Contraception options for transgender and non-binary people

Contraception prevents pregnancy. Some types of contraception can also help with other things, like stopping your period or making PMS symptoms more manageable.

Remember: Only condoms and oral dams can reduce the risk of getting sexually transmitted infections (STIs). Other forms of contraception can help with periods and avoiding pregnancy, but they don’t prevent STIs.

You need to think about contraception if you:

• Have penis-in-vagina sex

• Don’t want pregnancy

If you get a period, and you don’t want to, there are some forms of contraception that can stop menstruation. These options won’t make you look more masculine, but they might help relieve discomfort caused by bleeding.

If you want to start contraception to stop your period – or for any other reason than to prevent pregnancy – you’ll need to talk to a doctor first.

Gender-affirming hormone therapy (GAHT) doesn’t prevent pregnancy.

If you have a uterus and ovaries, GAHT usually involves taking testosterone (T). Testosterone can stop your period. But you can still get pregnant.

If you have a penis and testicles, your contraception options include:

• Condoms

• A vasectomy – this is a small operation that stops sperm being released when you cum

Some types of contraception use hormones. The combined contraceptive pill uses oestrogen – the feminising hormone. Others use the hormone progestogen.

Non-binary and transgender people often worry that using hormonal contraception will make T less effective or make their bodies more feminine. There’s no evidence of this happening. But some trans and non-binary people still feel uncomfortable using contraception with hormones.

You can stop the contraceptive pill at any time, and there won’t be any long-term side effects. But you can become hapū as soon as you stop taking the pill.

Intrauterine devices (IUDs) are a popular, long-lasting type of contraception. But they need to be inserted into (and removed from) your uterus by a trained nurse or doctor. These appointments can trigger gender dysphoria for some people. IUDs are reversible, which means the effect stops as soon as you have them removed.

The type of contraception you use is always your choice. And we’re always happy to kōrero about the best option for you.

• taking a pill every day (the combined oral contraceptive pill, or the progestogen-only contraceptive pill)

• having a hormonal IUD inserted into your uterus by a trained nurse or doctor (these can last up to 8 years)

• getting an implant in your arm (this can last up to 5 years)

• getting a Depo Provera injection every three months

• external condoms (that go over the penis)

• internal condoms (that go inside the vagina or anus)

• the copper IUD (inserted into your uterus by a trained nurse or doctor – this can last up to 10 years)

• tubal ligation (an operation to cut, block, or remove your fallopian tubes)

• hysterectomy (an operation to remove your uterus)

If you have unprotected sex, you might want to use emergency contraception to prevent pregnancy.

Maybe the condom broke, you didn’t use one, or you forgot to take your pill.

There are two forms of emergency contraception available in Aotearoa: the emergency contraceptive pill (ECP) and the copper IUD.

Neither the ECP nor the copper IUD will interfere with T. But both the copper IUD and the ECP can cause unscheduled bleeding.

If you have a uterus and ovaries, all types of contraception can impact your bleeding. Some bleeding is possible even if you’re on T and don’t normally bleed. This can be lighter or heavier, more frequent, or less frequent than usual periods. Your nurse or doctor should talk with you about how any contraception might impact you, but if they don't, make sure to ask them.

At Sexual Wellbeing, we offer a non-judgemental and welcoming environment where we can kōrero about the best contraception option for you. This includes options that stop your period.

If you want to start contraception to stop your period – or for any other reason than to prevent pregnancy – you’ll need to talk to a doctor first.

We can’t prescribe GAHT or T. Find out more about GAHT from Gender Minorities Aotearoa.

Make an appointment