Pratisandhi

Queer Contraceptive Care: Are You Covered in the Spectrum?

Discussions on contraception have primarily been focused on cisgender, heterosexual partnerships in the field of reproductive health. However, it is critical to realise that queer people, with their different gender identities and sexual orientations, require access to contraception tailored to their specific requirements. This blog will attempt to shine a light on the necessity of contraception for queer people, investigate the various methods, and address the issues they may face

RIT Reporter

Diverse Contraceptive Needs

As we mentioned before, Hormonal birth control is advertised to cis-het women predominantly. LGBTQ+ people might take birth control to avoid unplanned pregnancy but also to ease period symptoms, control their cycles, control hormonal imbalances and acne or stop their periods altogether to help with dysphoria. 

 

People often think there is no need for contraceptives for LGBTQ+ people since there is no risk for pregnancy between same-sex relations but sex and gender are two different things and unplanned pregnancy continues to be a risk for anyone with a uterus who has sex with partners who can produce sperm. 

 

Statistically, there’s a huge chance of trans men and non-binary people getting pregnant accidentally because there’s still a myth about people taking testosterone losing the ability to get pregnant and becoming infertile. But the truth is that testosterone may stop ovulation but it doesn’t make the eggs inside the ovaries disappear and the menstrual cycle can continue and they will be able to conceive again if the person stops taking testosterone. 

Healthline.com

What are current contraception methods available?

There are 3 types of birth control available in the market –

  • Hormonal implants – This is less accessible because it needs a doctor for implantation. It might not suit everyone since it is a small, plastic rod that is fitted into the upper arm, just under the skin, only for people with ovaries but it’s a longer solution to prevent pregnancy also known as the ‘fit and forget’ option since it lasts for 3- 10 years (depending on which kind of implant) and is proven to be 99% effective. The implants are categorised under the name of LARC (long-acting contraception). 

There are IUDs (Intrauterine devices) that is a T-shaped piece of plastic that needs to be inserted into the uterus by a doctor which stops ovulation, thickens cervical mucus and thins the lining of the uterus. It only releases progesterone which can be removed anytime, doesn’t have big side effects and lasts for 3-7 years. 

Non-hormonal IUD (Copper coil), on the other hand, uses copper instead of progesterone which changes the cervical mucus, making it more difficult for the sperm to reach the eggs during ovulation, this can have big side effects and lasts for 5-10 years. There are also contraceptive injections and patches available where progesterone is injected to work the same as IUDs but it only lasts up to 3 months a dose and has big side effects as well.

 

  • Hormonal Pills – It’s the most common form of non-permanent contraception. You need to consult a doctor before taking any since it may cause side effects like depression, anxiety, longer periods and low sex drive to name a few and may clash with things like HRT or puberty blockers. There are COCs (Combined Oral Contraceptives) which are a combination of artificial estrogen and progesterone and work the same way as IUDs to prevent pregnancies, it has timed doses every day with built-in seven-day break which can cause withdrawal bleeding similar to a period. Minipill works the same as the COC but without estrogen, it also has to be taken without breaks as well to be effective. 

Barrier methods – It’s the best option because it protects from both pregnancy and STIs. One must still use barrier protection even when they are taking hormonal birth control because of the STI risk. Condoms are an effective option because they can be used externally for Penetrative Sex. Flavoured ones are meant to be used for oral sex only. They can also be used for sex toys as well to prevent the spread of STIs. (There are latex-free options as well if the person has a latex allergy). Other than that, there are Femdoms which are used internally for Penetrative Sex, Dental Dam, which is used during Oral Sex and Oral to Anal Sex and Surgical Gloves which can be used for fingering.  

Other than those options, tracking ovulation and menstrual cycles can help queer individuals with uterus-based reproductive systems avoid or achieve pregnancy in case they can’t take hormonal contraceptives for any reason. This method does require consistent monitoring and education. In situations where regular contraception fails or is not used, emergency contraception (the “morning-after pill”) can be considered within a few days of unprotected sex but to truly protect yourself from STIs as well, barrier methods still need to be used even if the people participating are infertile. 

 

Surgical Sterilisation can also be a practical step since some trans individuals opt for bottom surgery (Genital Reconstructive Services) to help with their gender dysphoria. For transfeminine people, it can mean having Orchiectomy and/or Vaginoplasty surgery whereas for transmasculine people, it can mean having Phalloplasty, Metoidioplasty, Salpingo-oophorectomy, Vaginectomy and/or Hysterectomy surgeries. Some may even choose permanent contraception through procedures like tubal ligation or vasectomy, depending on their anatomy and reproductive goals since not everyone opts for bottom surgery because it can be a highly invasive and expensive procedure. 

 

Challenges and Solutions

Accessing contraceptives can be complex for queer individuals, especially those in less accepting environments, as they might lack information about contraception options. Fear of discrimination or misunderstanding in healthcare settings can discourage queer individuals from seeking contraceptive care. Queer-affirming healthcare providers and LGBTQ+-friendly clinics can help create a safe space by offering comprehensive information about the impact of contraceptives on gender-affirming treatments, such as hormone therapy, and offer personalised solutions that align with an individual’s medical journey. Using gender-neutral and affirming language in contraceptive discussions also ensures that queer individuals feel respected and understood during their healthcare interactions.

Conclusion

In the pursuit of comprehensive reproductive healthcare, it is imperative to recognize that the spectrum of gender identities and sexual orientations extends to birth control needs as well. It is all about figuring out what works best for your needs, preferences and goals even if the first contraceptive you try isn’t for you. Queer individuals deserve access to information, resources, and healthcare services that are tailored to their unique requirements. Medical professionals need to be able to use their expertise to help you explore your options until you find an alternative since birth control is meant to make your life easier, after all!

Author

Browse by Category