Francis A, Jasani S, Bachmann G
Clinical Instructor and Academic Faculty Scholar, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, 125 Paterson St, New Brunswick, NJ 08901 USA.
Womens Midlife Health. 2018 Jul 13;4:12. doi: 10.1186/s40695-018-0042-1. eCollection 2018.
In recent years public awareness of healthcare disparities experienced by transgender individuals throughout the world have garnered increasing attention within the media and from health advocates. Despite this increasing awareness, a paucity of research data and clinical protocols of care for clinicians continues to exist, especially in regard to the transgender individual's family planning needs. Clinicians should be on the forefront of promoting strategies that forge a meaningful and collaborative relationship with the transgender man, including as he transitions through to the menopause and his sexual and reproductive healthcare needs. Unfortunately, despite best efforts to address the health concerns of transgender men in midlife, including their contraceptive needs and pregnancy desires, there is currently a paucity of research. Although hormonal contraceptives are not an option for this group of individuals, especially those on masculinizing hormones, IUD's, both copper containing and progestin containing, should be considered for those with intact pelvic organs. For this group of transgender men with potential for pregnancy who have either completed their family or choose not to give birth, sterilization can be offered. Regardless of where they identify along the gender spectrum, these midlife individuals with potential reproductive potential should have equitable access to and up to date counseling on their contraceptive options. This commentary addresses the contraceptive challenges of the midlife transgender man. (Note: Pronouns used in this article are he/him for cis and transgender men and she/her for cis and transgender women).
近年来，全球跨性别者所经历的医疗保健差异已引起媒体和健康倡导者越来越多的关注。尽管人们的认识不断提高，但临床医生的研究数据和护理临床方案仍然匮乏，尤其是在跨性别者的计划生育需求方面。临床医生应站在促进与跨性别男性建立有意义的合作关系的策略前沿，包括在其过渡到更年期以及满足其性健康和生殖健康需求方面。不幸的是，尽管尽力解决中年跨性别男性的健康问题，包括他们的避孕需求和怀孕意愿，但目前研究仍然匮乏。尽管激素避孕对这一群体不可行，尤其是对那些正在服用男性化激素的人，但对于盆腔器官完好的人，含铜和含孕激素的宫内节育器都应予以考虑。对于这群有怀孕可能且已完成生育或选择不生育的跨性别男性，可以提供绝育手术。无论他们在性别谱系上处于何种位置，这些具有生殖潜力的中年个体都应能平等地获得关于避孕选择的最新咨询服务。本评论探讨了中年跨性别男性的避孕挑战。（注：本文中使用的代词，顺性别男性和跨性别男性用“他”，顺性别女性和跨性别女性用“她”）
