International Journal of
Nursing and Midwifery

  • Abbreviation: Int. J. Nurs. Midwifery
  • Language: English
  • ISSN: 2141-2456
  • DOI: 10.5897/IJNM
  • Start Year: 2009
  • Published Articles: 212

Review

A review of contraception and gender-affirming care

Alex Dworak
  • Alex Dworak
  • Department of Family Medicine, OneWorld Community Health Center, Omaha, Nebraska, University of Nebraska Medical Center, Omaha, Nebraska United States.
  • Google Scholar
Courtney Allen Cowardin
  • Courtney Allen Cowardin
  • Women’s Health Center, OneWorld Community Health Center, Omaha, Nebraska, United States.
  • Google Scholar
Lena Mininberg
  • Lena Mininberg
  • Women’s Health Center, OneWorld Community Health Center, Omaha, Nebraska, United States.
  • Google Scholar
Melanie Menning
  • Melanie Menning
  • Department of Family Medicine, OneWorld Community Health Center, Omaha, Nebraska, University of Nebraska Medical Center, Omaha, Nebraska United States.
  • Google Scholar
Peter Schindler
  • Peter Schindler
  • Department of Family Medicine, OneWorld Community Health Center, Omaha, Nebraska, University of Nebraska Medical Center, Omaha, Nebraska United States.
  • Google Scholar


  •  Received: 31 August 2023
  •  Accepted: 04 October 2023
  •  Published: 30 November 2023

Abstract

There are estimated to be more than 1.6 million transgender and gender-nonconforming individuals ages 13 and up in the United States. Many individuals who identify as trans or gender-expansive never received adequate contraceptive counseling. Certified Nurse Midwives play a crucial role in primary reproductive health care in many settings, particularly underserved settings. A patient's wants, needs, and goals should be discussed before choosing a contraceptive option. Several contraceptive options for transmasculine, transfeminine and non-binary populations are available. The same contraceptive options available for cisgender females should be available to transmasculine individuals. The same contraceptive options for cisgender males should be available to transfeminine individuals. Contraceptive options should not be dismissed based on a person's gender. Population-specific contraceptive recommendations are provided. Throughout the article, there are recommendations on approaches to help inclusivity and reduce barriers for non-cisgender persons. A modified algorithm to aid in contraceptive counseling for all persons is presented. Several innovative contraceptive methods are being developed that focus on fertile persons with testicles. Providing accurate, compassionate, and individual contraceptive counseling to all persons can help reduce barriers and prevent unwanted pregnancies. 

Key words: Transgender health, Gender-expansive, contraception, family planning, clinical decision-making algorithms.