may want to choose a method like progestin-only implantation, the intrauterine system, or injection, Bonnington says.

Combined hormonal contraceptives (HCC)

Transgender men and non-binary people on testosterone treatment should not use combined hormonal contraceptives (patches, pills, or the vaginal ring) that have estrogen and progestogens. This is because CHC has estrogen, which can potentially interfere with testosterone.

If you have had a major surgery (where a surgeon is removed pit tissues to create a more masculine breast), estrogen medications, such as birth control pills, patches or ring, may cause tenderness or breast pain. “There are people who observe distensions and things like that, but it really depends on the person,” Cronin says.

More permanent options

There are also more permanent forms of birth control. Either partner can get a vasectomy either tubal ligation (where a surgeon ties, cuts or blocks the fallopian tubes). Both procedures will help prevent conception.

How to talk to your doctor’s office and pharmacy

According to a recent study, approximately 56% of lesbians, gays or bisexuals and 70% of transgender people claim to have experienced discrimination while seeking medical attention.

Sometimes the best way to find LGBTQ-enabled providers is through word of mouth from family or friends, Cronin says. Local LGBTQ organizations often have a list of providers to whom they refer their patients, Bonnington adds.

Signs that the provider is LGBTQ compliant include:

  • A clearly published sign with non-discrimination policies that include protections against gender identity and expression
  • A waiting room with educational brochures, magazines or posters on transgender health
  • Bathrooms labeled for use in all genres
  • Admission forms that ask you for the correct name, pronouns, gender identity and gender assigned at birth
  • Suppliers who have their pronouns on their name badges

Still, he says, there are no guarantees that a provider or clinic will be LGBTQ compliant.

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