MedStar Investigators Conduct Observational Research Study on Family Planning in the Transgender Community

Physician speaking with male patient in clinic room

Recent collaborative research sought to understand the contraceptive practices and fertility plans among transgender men. The study sought to address a gap in literature for family planning for individuals assigned female at birth and self-identified along the masculine spectrum.

The research team from MedStar Washington Hospital Center, MedStar Health Research Institute, Children’s National Health System, and the Mazzoni Center found that transgender men experience unintended pregnancies, as well as future fertility desires, after transitioning and there is a lack of ongoing reproductive healthcare education for this unique population. “Family Planning and Contraception Use in Transgender Men” was published in Contraception. The research team was Alexis Light, MD, MPH; Lin-Fan Wang, MD; Veronica Gomez-Lobo, MD; and Alexander Zeymo.

The goal of the research was to identify the current family planning practices and pregnancy desires within the transgender men population. The study utilized an anonymous online survey that was distributed at six LGBT health centers throughout the United States, 26 transgender healthcare providers, and 14 online listservs and Facebook groups for transgender men. The survey included questions regarding general health, fertility desires, use of testosterone, contraceptive use, and pregnancy history.

Analysis from 197 respondents concluded that participants who had never taken hormones were nearly three times more likely to have been pregnant than those who have taken testosterone. A majority of the study participants had the desire to become parents, while a significant group of participants was afraid of not achieving the desired pregnancy. Surprisingly, for those that were not afraid of pregnancy, 51% reported that their healthcare providers had not asked about their fertility desires. The majority of men reported using, or had used, contraception options that included condoms, pills, and intrauterine devices.

The study concluded that transgender men use contraception, experience pregnancy, and have abortions, even after transitioning. The results also display the need for counseling and ongoing care of healthcare providers to transgender men regarding reproductive health, including contraceptive and conception counseling. Further research is needed to assess fertility desires, contraceptive effectiveness, and unintended pregnancy to develop best practices for family planning and pregnancy desires in the transgender men community.