Maybe you just accidentally downed your partner’s daily pill instead of your multivitamin or perhaps you’re just curious what happens when a man takes hormonal birth control (intentional or not).
Though most people think of birth control as a ladies-only pill, some men take it too. What happens to guys when they take BC depends on whether they’re cisgender men or transgender men.
First, you’ll need to consider this: What’s your reproductive anatomy?
How birth control pills affect trans men
Some trans men opt out of bottom surgery, which means they might still have ovaries, a uterus, and a vagina. In this case, taking birth control can help control monthly flows and prevent pregnancy.
So what about transgender men on hormone therapy?
Hormone therapy, which involves doses of testosterone, triggers big changes in trans men’s bodies, like a deeper voice and facial hair. But that doesn’t mean it’s an effective substitute for birth control.
According to an article by Dr. Maddie Deutsch, Director of Clinical Services at the UCSF Center for Excellence for Transgender Health, “Testosterone greatly reduces your ability to become pregnant but it does not completely eliminate the risk of pregnancy.”
How birth control pills affect cis men
For cis men who don’t have ovaries, a uterus, or a vagina, popping BC pills takes a different turn.
If you accidentally take hormonal birth control once or twice, no worries. You probably won’t experience any side effects. But if you take BC pills consistently, the estrogen intake can mess with your sex drive, lower your fertility, and even cause breast tissue growth.
Human gender and sexuality are beautifully complex. It’s easy to assume men can’t get pregnant, but that doesn’t take into account transgender men who were assigned female at birth.
If you’re a cisgender man — meaning you identify with the gender you were assigned at birth — it’s physically impossible for you to get pregnant. But if you’re a trans man engaging in penis-in-vag activity, you run the risk of babymaking.
Remember, even though testosterone hormone therapy lowers your odds of pregnancy, it could still happen. If you’re a gender-nonconforming person or a trans man, you should consider your birth control options.
Though many trans men are on birth control to avoid pregnancy, some men take the pill to manage hormone imbalances or to stop getting periods.
Cis men, sorry to break it to you, but estrogen- or progesterone-based birth control pills won’t stop your swimmers from swimming. You’ll need another kind of protection.
Trans men, you’re in luck. You can take birth control pills even if you’re on hormone therapy. These two prescription meds shouldn’t cause any harmful drug interactions or side effects. Talk to your doctor to figure out the best combination for you.
You’ve got options
Cis men, you shouldn’t take birth control pills, but you still have options. Condoms for a quick fix and vasectomies for… forever.
Trans men, you have a variety of birth control options depending on what works best for your body:
- hormonal birth control pills
- hormonal implant
- sponge with spermicide
- hormonal injections
- the ring
- the patch
- condoms (internal or external, depending on your anatomy)
Whether you’re cis, trans, or nonbinary, it’s always best to discuss your birth control options with a doctor.
Are there side effects?
Sure. Literally, every form of birth control comes with potential side effects.
Some people get crazy cramps with IUDs, some don’t. Some peeps get bad bloating with BC pills, some don’t. Every body reacts differently, so it might take time to figure out what works best for you.
Oh, and ignore the rumor that estrogen-based BC will cancel out testosterone therapy’s masculine powers. There’s no proof of that.
If you’re a trans man, you should be able to use both progesterone-only or estrogen-based birth control to prevent pregnancy.
Pregnancy myths, debunked
Myth 1: A man can’t get pregnant because men don’t have uteruses.
Fact: Au contraire! Trans men, who were assigned female at birth, are men with uteruses, ovaries, and a vagina.
Myth 2: Trans men can’t get pregnant if they’re taking testosterone.
Fact: Testosterone doesn’t count as birth control. If you have ovaries and a uterus, you can get preggo. Womp womp.
Just like cisgender women, trans men can get PMS, period breakouts, and irregular flows. Birth control pills can help alleviate these issues.
For some trans men, getting a monthly period triggers serious gender dysphoria. Even those on hormone therapy bleed from time to time. If this bothers you, consider using birth control to stop your flow.
Talk to your doctor about which birth control methods will work for the specific symptoms you want to manage.
- For acne, your doctor might prescribe hormonal birth control pills, a topical cream, antibiotics, or isotretinoin (Accutane).
- For heavy periods, you might be prescribed certain types of hormonal birth control pills or the hormonal IUD.
- To stop your periods completely, your doctor might recommend continuous birth control dosage (aka, skipping the placebo pills), the hormonal IUD, or contraceptive implant or injection. Many trans men opt for the injection or implant.
Depending on your biology and medical issues, you might be able to find relief without using birth control.
Side effects to consider
Experiences vary wildly from person to person, so chat with your doc about any worrisome reactions to your birth control. You obvs don’t want side effects that are worse than your original malady.
Common birth control side effects include:
- changes in your sex drive
- bloating or weight gain
- chest tenderness
PSA for folks with high blood pressure: Birth control pills that contain estrogen can increase blood pressure or make it more difficult to control in those who already have high blood pressure. Birth control pills that contain estrogen can also increase the risk of developing blood clots (separate from high blood pressure) which can be life-threatening.
Make sure you reveal your whole medical history so your doctor can prescribe the safest meds for your body.
Period myth, debunked
Myth: People taking testosterone will not menstruate.
Fact: Testosterone makes your flow lighter and more irregular, but that doesn’t mean your cycle stops altogether. Sometimes peeps who take testosterone long-term do eventually stop menstruating.
Rumor has it that estrogen-based birth control boosts feminine looks. Truth is, that’s just a rumor. Simply taking birth control pills won’t work.
If you’re someone assigned male at birth who identifies as female or nonbinary, you might be on the lookout for “feminization” treatments or meds. It’s totally normal for transgender peeps to do hormone therapy, but do 👏 not 👏 attempt 👏 this👏 without 👏 medical 👏 supervision 👏!
Hormone transitioning is complicated. Depending on your biology and anatomy, your doctor might prescribe:
- estrogens to reduce your testosterone levels and trigger feminine secondary sex characteristics (boobs, a higher voice, etc.)
- anti-androgens to reduce your body’s masculinizing hormones
- a blend of estrogens and anti-androgens
We’re sounding like a broken record here, but find a professional, trans-friendly medical specialist to begin feminizing treatments or hormone therapy.
Docs who specialize in hormone therapy can make sure they find the exact treatments and doses that are safe for you. They can also answer any questions you have about transitioning.
Any side effects?
Yes. There are several possible symptoms related to feminizing hormone therapy, including:
- erectile dysfunction
- decreased sex drive
- weight gain
- high blood pressure and high triglycerides
- blood clots
- type 2 diabetes
- cardiovascular disease
Hormone therapy can also increase your risk for certain cancers, such as breast cancer and uterine cancer. Hormone treatments are particularly risky if you’ve already had reproductive cancers or blood pressure issues.
Your doctor should thoroughly understand your family’s medical history and your potential for certain health conditions before beginning your hormone therapy.
“Feminization” myth, debunked
Myth: People assigned male at birth can take estrogen-based birth control pills to trigger or speed up feminization.
Fact: Nope. Birth control pills don’t work for feminization. You’ll need specialized hormone therapy.
Talking to a doctor about gender dysphoria can be scary at first. You’ll want to find a healthcare provider who is knowledgeable, supportive, and trans-friendly.
Here are some tips to get started:
- Contact local trans-specific organizations to ask about recommended medical providers in your area.
- If you feel comfortable, talk to your current primary care physician. Ask for a referral to a specialist in hormone therapy.
- Ask your transgender friends for their recommendations.
- Join an online forum for trans folx in your area. Ask fellow members who they see for medical care.
- Check out our guide to finding an LGBTQ-friendly healthcare provider.
- Anyone assigned female at birth — from cis women to trans men — can take birth control pills for contraception or to manage hormonal issues such as PMS and acne.
- Transgender men taking testosterone can still take birth control pills.
- People assigned male at birth — even trans women! — shouldn’t take hormonal birth control pills meant for people with uteruses.
- Long-term misuse of birth control (such as taking hormonal BC pills without a uterus) could cause undesirable side effects.
- Hormonal birth control is not an effective method of “feminization.”
- Talk to your doctor about any concerns regarding birth control or hormone therapy.