Abstract
INTRODUCTION:Transgender individuals are often reluctant to seek reproductive health care and have under-addressed needs. Our objective is to determine use and awareness of contraceptive methods and views on abortion in this population.
METHODS:Transgender patients ages 18-65 participated in an online survey about reproductive history, contraceptive use and knowledge, and abortion views.
RESULTS:100 transgender men and 20 transgender women completed the survey. The mean age of transgender men and women was 22.9 (SD 5.6) and 25.9 (SD 9.5) respectively. The majority was white (85%). 76/101 (75%) were at risk of unintended pregnancy. 30/97 (31%) transgender men and 12/18 (67%) transgender women believed or were unsure if testosterone or estrogen therapy prevents pregnancy. 1/18 (6%) transgender women and 9/93 (9%) transgender men indicated that a provider stated gender affirming hormones prevented pregnancy. Over 70% had knowledge of condoms, oral contraceptive pills, and sterilization. 70% of transgender men were also aware of the contraceptive ring and implant. However, only 18/89 (20%) transgender men and 4/11 (36%) transgender women used contraception. 8/17 (47%) transgender women and 44/87 (51%) transgender men stated a provider did not discuss contraception after initiating hormone therapy. There were no unplanned pregnancies (0/16, 0%) in partners of transgender women. 3/93 (3%) transgender men had unplanned pregnancies. 2/3 chose abortion. The vast majority (95%) identify as pro-choice.
CONCLUSION:Although many transgender individuals in our cohort were at potential risk of pregnancy, contraceptive use was limited. This highlights need for educational interventions for patients and providers and increased access to contraceptive and reproductive services.
