Birth Control: What Trans And Nonbinary People Need To Know?

Many trans and nonbinary people who take gender-affirming hormone therapy think that they no longer require birth control. However, hormone therapy alone cannot prevent pregnancy in trans and nonbinary people.

Menstruation ceases for most trans men and non-binary people who were Assigned Female At Birth (AFAB) after taking testosterone therapy for a couple of months. However, ovulation can still occur – even if they never have a period.

Now, if trans women and nonbinary people who were Assigned male At Birth (AMAB) are taking estrogen, the production of sperm in the testicles can still take place. Gender-affirming hormone therapy decreases fertility, although it cannot be counted on as a form of contraception.

Irrespective of gender identity, if two individuals are having sexual intercourse, pregnancy can occur. 

Trans And Nonbinary People Who Aren’t Taking Hormones

The same notion applies to trans and binary people who aren’t undergoing any gender-affirming hormone therapy. All that really matters are the body parts of the person and their partner, and not gender identities. If someone is having intercourse where the chance for egg and sperm to meet prevails, and they don’t wish pregnancy to happen, then some form of contraception is advised.

What’s The Best Birth Control Method For People On Hormone Therapy?

Remember, no single method is the best. Whichever method is most comfortable is the most significant and the best method for them. Experts from the American College of Obstetricians and Gynecologists (ACOG) suggest that trans and nonbinary people who were AFAB may choose any of the available contraceptive methods for cisgender women – even if they are taking testosterone. They should discuss their alternatives with a healthcare specialist because some methods aren’t safe for them because of underlying medical conditions, but not due to their gender identity. 

Also Read: Best Ways To Control Pregnancy

Does Hormone Therapy Impact In The Long Run?

Gender affirming hormone therapy can impact long-term fertility. Further research is required, but some trans men and nonbinary AFAB people taking testosterone who discontinue ovulating, and transgender women and nonbinary AMAB people taking estrogen who discontinue producing sperm, might not continue these functions after going off hormones. Others can be fertile again 3 – 6 months after ceasing hormone therapy.

Discussing prospective fertility retention methods is advised before initiating hormone therapy if biological children are required in the future. Fertility retention can include freezing eggs, ovarian tissue, or embryos (from fertilized eggs) in AFAB people and freezing sperm or testicular tissue in AMAB people. Regrettably, in several countries, these retention methods are highly expensive and/or not covered by health insurance, making them unobtainable for several individuals. Plannings for future fertility should also be considered before having any gender-affirming surgeries, like ejection of the uterus and/or ovaries in AFAB people or ejection of the testicles in AMAB people, as these surgeries are irreversible.

Can Trans Women Use Birth Control Pill As A Type Of Hormone Therapy?

Trans women need to be aware that birth control methods such as the pill shouldn’t be used as gender-affirming hormone therapy. The estrogen identified in birth control is distinct from what is prescribed to trans women. Trans women generally also use an anti-androgen, which obstructs the impact of testosterone on the body. Trans women would have the safest and best outcomes when they are prescribed the appropriate type and dose of estrogen and antiandrogen by a healthcare specialist. 

How Can You Find A Reliable Trans-friendly Healthcare Provider?

Finding a respectful and quality trans-friendly healthcare provider seems to be a daunting task for most people. Around 30% of transgender people have deferred or avoided seeking desired health care due to felt discrimination. About 15% of transgender people claim that they have been denied care because of their gender identity. Requesting for a referral from a healthcare provider who has been kind and supportive in the past, dependable friends or loved ones, or from local support or advocacy groups could be highly beneficial. You can also visit here and choose a healthcare provider from the directory of providers. 

Trans men and nonbinary AFAB people, irrespective of whether they are taking testosterone therapy or not, can use any form of birth control to cease or manage their periods. Protection from pregnancy is adequate for satisfying sexual intercourse as you don’t need to stress over unplanned pregnancies. Bear in mind, hormonal birth control and copper IUDs don’t offer protection against sexually transmitted infections (STIs). To minimize the possibility of STI transmission, kindly use a barrier method like condoms.


Tags: what happens if a man takes birth control regularly, progesterone for mtf transition, birth control pills for mtf transition

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Natasha Patel

Natasha Patel is the senior writer for the women’s health edition at She worked as a primary care provider before joining the writer’s panel of the blog. She is also trained in routine obstetrics and continues to practice in Oklahoma, where she lives with her family.