Contraception in transgender and gender diverse patients

Transgender and gender diverse (TGD) individuals assigned female at birth have specific contraceptive needs that are often unmet. This can be because of bias, systemic barriers, and misinformation as this field continues to grow. As the TGD population increases, there remains a need for evidence-based guidance on gender-affirming, comprehensive contraceptive counseling.

TGD patients may pursue contraception for pregnancy prevention, menstrual suppression, or gender affirmation. Testosterone is not an approved form of contraception, so TGD patients on testosterone may choose other hormonal contraceptive options with side effects that may help alleviate gender dysphoria. Limited provider training and structural obstacles, such as insurance limitations and gendered clinical environments, continue to be barriers to care. Appropriate TGD care involves a trauma-informed, autonomy-centered approach to contraceptive counseling.

Providing high-quality contraceptive care to TGD patients requires individualized, affirming, and evidence-based counseling. Understanding the interaction between gender identity, reproductive goals, and contraceptive methods is essential. Clinicians must adopt inclusive practices and advocate for expanded research and policy reform to reduce disparities and support reproductive autonomy for TGD individuals.