Contraception for Transgender Men assigned female at birth


We understand that it may not always be easy to get reliable information or feel at ease with talking about contraception. We are here to offer you a warm, friendly, and professional space to address your queries as best we can. We may not always get the terminology right, but we are constantly learning and are keen to learn from our patients to improve the quality of care that we provide.

A few quick-fire facts!

  • Transgender men can get pregnant
  • Transgender men can get pregnant on testosterone. Although testosterone makes it more difficult to get pregnant, it is still possible to get pregnant on this medication
  • Transgender men on testosterone can still menstruate, although it can make your period much lighter and less regular
  • Testosterone is not a form of contraception

To avoid pregnancy, you have the option of hormonal and non-hormonal contraceptive choices. You may also need contraception to manage hormone-related symptoms, or to avoid menstruating altogether.

We are here to help

At 2me Clinic we welcome any person who identifies as a woman or any person who has a vulva or any person who feels that our clinic is the right place to address their concerns.

If you are a trans-man or non binary person assigned female at birth we can help you with your contraception choice if needed.

There is no restriction on the use of any method of contraception for people assigned female at birth on account of their current gender identity.

Your individual’s personal characteristics and any existing medical conditions or drug therapies must be taken into consideration when assessing your eligibility to any contraception method.

Things to consider

If you have not undergone hysterectomy or bilateral oophorectomy, and you are having vaginal sex with a risk of pregnancy and do not wish to conceive, you may be interested to be informed about your contraceptive options.

If you are receiving testosterone therapy you should be aware that testosterone treatment does not provide adequate contraceptive protection.

And also that pregnancy is an absolute contraindication to testosterone therapy. If you are taking testosterone you should be aware that if pregnancy does occur, testosterone treatment used in current regimens can be associated with teratogenicity i.e. masculinisation of a female foetus.

What are your options?

Condoms are advised for protection against sexually transmitted infections (STIs) and provide contraception when used correctly and consistently. The contraceptive failure rate of condoms with perfect (correct and consistent) use is about 2% and with typical use failure rate is about 18%.

Permanent contraception (sterility) if required in either partner can be achieved with tubal occlusion or vasectomy.

Non-hormonal copper intrauterine devices (Cu-IUDs) are safe to use and do not interfere with hormone regimens used in the treatment of transmen and non-binary people. However, a Cu-IUD may be associated with unwanted and unacceptable side effects such as unpredictable vaginal spotting and bleeding.

Progestogen-only contraceptive methods such as pills, injections, implants and the levonorgestrel intrauterine systems (MIRENA 52mg LNG-IUS and KYLEENA 19.5mg LNG-IUS) are not thought to interfere with the hormone regimens used in the treatment of trans and non-binary people.

Progestogen-only injections DEPO INJECTION/ SAYANA PRESS and HORMONAL COILS may provide the additional non-contraceptive benefit of reducing or stopping vaginal bleeding.

Use of combined hormonal contraceptives (CHC) such as pills, patches or the vaginal ring containing estrogen and progestogen by trans men and non-binary people undergoing testosterone treatment are not recommended as the estrogen component of CHC will counteract the masculinising effects of testosterone.

Emergency Contraception

If you have had vaginal sex with a risk of pregnancy and do not wish to conceive, you should be offered emergency contraception (EC) after unprotected vaginal intercourse or if the regular contraception has been compromised or used incorrectly.

Both oral EC methods, (ulipristal acetate 30 mg and levonorgestrel 1.5 mg) and the COPPER COIL can be used by trans men and non-binary people without interfering with the hormone regimens used in the treatment of trans and non-binary people.

Testosterone is not thought to affect efficacy of emergency hormonal contraception.

Be aware that the copper coil is the most effective method of EC.

If you choose oral EC, these methods do not provide contraceptive cover for subsequent unprotected vaginal sexual intercourse so youn will need to use contraception or abstain from sex to avoid further risk of pregnancy.

Talk to us

You can book a free 10-min chat with us to get more information about your options. If you have already made a decision about a particular form of contraception, you can book a ‘doctor face/face appointment’ directly from the website. We also have appointments for specific forms of contraception such as the coil and implant which you can also book from the website.

Join our community

Get the latest news and recourses for women’s healthcare.

Subscribe to the Newsletter