When the push notification declaring that the Supreme Court intended to overturn Roe v. Wade popped up on my phone, I felt like a lot of people did: incredibly afraid for my future. I’m a trans man, and I’ve been on testosterone for half a year, but I knew I wasn’t immune from an unwanted pregnancy. After taking a moment to cry, I googled “tubes tied near me.”
I got a tubal salpingectomy, the removal of both my fallopian tubes, in late July. It was a procedure I had wanted for years, but the need for it had suddenly become immediate and urgent.
In the aftermath of the Dobbs decision, access to contraception will become even more important for anyone who is concerned about their reproductive health, including trans men, transmasculine people, and nonbinary people. Of course, there are tons of birth control options out there—but not all transmasculine folks want to deal with daily reminders to take the pill or weekly swaps to re-up their birth control patch. On top of that, frequent visits to your ob-gyn’s office or the pharmacy present their own challenges, especially when it comes to facing possible stigma from health care providers and grappling with the effects of gender dysphoria.
That’s when long-acting reversible contraception (LARC) and permanent contraception (sterilization) can be helpful options, because they’re basically set-it-and-forget-it methods. To help you make sense of it all, SELF spoke to three experts about what transmasculine people should keep in mind when looking into LARC and sterilization.
One big thing before we get into it: None of the methods of birth control we’re covering in this article provide protection from sexually transmitted infections (STIs). For that, you’ll need to use a condom or another barrier method. Okay, here’s what you need to know:
I’m a trans guy on testosterone. Can I still get pregnant?
Despite popular misconceptions, taking testosterone is not a reliable form of pregnancy prevention. Even if your period has stopped or you have been on testosterone for a while, you may still ovulate, which means you can still potentially get pregnant. If you want to avoid getting pregnant, you should consider birth control.
Can transmasculine folks on T use hormonal birth control methods?
Yes! According to Holly Cummings, MD, MPH, a Pennsylvania-based ob-gyn who specializes in transgender gynecologic care, trans people on testosterone can use any form of birth control, even if it contains hormones. Because the progestin in hormonal birth control, including in certain LARC options, is unlikely to hinder the effects of testosterone, you should feel free to choose whatever birth control method feels like the right fit for you. That said, Dr. Cummings tells SELF that if you aren’t comfortable using hormonal birth control or have had negative experiences with certain hormonal methods, you have other options (more on that shortly).
What are my options for long-acting reversible contraception?
When providers talk about LARC methods, they’re typically talking about intrauterine devices (IUDs) and the birth control implant, Mary Jane Minkin, MD, a member of SELF’s medical review board and a clinical professor of gynecology and reproductive sciences at the Yale School of Medicine, tells SELF.
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