I’m Trans. Do I Need Birth Control to Prevent Pregnancy?

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All pregnancies require four things to get going: a uterus, an egg, sperm, and for the egg and sperm to come together.

March 2, 2020

Like cisgender people (or people whose gender identities match the sex they were born), trans people can get pregnant or get someone else pregnant. Does this mean they need to use birth control? Well, yes — if a trans person doesn't want to get pregnant, they might want to think about their birth control options. The method they choose will depend on their anatomy and their partner's anatomy.

If you or your partner are trans and you'd like to know how birth control can help you not get pregnant, we've provided some helpful information below. You can also visit your nearest The Right Time health center to discuss your personal needs in more detail and to get free or low-cost access to all the methods of contraception.

Trans men

(people who were assigned female sex at birth and identify on the male gender spectrum)
For those who still have their uterus and ovaries (where eggs are made): you can get pregnant if you’re having sex with someone who has a penis and testicles.

Many trans men use testosterone (T). For most, T stops their monthly period, but that doesn’t mean they can’t get pregnant. How is that possible? Well, testosterone doesn’t completely stop egg production, so some guys will still release eggs even on T and even without a period. In other words, T isn’t birth control.

If getting pregnant isn’t in your plan, what are your options? All the methods that cisgender women may consider are also good options for trans guys.

Trans women

(people who were assigned male at birth and identify on the female gender spectrum)
For those who still have their penis and testicles—if your partner has a uterus and ovaries, you can get them pregnant. Many trans women think that if they are on estrogen they can’t get another person pregnant. Not true. Though it may be harder to get an erection, make sperm, and ejaculate when you are on estrogen, it’s not impossible.

If you are trans or you are in a relationship with a trans person and you do not want to get pregnant, birth control is something to consider. All the methods that cisgender men use for contraception are on the table. Condoms are especially cool because they protect against both sexually transmitted infections and pregnancy.

Updated February 2020

Juno Obedin-Maliver is an OB/GYN working at the San Francisco Veterans Affairs Medical Center and at the University of San Francisco, where she provides full-spectrum gynecological health care. Her main interests are women’s health, the health and wellness of lesbian, gay, bisexual, and transgender individuals, and promoting reproductive rights. She is the co-director of The PRIDE Study, looking at the relationship between being LGBTQ and health. She lives in San Francisco, CA, loves to hike, dreams of getting out of the city for hot springs, but loves staying in the city for the food and fun!