The contraceptive and reproductive history and planning goals of trans-masculine adults: a mixed-methods study

Abstract

Objectives: This study aims to identify factors associated with the reproductive planning of transmasculine adults. Study design: Between 2015 and 2016, providers enrolled 150 trans-masculine adults in a sexual health study assessing sociodemographics, social support, gender affirmation, sexual partnering, and reproductive history and planning. A brief clinical interview assessed contraceptive use and concerns. Bivariate and multivariable logistic regression analyses examined associations between participant characteristics and three outcomes: current contraceptive use, lifetime pregnancy history and reproductive planning. Results: Overall, 37.3% are currently using contraceptives; 5.3% have been pregnant; and 20.0% plan to have biological children (9.3% plan to become pregnant; 12.0% plan to use their oocytes with a surrogate). Participants are less likely to use contraceptives if they are students vs. not, have socially affirmed their gender vs. not and have a partner vs. are single. Greater number of sexual partners is associated with the increased odds of contraceptive use. Further, as social support increases, the odds of having been pregnant decreases. Participants with a nonbinary gender identity are more likely to want to become pregnant than those with a binary gender identity, whereas those who have socially affirmed their gender are less likely to want to become pregnant than those who had not. Finally, participants of color more commonly planned to use their oocytes with a surrogate than white participants. Conclusion: Sociodemographic, gender affirmation, social support and sexual partner factors are associated with contraceptive use and reproductive history among trans-masculine patients.

Contraceptive Beliefs, Decision Making and Care Experiences Among Transmasculine Young Adults: A Qualitative Analysis

“…The few published empirical studies investigating this topic have largely focused on ascertaining the prevalence of contraceptive use among transmasculine adults. 3,10,12,13 For example, in a medical chart review of 26 transgender men, Cipres and colleagues found that most reported using condoms (38%) or no contraceptive method (42%). 3 An online survey of 197 transgender men by Light et al found that 60% reported using contraceptives, especially condoms (49%) and the pill (34%).…”

“…10 And in a study of 150 transmasculine adults, Stark et al found that 37% were currently using a method, including condoms (24%), IUDs (8%) and the pill (3%). 12 Even fewer studies examined the specific and unique aspects of contraceptive use within the transmasculine population, including gender affirmation, lack of provider competency in transgender reproductive health care and gender discrimination in reproductive health care settings. [12][13][14] Understanding the patient-, provider-and system-level conditions that shape transmasculine individuals' contraceptive use is essential for developing tailored educational materials, programs and practices to facilitate high-quality contraceptive care among this marginalized and underserved population.…”

“…12 Even fewer studies examined the specific and unique aspects of contraceptive use within the transmasculine population, including gender affirmation, lack of provider competency in transgender reproductive health care and gender discrimination in reproductive health care settings. [12][13][14] Understanding the patient-, provider-and system-level conditions that shape transmasculine individuals' contraceptive use is essential for developing tailored educational materials, programs and practices to facilitate high-quality contraceptive care among this marginalized and underserved population. To address this need, we conducted a qualitative study to elicit detailed information about the multilevel barriers to and facilitators of contraceptive use among transmasculine people.…”

“…Research examining contraception in the transmasculine population is extremely scarce. The few published empirical studies investigating this topic have largely focused on ascertaining the prevalence of contraceptive use among transmasculine adults . For example, in a medical chart review of 26 transgender men, Cipres and colleagues found that most reported using condoms (38%) or no contraceptive method (42%) .…”

“…An online survey of 197 transgender men by Light et al found that 60% reported using contraceptives, especially condoms (49%) and the pill (34%) . And in a study of 150 transmasculine adults, Stark et al found that 37% were currently using a method, including condoms (24%), IUDs (8%) and the pill (3%) . Even fewer studies examined the specific and unique aspects of contraceptive use within the transmasculine population, including gender affirmation, lack of provider competency in transgender reproductive health care and gender discrimination in reproductive health care settings …”