A review of contraception and gender-affirming care

Abstract

There are estimated to be more than 1.6 million transgender and gender-nonconforming individuals ages 13 and up in the United States. Many individuals who identify as trans or gender-expansive never received adequate contraceptive counseling. Certified Nurse Midwives play a crucial role in primary reproductive health care in many settings, particularly underserved settings. A patient's wants, needs, and goals should be discussed before choosing a contraceptive option. Several contraceptive options for transmasculine, transfeminine and non-binary populations are available. The same contraceptive options available for cisgender females should be available to transmasculine individuals. The same contraceptive options for cisgender males should be available to transfeminine individuals. Contraceptive options should not be dismissed based on a person's gender. Population-specific contraceptive recommendations are provided. Throughout the article, there are recommendations on approaches to help inclusivity and reduce barriers for non-cisgender persons. A modified algorithm to aid in contraceptive counseling for all persons is presented. Several innovative contraceptive methods are being developed that focus on fertile persons with testicles. Providing accurate, compassionate, and individual contraceptive counseling to all persons can help reduce barriers and prevent unwanted pregnancies.