Berry Jasmine, Obedin-Maliver Juno, Ragosta Sachiko, Hastings Jen, Lunn Mitchell R, Flentje Annesa, Capriotti Matthew R, Dastur Zubin, Lubensky Micah E, Inman Elizabeth M, Moseson Heidi
Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, United States.
Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, United States; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States; The PRIDE Study/PRIDEnet, Stanford University, Palo Alto, CA, United States.
Contraception. 2025 Apr;144:110784. doi: 10.1016/j.contraception.2024.110784. Epub 2024 Dec 17.
To explore whether discussing contraceptive use with a healthcare provider is associated with current contraceptive use among transgender men and gender-diverse (TMGD) individuals.
In 2019, we conducted a cross-sectional survey among transgender men and gender-diverse adults in the United States who were assigned female or intersex at birth. We measured whether respondents had ever discussed contraception with a healthcare provider as well as current use of contraception, reasons for use, and barriers to use. We described frequencies and ranges for key variables and implemented a series of nested logistic regression models to evaluate the association between ever having spoken to a provider about contraception and current use of contraception for any reason, overall and by method type.
Among 1694 respondents, about half (48%) were currently using a method of contraception for any reason, most commonly barrier methods (17%) and long-acting-reversible-contraception (LARC) (17%). Compared to those who never had a conversation about contraception with a provider, respondents who spoke with a provider were more likely to be currently using contraception - particularly among those who self-initiated the conversation (aOR: 3.8, 95% CI: 2.5-5.6). Having discussed contraception with a healthcare provider was most strongly associated with current LARC use.
Having had a conversation with a provider about contraception use was positively associated with current contraception use among a large, national sample of transgender men and gender-diverse people. Facilitating patient participation in contraception counseling for transgender and gender-diverse patients should be emphasized in provider training.
Given formidable barriers to healthcare faced by TMGD people, training providers on how to initiate affirming and relevant conversations with TMGD patients about contraceptive needs and preferences is essential, as are efforts to educate and empower TMGD individuals to advocate for the information they need in these interactions.
探讨与医疗保健提供者讨论避孕措施是否与跨性别男性和性别多样化（TMGD）个体当前使用避孕措施有关。
2019年，我们在美国对出生时被指定为女性或具有中间性特征的跨性别男性和性别多样化成年人进行了一项横断面调查。我们测量了受访者是否曾与医疗保健提供者讨论过避孕措施，以及当前的避孕措施使用情况、使用原因和使用障碍。我们描述了关键变量的频率和范围，并实施了一系列嵌套逻辑回归模型，以评估曾与提供者谈论过避孕措施与当前因任何原因使用避孕措施之间的关联，总体情况以及按方法类型进行评估。
在1694名受访者中，约一半（48%）目前因任何原因使用某种避孕方法，最常见的是屏障法（17%）和长效可逆避孕法（LARC，17%）。与从未与提供者讨论过避孕措施的人相比，与提供者交谈过的受访者目前更有可能使用避孕措施——尤其是那些主动发起对话的人（调整后比值比：3.8，95%置信区间：2.5 - 5.6）。与医疗保健提供者讨论避孕措施与当前LARC使用的关联最为强烈。
在一个大型的全国性跨性别男性和性别多样化人群样本中，与提供者谈论避孕措施的使用与当前使用避孕措施呈正相关。在提供者培训中应强调促进患者参与跨性别和性别多样化患者的避孕咨询。
鉴于TMGD人群面临巨大的医疗保健障碍，培训提供者如何与TMGD患者就避孕需求和偏好展开肯定性且相关的对话至关重要，努力教育和赋能TMGD个体在这些互动中倡导他们所需的信息也同样重要。
