Navigating Birth Control as a Trans Person

By: Cole Farhat

Why Do Trans Folks Need Birth Control? 

 Transgender people can still get pregnant or impregnate others even if they’ve been on hormone replacement therapy. People that were assigned female at birth (AFAB) that have sex with a person with a penis should seriously consider birth control in order to prevent unwanted pregnancies. In the same way, people that were assigned male at birth (AMAB) that have sex with a person with a vagina should also consider looking into birth control options.  

Birth control can be used by people that are AFAB for other reasons besides pregnancy prevention. For instance, some birth control options can stop you from menstruating, which can be a significant source of gender dysphoria (the feeling of a disconnect between your brain and your biology) for AFAB people.  

Birth Control for People AFAB 

Many people AFAB opt for non-hormonal (or progestin only) birth control because of the fear that estrogen will counteract the effects of masculinization hormones. However, research shows that birth control that contains estrogen is unlikely to significantly impact the effects of masculinization hormones. But, if you are interested in birth control without estrogen, some progestin only options include: 

• Depo-Provera Injection – A once every 3 months injection done by a healthcare provider. 96-99.8% effective 

  *We can also get you set up to give these shots to yourself at home. Ask us! 

• Progestin-only Pills (Mini-pills) – One pill is taken at the same time daily. Around 91% effective. 

• Hormonal (Progestin) IUD (Mirena, Liletta, Skyla) - Inserted into uterus and lasts for 3-8 years. 99.4-99.9% effective. 

 Some non-hormonal birth control options: 

• Copper IUD (ParaGard) – Inserted into uterus and lasts for 10-12 years. 99.4-99.9% effective. 

• Condoms/Dental Dams – Protective barrier around penis. 87-98% effective depending on correct use. 

• Emergency Contraception (Plan B, ella, etc.) – Taken after unprotected sex. 85-99.9% effective. 

• Reproductive Surgeries – Permanently prevents pregnancies. 

  • Tubal Ligation is a procedure in which the fallopian tubes are cut or tied to prevent sperm from reaching eggs. 

  • Salpingectomy is when one or both fallopian tubes are removed. 

  • Hysterectomy is the removal of the uterus. 

Some people prefer using hormonal birth control for many reasons. For instance, a family history/personal history of health issues, like cancer or heart problems, can make using other types of birth controls dangerous. Additionally, hormonal birth control, like the pill, can be used to prevent one’s menstrual cycle or help acne as well as pregnancy prevention. Some hormonal birth control options include: 

• Birth control pills – One pill is taken at the same time daily. 93-99.7% effective. 

• Nexplanon – An arm implant that lasts up to 5 years. 99.9% effective. 

• Birth control ring – A ring placed inside vagina that is replaced every 3-5 weeks. 93-99.7% effective. 

Birth Control for People AMAB 

People with penises that have intercourse with someone with a vagina can still impregnate them, so birth control should be discussed if pregnancy is not desired. However, there are not many birth control options for people with penises. The options available include: 

• Condoms – A protective barrier around penis. 87-98% effective depending on correct use. 

• Reproductive Surgery – Permanently prevents pregnancies. 

• Vasectomy – Vas Deferens is cut and sealed to prevent sperm from exiting penis.  

Unplanned pregnancies can cause tremendous discomfort and dysphoria for transgender people, which is one of a few reasons why considering birth control could be very beneficial to their quality of life!