Contraception Considerations in Transmasculine and Gender Diverse Adolescents and Young Adults.

Contraception care is an important aspect of comprehensive gender affirming care in transmasculine and gender non-binary (TGD) adolescent and young adults (AYA). TGD AYA seek contraception care for a variety of reasons and there are several important considerations that are unique to this population. In addition to pregnancy prevention, transmasculine and gender nonbinary persons may seek contraception to achieve amenorrhea, reduce gender dysphoria, or as part of their gender affirming journey. While patients on testosterone therapy often experience amenorrhea, pregnancy has been reported and testosterone is not a form of contraception. Visits for contraceptive counseling provide an opportunity to discuss fertility goals and preservation planning as well as the possibility that some methods may provide endometrial protection. In this narrative review, we analyze the current literature and discuss specific considerations for contraceptive use in this population. We also propose a contraception overview for shared decision making for patients and their clinicians.