REPRODUCTIVE HEALTH IN TRANS AND GENDER DIVERSE PATIENTS: Contraception considerations in transmasculine and gender diverse adolescents and young adults.

IN BRIEF

Transmasculine and gender diverse adolescents and young adults can often have nuanced considerations when utilizing contraception. This narrative review discusses contraception utilization patterns and specific considerations in this population and proposes a patient-oriented comparison of contraceptive options.

ABSTRACT

Contraception care is an important aspect of comprehensive gender-affirming care in transgender and gender diverse (TGD) adolescents and young adults (AYAs). TGD AYAs seek contraception care for a variety of reasons, and several important considerations are unique to this population. In addition to pregnancy prevention, transmasculine and gender nonbinary persons may seek contraception to achieve amenorrhea and reduce gender dysphoria, or as part of their gender-affirming journey. While patients on testosterone therapy often experience amenorrhea, pregnancy has been reported and testosterone is not a form of contraception. Visits for contraceptive counseling provide an opportunity to discuss fertility goals and preservation planning as well as the possibility that some methods may provide endometrial protection. In this narrative review, we analyze the current literature and discuss specific considerations for contraceptive use in this population. We also propose a contraception overview for shared decision making for patients and their clinicians.