The LGBTQ+ health movement has no doubt seen progress in the past few years. However, the lack of LGBTQ+ affirming healthcare still persists. Research as recent as 2016 revealed that LGBTQ+ communities still face disparities in receiving these services, and are deterred from seeking treatment due to the difficulties they face in finding an affirming and sensitive healthcare provider. This gap is further attributed to systemic social structures surrounding healthcare bodies that exclude LGBTQ+ persons through the lack of access to information relating to LGBTQ-specific healthcare, and the social stigma associated with LGBTQ+ communities.
Speaking to a doctor can be a daunting experience for LGBTQ+ persons considering the aforementioned barriers to healthcare. Here at Ease, we believe that healthcare is a fundamental human right, and both physical and mental health services should be enjoyed by everyone regardless of race, class, sexual orientation, or gender expression and identity. This blog post hopes to act as a comprehensive guide to LGBTQ+ persons who are seeking out contraception, but are unsure of what to ask their healthcare providers.
“If I’m not having heterosexual sex, how can I use hormonal contraceptives?”
Some people who menstruate and don’t identify as female find that experiencing menstruation triggers distress arising from gender dysphoria. Hormonal contraception may be used to manage hormone-related symptoms, or to stop menstruation entirely, and can thus help alleviate the distress that accompanies gender dysphoria. Different methods of contraception can be used to treat different symptoms (i.e. avoiding menstruation, alleviating the symptoms of PMS, treating acne, etc.). It is therefore best to discuss these methods with a doctor to better understand which best suits your unique health needs.
“Is it necessary for me to use hormonal contraceptives if I am undergoing hormone therapy?”
Some people might have the misconception that undergoing gender-affirming hormone therapy and taking testosterone eliminates their chances of becoming pregnant. In actual fact, this alone is not a reliable form of contraception. Although testosterone can reduce the likelihood of pregnancy, it is still possible to conceive while undergoing gender-affirming hormone therapy. If you engage in sexual activity that could result in pregnancy, it might be worth considering the use of hormonal contraception to avoid that risk.
“If I don’t want to use hormonal contraceptives, what are my options?”
With contraceptives, there are hormonal (e.g. the pill, patch, injection, etc.) and non-hormonal (e.g. copper IUDs, etc.) methods available. The option of non-hormonal copper IUDs, for example, can be used to help regulate the menstrual cycle.
“What are the side effects of hormonal contraceptives?”
Depending on the method of contraception, side effects and their severity can vary from person to person. The common side effects experienced by birth control users are nausea, chest tenderness, bloating and headaches. These side effects usually resolve on their own within 2 to 3 months with continued use of the contraceptive method. However, if they seem to persist beyond that, or become severe, it might be an indication that the current method of contraception is not suitable.
“How will the use of hormonal contraceptives affect hormone therapy?”
While there is no evidence to suggest that the estrogen component in hormonal contraception interferes with the testosterone in gender-affirming hormone therapy, it is best that you consult with a doctor to determine the best brand of birth control for you. It is important to note that hormonal contraception should not be used in substitution of gender-affirming hormone therapy.