I’m AMAB—Can I Use Birth Control As Hormone Replacement?

For way too long, our society has been content to assume that hormonal birth control is only for one specific type of person: a straight, cisgender female in a heterosexual relationship. We know better now—just look at our Birth Control Is For Every Body blog post for examples of who else uses birth control. However, there’s still a ton of confusion out there about what birth control does for the LGBTQIA+ community; specifically, how birth control can be used by transgender individuals.

In fact, one of the most common questions we get is whether patients who are assigned male at birth (AMAB) can use hormonal birth control as hormone replacement therapy (HRT). After all, the pill has estrogen, right?

In short, no—but we do have some helpful options and online resources for you to explore. Let’s dive in.

What is transgender/nonbinary hormone therapy?

Hormone therapy is a common way for patients to affirm their gender identity by using synthetic hormones to produce secondary sex characteristics that match their gender. There are two forms of transgender/nonbinary hormone therapy (also known as gender-affirming hormone therapy): Feminizing Hormone Therapy and Masculinizing Hormone Therapy. 

Feminizing Hormone Therapy (MtF) is used to produce feminine secondary sex characteristics. Patients undergoing this therapy are given medication to reduce the level of testosterone (a male hormone) while yielding enough estrogen, or estradiol, to allow feminine characteristics to develop. 

On the other hand, for Masculinizing Hormone Therapy (FtM), the patient would be given testosterone, which will cause masculinizing changes to occur. Think growing facial hair, your body fat redistributing, and your voice getting deeper. It’s kinda like going through puberty, TBH.

Can transgender men use birth control?

Well, it depends. Transgender men (men who have a uterus and ovaries) can get pregnant. A transgender man who’s sexual partner(s) has male reproductive organs, might want to consider contraceptive methods to avoid unwanted pregnancies. 

Some transgender men might also use birth control as a gender affirming tool. For example, it might be distressing to get a period every month, so a transgender man might take birth control to skip their period or reduce PMS symptoms. And of course, a transgender man with PCOS or endometriosis might choose to take birth control to help manage their symptoms. 

Here’s the but: more study is needed to understand the efficacy and effectiveness of hormonal contraceptive methods in transgender men who are undergoing testosterone therapy. So for that reason, SimpleHealth is not able to provide contraception to anyone on gender-affirming hormonal therapy. It’s important to disclose your fertility goals and preferences to your in-person provider, and our doctors know how important it is to understand your whole life when deciding on a plan for your reproductive health.

Why can’t I use birth control for Feminizing Hormone Therapy (MtF)?

Birth control pills or other contraceptive methods with estrogen are not considered as a form of Feminizing Hormone Therapy. That’s because the dosage for contraceptive medication is different from the dosage prescribed for estrogen therapy and does not include the testosterone blocker component. So in short, it wouldn’t do anything for your gender affirming goals.

Taking the accurate medication prescribed by a trained medical provider will allow the effects of Feminizing Hormone Therapy to materialize. We recommend going to an endocrinologist or trying out getplume.co to get the tailored care you deserve.

Why is SimpleHealth unable to provide transgender/nonbinary hormone therapy to me?

At SimpleHealth, your safety is our top priority, and we want to make sure you’re receiving the appropriate treatment. Hormone treatment is individualized and should be monitored by an appropriately-trained medical provider who can provide you with the necessary education, counseling, and medical evaluation. 

Feminizing and masculinizing hormone therapy each have a variety of medical risks that we don’t take lightly. We believe it’s important for you to seek in-person care where a doctor can create a customized plan specifically for you—you are worth it.

How does SimpleHealth support trans and nonbinary patients?

At this time, we’re able to work with trans and nonbinary patients who are *not* undergoing hormone therapy and have not undergone surgical transition. In these circumstances, our doctors will want to ask a variety of follow-up questions before deciding what kind of contraceptives to prescribe you.

If you’re currently on gender-affirming hormonal therapy, or if you’ve undergone surgical transition (like a hysterectomy, an oophorectomy, the removal of uterus or ovaries, or bottom surgery), we unfortunately won’t be the best fit for you at this time. However, we can help point you towards other resources that can help you on your reproductive health journey. 

What are some resources I can access for gender affirming hormone therapy?

We recommend visiting the National Center for Transgender Equality, Human Rights Campaign Foundation, and World Professional Association for Transgender Health for more information regarding transgender health. Through these trusted organizations, you can find a gender affirming doctor that will help you realize your fullest expression of your identity.

Sources

Hormone therapy for transgender patients
Feminizing hormone therapy
Masculinizing hormone therapy
Contraception Journal
Transgender Medicine: Essentials for the Primary Care Provider 
Get Plume
National Center for Transgender Equality
Transgender Patient Services & Support: Resources for Providers and Hospital Administrators
WPATH