I’m Trans. Do I Need Birth Control?

Image from Bedsider

Image from Bedsider

All pregnancies require 4 things to get going: a uterus, an egg, a sperm, and for the egg and sperm to come together.  

Just like cis-gendered people, not all trans people use birth control to prevent pregnancy. There are important things to consider before waging your chances of getting pregnant. As Juno Obedin-Malvier, MD, explains, pregnancy depends on “what equipment you’ve got, what you’re doing with it, who you’re doing it with (and what they’ve got), and whether pregnancy is a goal or not”.

Here are important points about the possibilities of getting pregnant for trans people:

  • Testosterone isn’t both control. For many trans men, taking testosterone may halt the menstrual cycle. However, testosterone doesn’t complete end egg production from the ovaries and some trans men have gotten pregnant even without a period.
  • Birth control methods available for cis-women are equally effective for trans men.
  • Likewise, estrogen is not birth control. Trans women who take estrogen and have a penis and testicles can still get their partner(s) pregnant.
  • Condoms are a great option for trans women. Plus they are the only form of protection that helps prevent STIs and pregnancy.
  • There are many health care providers that specialize in the trans community. Check out the resources at the bottom of this article.

This article by Juno Obedin-Maliver was originally published at Bedsider.

BY BEDSIDER | Bedsider.org

Do trans people need to use birth control? Well, it all depends. It depends on what equipment you’ve got, what you’re doing with it, who you’re doing it with (and what they’ve got), and whether pregnancy is a goal or not.

For any readers who aren’t familiar with the terminology, here’s a primer. Briefly, being transgender (“trans” for short) is about living in a gender that is different than the sex you were born with. Being cisgender is about having that sex and gender line up. Whether one needs birth control depends on what sex you were born with and what sex your partner was born with.

Transgender folks and cisgender folks come in all shapes and sizes. But everyone—no matter whether they identify as a transgender man, transgender woman, man, woman, or another identity—is born with only one set of gametes (if any). Gametes are the cells from two different people that come together to make a baby. For humans, gametes come in two types: the sperm type and the egg type. And all pregnancies require at least four things to get going: a uterus, an egg, sperm, and for the egg and sperm to come together.

Trans men

(FTM, or folks who were assigned female sex at birth and identify on the male gender spectrum)
For those guys who were born with a uterus and ovaries (where eggs are made), if you still have those parts, you can get pregnant. So, if you’re doing someone who has a sperm delivery system (a penis and testicles) you have to think about the possibility that you could get pregnant.

Many, but not all, trans men use testosterone (T). For most, that stops the monthly visit from Aunt Flo. But that doesn’t necessarily mean you can’t get pregnant. Some trans men have gotten pregnant even when they weren’t having their periods and were still taking testosterone. How is that possible? Well, testosterone doesn’t completely stop egg production, so some guys will still release eggs even on T and even without a period. In other words, T isn’t good birth control.

So if getting pregnant isn’t in your plan, what are your options? All the methods that cisgender women may consider are also good options for trans guys. You should talk about them with your health care provider, who can help you tailor the method to your needs. If you want to get pregnant, you should also talk with your provider because there are things you can do to make sure you’re as healthy as possible before you do.

Trans women

(MTF, or folks who were assigned male at birth and identify on the female gender spectrum)
For those gals who were born with a sperm delivery system (penis and testicles)—if you still have those parts and your partner has a uterus and ovaries, you can get them pregnant. Many trans women think that if they are on estrogen they can’t get another person pregnant, but that’s not true. Though it may be harder to get an erection, make sperm, and ejaculate when you are on estrogen, it’s not impossible.

So if you and your partner have the equipment to get pregnant but don’t want to be, you’ve got to think about birth control. All the things that cisgender men think about for contraception are on the table. Condoms are especially cool because they protect against both sexually transmitted infections and pregnancy.

If you want to have kids and you’ve got sperm, you should talk with your health care provider—ideally before starting estrogen—about saving those spermies for a rainy, pregnancy-desiring kind of day.

Finding good care

If you want to talk to a health care provider about any of these issues and don’t already have one you trust, check out the providers on this list. If you’re in one of the following cities, you can go to a health center that specializes in care for the trans community:

Baltimore : Johns Hopkins Bayview Medical Center

Boston: The Fenway Institute

Chicago: Center for Gender, Sexuality and HIV Prevention at Ann & Robert H. Lurie Children’s Hospital, the Howard Brown Health Center

Cleveland: The PRIDE Clinic at MetroHealth Medical Center

Los Angeles: The Los Angeles LGBT Center

New York: Callen-Lorde Community Health Center

Philadelphia: The Mazzoni Center

San Francisco: Lyon-Martin Health Services, the Tom Waddell Health Center, the Asian and Pacific Islander Wellness Center

Washington, D.C.: Whitman-Walker Health

There are also Planned Parenthood clinics—like the ones listed here under “What health services”—that have providers who can help trans folks with general health questions, as well as birth control questions.

condom ad condoms too loose

bedsiderBEDSIDER is an online birth control support network for women operated by The National Campaign to Prevent Teen & Unplanned Pregnancy. Bedsider is totally independent (no pharmaceutical or government involvement). Honest and unbiased, Bedsider’s goal is to help women find the method of birth control that’s right for them and learn how to use it consistently and effectively, and that’s it.
Find Bedsider on twitter @Bedsider

Should You Provide Sexuality Education to Your Patients?

Photo credit: Eva Blue

Photo credit: Eva Blue

It is a rare thing these days to receive comprehensive sex education from a health care practitioner. When it is offered, it’s typically limited to the health of sex organs. However, as Melanie Davis explains in the following article, sex and sexuality go beyond the biological. Crucial aspects of sexuality that influence one’s individual choices are often overlooked by health care providers- such as one’s degree of autonomy as well as knowledge about safer sex tools.

The article speaks to health care providers and offers concrete examples of how sexual health envelops aspects about identity, relationships, and intimacy- all of which impact a person’s overall health.

This article was originally published here.

BY MELANIE DAVIS, PhD | MelanieDavisPhD.com

Physician involvement in sexuality education began in 1904, when dermatologist Prince Morrow, MD published Social Diseases and Marriage. His goal was to protect women whose husbands were bringing home sexually transmitted infections (then called venereal disease) from sex workers.

Sexuality education and medicine became more enmeshed when other physicians and the American Purity Alliance joined Morrow’s work to reduce STIs as a way to promote sexual morality. Today, healthcare providers don’t usually discuss sexual morality with patients, but you are an important source of information about sexuality.

Sexuality education is a lifelong process of acquiring information and forming attitudes, beliefs, and values about identity, relationships, and intimacy. Sexual health and decision making are critical aspects of sexuality education, and you may have more opportunities to educate patients than you may realize.

The Breadth of Patient Sexuality

If you limit your exam room consultation to discussions of the function and health of sexual organs only, you risk missing out on information that could have an impact on a patient’s sexual health and overall wellness. There are five categories of sexuality that comprise every person’s sexual being:

  • Sensuality = awareness, acceptance and enjoyment of our own or others’ bodies.
  • Intimacy = the degree to which we express and have a need for closeness with another person.
  • Sexual identity = how we perceive ourselves as sexual beings in terms of sex, gender, orientation, expression.
  • Sexual health and reproduction = attitudes and behaviors toward our health and the potential consequences of vaginal, oral, and anal intercourse.
  • Sexualization = using sex or sexuality to influence, manipulate, or control others.

The area of sexuality in which healthcare providers address most often is sexual health and reproduction for two reasons: 1) It is where most acute medical issues fall, and 2) There are fewer gray areas that can be time-consuming to discuss. However, the other areas of sexuality are less concrete but equally important to discuss, as these examples illustrate:

  • Patients may avoid sexual intercourse or masturbation because they believe genitals are ugly or shameful.
  • Patients may not experience sexual pleasure because they don’t understand their sexual anatomy or the sexual response cycle.
  • A partner’s turn-ons may hurt your patient emotionally or physically.
  • A patient may be struggling with gender identity or sexual sexual identity.
  • A patient may be too embarrassed to disclose sexual coercion/abuse.
  • Research shows that patients often fear being judged by their providers or being embarrassed, so they may not bring up their concerns. Be sure to open the door to conversations about sexuality — One quick way to begin is to ask, “If there were anything you would change about your sex life?”

Contact me if you’re interested in learning more about essential, yet easy educational conversations you can have with patients about sexuality.

melanie_davisMELANIE DAVIS, PHD, consults with individuals and couples to help them build sexual knowledge, comfort, and pleasure through the New Jersey Center for Sexual Wellness. Through her firm Honest Exchange LLC, she provides professional development in sexuality. She’s a popular speaker on self-esteem and body image, and the sexual impact of cancer, menopause and aging. She’s an AASECT-Certified Sexuality Educator. On Twitter @DrMelanieDavis

Reacquainting With Condoms After 11 Years On The Pill

Switching to condoms as one’s only birth control at 30 years old can be a dramatic shift in mindset from the comfort of quick-fix Pills to latexy shopping adventures with a partner. Here, Rose Crompton from the Condom Monologues collective shares her dramatic contraceptive story that spans over a decade, told in 1000 words.

Here are some things she’s learned along the way:

  • Throughout life, every person should take the time to reflect and re-evaluate their contraceptive choices as their body changes.
  • There is important knowledge about condoms that’s not taught in sex education, such as the importance of fitting and experimenting with different brands and types. There are condom sampler packs to guide your discovery of the best condoms for you and your partner(s).
  • If there is an opportunity to shop for condoms with your partner then you should. It can be like an extension of foreplay!
  • Shopping online provides way better selection and price.

This piece is originally published here.

BY ROSE CROMPTOM at CONDOM MONOLOGUES | CondomMonologues.com

“Which ones should we get?” I asked my boyfriend. Well, he’s a man and he’s the one that has to wear them, so naturally I assumed he’d know best. “I dunno,” was the mumbled response. I’d not been “hat” shopping in over a decade. For nearly 11 years I was on the Pill and in three monogamous relationships, for the majority of that time, so ‘safe’ meant not getting pregnant.

Standing there, facing a wall of johnnies, there were three main changes I noticed: the packaging of condoms 11 years on was nicer, there were brands other than Durex available, and the price was higher. No wonder the supermarket kept them in security boxes. Ten quid ($16) for 10 condoms, so a pound a fuck essentially, and me and my boyfriend fuck a lot. Giving up the Pill was apparently going to cost me in more ways than I expected!

That said, coming off the pill four months ago was one of the best decisions I’ve made and I’d like to state that this was what was right for me, not what every woman should do, although I do think every woman should take the time to stop and re-evaluate their contraceptive method as their body changes.

The biggest question I’ve faced since is what contraception should my partner and I use instead?

Long term, that’s still a frustrating debate I’m having with myself, my partner and sexual health advisers. For now though, my chap and I are only using condoms and that is how I found myself: Standing in Tesco adding ‘condoms’ to our weekly, big shop shopping list.

Just call me Goldilocks

After much deliberation we went for the clichéd ribs and dots for her pleasure style. You have to start somewhere. They were good, but not quite right. If we’re being honest (and I think we can be here) too much dotting and ribbing can lead to chaffing.

Thankfully, there’s more to safe sex-life than that one style and so the hunt began online to try something new. Scouring the sites we found a ridiculous number of options. Without wanting to sound too Disney about it, there was a whole new world opening up before my eyes. Previously my experience of condoms had been whatever was free and easy to grab from the GP or sexual health clinic as they were only ever used briefly when there was a Pill glitch.FlyingCarpetCondomsAnim

Now though, scouring the various sex e-tailers, there was this whole exotic, rubbery, latex fantasticness that had the potential to be a lot of fun. Maybe shopping for condoms would be a great, new, sexy part to our foreplay?

We came across an American brand called One and they had an interesting pack called Tantric with tattoo style patterns and extra lubrication. Oh, they sound fancy and you can never have too much lube, so we ordered some.

It wasn’t long before the boyfriend and I found ourselves back online, looking for something different the next time. We “um-ed” and “ah-ed” over the various boxes, brands, descriptions, shapes and textures for nearly as long as we’d spend trying to pick a nice bottle of wine to go with dinner.

Obviously, sex is a shared experience and if there is the opportunity to choose together, then you should. Like with any aspect of sex you should both get enjoyment out of what you’re using. There aren’t very many things that we put on our bodies that are as intimate as condoms. It’s going on his most sensitive area and in hers, so when it comes to condom shopping it’s important to find some rubbers that you’re both gonna’ love. Generally, that means experimenting.

Getting comfy with condoms

Through shopping around, I’ve learnt more about condoms in the last four months than I ever learnt at school, or was bothered to listen to after that, because they just weren’t relevant to my life. It’s a bad attitude to have, I know. It’s shocking how the “fit and forget” or pill-popping culture we have today means it’s easy to overlook the humble condom. Especially when you’re in a relationship that uses one of the aforementioned methods.

It’s been a re-education: I’m aware now about the importance of fit and how that effects sensation and minimises the risk of breakage, the safest way to take them off to avoid any ‘accidents’ and I’ll admit that I’m still perfecting my roll on method (anything billed as ultra thin is definitely the trickiest).

The biggest adjustment (and I don’t reckon I’m the only woman who’s come off the Pill to feel this) is becoming confident with the idea that condoms can keep me safe. Not from STDs as that’s not an issue in my relationship, but of pregnancy. A lot of people my age and a bit older seem keen to use Fertility Awareness Methods and the pull-out method, but for many of them pregnancy wouldn’t be so much of a disaster. For me and my boyfriend, it certainly would be.

Making the move from the pill to condoms is scary. Anything you get fitted, implanted or swallow every morning has a success rate of approximately 99 percent. Sure, there are some side effects, but you’re willing to put up with them because it’s a shared ideology that now we have these methods, why bother with condoms that have a slightly lower success rate at all if your aim is to not get pregnant?

Living with that mentality for over a decade, then changing what you use and your body changes too, is a lot to get your head around, but it is doable. On the plus side, not only has it led me to take another look at the whole contraceptive menu – not just what the GP would prefer me to use – but it’s made me and my partner look again at correct condom use and I don’t think it’s a bad thing for any couple to do that no matter how long they’ve been together.

This monologue was written by Rose Crompton (@RoseC_Liec). Monologues are independent stories. The opinions shared are the author’s own. Go here for more monologues.

 

condom-monologuesCONDOM MONOLOGUES Affirming safer sex and sexuality one story at a time… Condom Monologues dispel harmful myths about safe sex and sexual stereotypes that permeate our ways of understanding what is “healthy sexuality”. They accomplish this through sex-positive, pleasure-focused approaches to sexuality that affirm the diversity of people- genders, sexualities, kinks and relationships.
Find them on twitter @CondomMonologue. Share your story

Shaving and STIs: How to Minimize Risk of STI Transmission

rose

Do you wax, shave or trim your pubic hair? Even if you prefer the wild bushy look, this post by Jenelle Marie, is relevant to you because everyone, regardless of preferences, should be able to make informed decisions about their bodies. Yet medical facts about shaving and how to manage the risks involved tend to get muffled among all the summer party and craze.

The fact is, genital hair has biological purpose. It acts as a barrier to protect abrasions caused by rubbing and friction. When hair is removed it opens up your skin and forms microscopic entry points for STIs and other pathogens.

But let’s be clear: We are not advocating for or against pubic perfection. As Jenelle Marie states, what you do with your body is your own business.

Here we share her article about important medical factors to consider and the ways to manage risks of shaving.

Here are points to remember:

  • Any kind of hair removal can increase one’s risk of contracting STIs.
  • Some professional services reuse the waxing spatula or do not change the wax often enough, both of which violate health codes and can spread bacteria.

Here is Jenelle Marie’s list of what you can do to reduce your risk and shave safely.

The original post is featured on The STD Project.

BY JENELLE MARIE | theSTDProject.com

So, how do you achieve pubic perfection without winding up with an unwanted infection?

Here’s a list of things you can do to minimize inflammation, microscopic cuts, abrasions, and your overall risk of contracting or transmitting STDs:

  • Consider shaving or waxing less of the area you previous manicured or less often
  • Apply hydrocortisone cream or an OTC antibiotic cream after your maintenance routine
  • Only book professional services at salons with fully licensed estheticians and stringent health policies, like soaking tools in hospital-grade disinfectant between procedures
  • Apply pure aloe vera to freshly shaven and waxed areas to speed healing time
  • Don’t shave, wax, etc. directly before engaging in sexual activities – allow time for your body to heal the small wounds that occur but are not always noticeable to the naked eye
  • Always use fresh, clean and sharp razors
  • Moisten the area before shaving with warm water to help soften hair follicles

Yes, you can have the lightning bolt or landing strip of your dreams, but be smart, aware of your risks, and consider some additional steps to negate your risk of infection.

1533882_446848112083407_2051712922_n THE STD PROJECT is a multi-award-winning independent website and progressive movement eradicating STD stigma by facilitating and encouraging awareness, education, and acceptance through story-telling and resource recommendations. Fearlessly led by Founder, Jenelle Marie, The STD Project is committed to modern-day sexual health and prevention by advocating for conscientious and informed decisions. Find them on twitter @theSTDProject

Hello, Birth Control!

Image from Bedsider

Image from Bedsider

All of us who need birth control want to find the right method that fits perfectly in our lives. Each of us have different needs, and those needs change throughout life. Thankfully, there are many effective methods to choose from today. Before you start deciphering between different brands, you should first look at what method are available. Take into consideration your lifestyle, personality, self-agency, sexual relationships and health history. It’s important to match the right method with all these aspects.

Because when it comes to birth control, you’ve got a lot to choose from.

Some health care providers divide methods up into 10 to 12 choices. Bedsider, however, has one of the most accessible schemes, breaking down birth control options into four simple categories.

This post was originally published here.

BY BEDSIDER | Bedsider.org

Birth control may seem like a modern idea, but it’s actually been around for thousands of years.

They say women in ancient Egypt used crocodile dung suppositories to avoid pregnancy. (Um… ew!) Condoms made of animal intestines were used in Europe as early as the 17th century. And guys have been “pulling out” for as long as anyone can remember.

Lucky for us, there are lots more effective methods to choose from today. And remember, if a certain method doesn’t fit your life or your body, it’s easy to find another one that will.

Hormonal Methods

There are a bunch of hormonal methods out there—not just the pill. There’s the ring, the patch, the implant (or Implanon), and the shot (Depo), too. All of them release hormones into your body, but they work in slightly different ways. Check out their individual pages to learn more.

Intrauterine Devices

Okay, first of all, “Intrauterine Device” is a horrible name for a really effective method. Intrauterine just means “in the uterus.” IUDs are little, t-shaped pieces of plastic (some also contain copper) that get put in your uterus to mess with the way sperm can move and prevent them from fertilizing an egg. Sounds odd, but they work like a charm.

Behavior-Based Methods

“Pulling out,” or withdrawal, is a method of birth control. So are Fertility Awareness-Based Methods (which means observing your body and counting the days of your cycle to figure out when you’re fertile). Both methods work better than nothing, but before you rely on one of them, consider this: These methods take a lot of self-control and 100% consistency on the part of both partners. Like, A LOT. You can’t say “just this once” and you can’t have any “oops” moments.

Barrier Methods

These methods literally block sperm from getting to the egg. The male condom is a perfect example. There’s also the diaphragm, the sponge, the female condom and the cervical cap. (Some of these have to be used with spermicide, which is a barrier method itself.) The only tricky bit with barrier methods is that you have to remember to use them every time you have sex. And sometimes, when you’re in the heat of the moment, finding a condom is the last thing on your mind.

 

bedsiderBEDSIDER is an online birth control support network for women operated by The National Campaign to Prevent Teen & Unplanned Pregnancy. Bedsider is totally independent (no pharmaceutical or government involvement). Honest and unbiased, Bedsider’s goal is to help women find the method of birth control that’s right for them and learn how to use it consistently and effectively, and that’s it.
Find Bedsider on twitter @Bedsider

5 Things I’ve Learned from Teaching People about Sex

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BY KATE MCCOMBS | KateMcCombs.com

Even before I got my first formal sex ed job, I was teaching friends about how to use safer sex methods.

Like most Americans, I didn’t get much in the way of sex ed in school, so it was up to my budding sex geeky research skills to get information I needed on my own. With this knowledge, I became an unofficial peer educator, sharing what I knew with friends (and even their friends) at after-school hangouts and parties.

In college, I became an official peer educator and continued teaching about safer sex and birth control, this time in one-on-one counseling sessions and workshops. It was a great training ground for the sex ed career I have now where I specialize in educating adults about the intersections of health and pleasure.

Through the research I did during my masters of public health, workshops and lectures I’ve taught on two continents, and through years of causal conversations with folks about their sex lives, I’ve learned five key things from teaching people about safer sex

1. Health and pleasure are not mutually exclusive.

The single most common reason people give for not using condoms is that it “doesn’t feel as good.” There is some reality to barriers diminishing sensation for some people, but the research doesn’t back up the claim that it ruins sex. In a study carried out by Indiana University, they found that on the whole, people’s sexual pleasure and satisfaction were not diminished by condom use.

There are many things people can do to increase their pleasure and satisfaction during sex, regardless of whether barriers are used. For some people, using barriers allows them to relax more fully, which increases their enjoyment of the overall experience.

2. Finding the right lube is paramount.

I am a lube evangelist and I still marvel at how many people aren’t aware of the benefits of using lube with condoms. Lube helps transmit more sensation, reduce uncomfortable friction, and keep condoms form drying out. It’s also handy to have around for other types of pleasure, like mutual and solo masturbation.

Not all lubes are created equal. Finding a formulation that feels best to you and your partner’s body is essential and experimenting with lubes can be a fun thing to sex lab too.

3. One size does not fit all.

I remember one of the first times I saw someone teach how to put on a condom. The educator stretched a condom over his whole arm and said, “No one is this big!” and that men who complained that condoms were too tight are just making it up. This is neither helpful nor true.

Condom fit is hugely important in pleasure and safety. A condom that’s too tight can break more easily and a condom that’s too loose can slip off. A bad fit can make using barriers less pleasurable too. Get a sampler pack from Lucky Bloke and find one that fits you like a glove.

4. Communication is key.

For many people, talking about sex at all can be really challenging – especially with the people they’re having it with. Learning to talk, listen, and learn about sexuality is a key adult skill, but there are few opportunities for people to learn the things about sex that help build an amazing, healthy sex life.

Having meaningful conversations about sex with our peers can be great practice for having challenging conversations within our romantic relationships. By fostering curiosity, learning compassion, and creating safe spaces within our relationships, we can more easily negotiate the kind of pleasure and health we desire.

5. It’s important to meet people where they’re at.

Early in my sex ed career, I was very absolutist in my opinions about condoms. People should just wear them! As I’ve listened, learned, and taught more, it’s become clear to me that this message doesn’t land with some people. It’s not empathetic and it doesn’t reflect understanding of the complexity of people’s feelings and desires.

All humans make calculated risks and meeting people where they’re at to help them reduce their risk is a more fruitful strategy then telling them what they “should” do. What I can do is give people information and support them in making choices that align with their health goals.

 

kate_mccombs

KATE MCCOMBS is a NYC-based sex educator, writer, and maker of puns.
Ultimately, all of Kate’s work is about helping people feel more comfortable talking about sex. She believes that meaningful conversations + accurate information can help us create a healthier and more pleasure-filled world. Kate writes articles and teaches workshops about sexual health, pleasure, and communication.  Follow Kate on Twitter @katecom