I’ve been thinking about getting birth control for awhile but I don’t know what kind to ask for and as a trans person, clinics make me uncomfortable, so I want to be prepared. I’m really bad at taking pills every day, I don’t want anything with estrogen in it, and I’d like to not bleed every month. Is there anything out there for me?
Yes! Birth control is one of the most globally sought-after prescriptions, for many reasons other than contraception. There are lots of options other than pills, and plenty of non-estrogen possibilities. Some types of birth control are better at stopping bleeding than others, but it might end up as a trial-and-error process depending on your body and cycle. Even so, you have some strong contenders!
I’ll flesh out most of the birth control options on the market right now below, and you can pick from the lot.
Pills are the most common birth control, but they tend to have an armful of side effects, have to be taken on time every day, and can conflict with some other oral medicines (ask your doctor!). The “standard” pill is estrogen based, and the “mini” pill is non-estrogen based. Both are fairly effective at stopping bleeding if you skip the placebo week! Emergency contraceptive pills are one time use, non-estrogen based, and only work WITHIN 72 HOURS.
The patch is a subtle adhesive skin patch that’s replaced weekly. It can be hard to peel off, and it usually only comes in one color (say hello to racist medical practices). It is estrogen-based and isn’t particularly helpful with stopping bleeding.
The ring is a small, flexible silicone ring (touch your index finger to your thumb and that’s about the size) that’s inserted like a tampon into the vagina. It stays there for 21-30 days before being replaced by another. It can be taken out for sex and replaced, and skipping the “break” period between rings can help stop bleeding (though it’s recommended you take a break at least every 3 months). It is estrogen-based.
The shot is just that: an injection that’s administered in a clinic every 3 months. It’s fairly good at stopping bleeding, but it is also estrogen-based.
Intrauterine devices or IUDs are small (0.5 -1 inch) T-shaped objects inserted into the uterus by a doctor. The procedure is non-surgical and usually about 5-10 minutes long, but it can be painful. There are three main options for IUDs: the copper IUD, which is larger, non-hormonal, and lasts 10 years; and the “Mirena” and “Kyleena” which are both non-estrogen based hormonal options and last for five years (the “Kyleena” is a little smaller). All can help stop bleeding, but it depends on the person.
The implant is a small, 0.5 inch plastic stick inserted into the upper arm by a doctor in a non-surgical, short procedure. It can stay for up to 3 years, is non-estrogen based, and is one of the most effective at stopping bleeding; however, it comes with a long list of potential side-effects.
Other options include spermicide, which is a cream inserted into the vagina to kill sperm (NOT recommended, as it can cause yeast infections and is only around 75 percent effective), and standard barrier methods like condoms and diaphragms. Please use barrier methods in combination with any other type of birth control! They are the ONLY form of birth control that protects against STIs and HIV.
Most doctors, including primary care physicians and HRT providers, also have access to this information and have the ability to prescribe birth control. Family Planning Service of Western Illinois is right on Main Street here in Galesburg, and (while not perfect) does have experience with trans patients. Like all prescriptions, birth control has to be tailored to each body individually, so remember: be patient!
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