Contraception for Transgender Men: A Call to Action
ACOG ePoster. Bonnington A. Apr 27, 2018; 211822; 18G
Adam Bonnington
Adam Bonnington
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Abstract
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Introduction: Contraceptive counseling is a cornerstone of most OBGYNs' practices and should extend to transgender patients. There are several reports of transgender men who become pregnant even when amenorrheic on testosterone, but discussing contraception with this population can be challenging given the lack of guidance available. Unmet contraceptive need can result in unplanned pregnancies and poorer pregnancy outcomes among cisgender women, but there are potential additional risks for transgender men. Given the paucity of contraceptive data for transgender men, providers find themselves needing guidance.

Methods: We conducted a review of available literature on contraception, pregnancy intention, and pregnancy capability for transgender men. We reviewed clinical medicine, psychology, social science, basic science, and public health literature. Using the Centers for Disease Control contraceptive efficacy model, we highlight key contraceptive considerations by method from provider and patient perspectives.

Results: Overall, we don't anticipate that the risks associated with the various contraception methods differ significantly for transgender men, though more study is necessary. However, considerations of context and administration reflect transgender men's unique needs. Bothersome side effects, need for frequent office visits, and role of pelvic exams, are just a few examples of factors that may differentially effect this population.

Conclusion/Implications: Transgender individuals face pervasive discrimination, violence, and barriers to medical care. As OBGYNs, we are uniquely poised to care for this underserved population and provide solace and comprehensive care. By providing a safe and accepting space, we can use our knowledge to ensure intentional family planning and access to appropriate reproductive healthcare for these patients.
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