Thanks for your question. It’s important to know there is a risk of pregnancy with vaginal sex. People assigned female at birth (AFAB) on gender affirming hormones can still get pregnant from vaginal sex. People assigned male at birth (AMAB) on gender affirming hormones can still get their partner pregnant from vaginal sex. Basically, if you are having vaginal sex and don’t want to get pregnant it’s a good idea to use a form of contraception, or birth control.

Gender Affirming Treatments

According to the World Health Organization gender-affirming health care can include social, psychological, behavioral or medical (hormones or surgery) care that supports a person’s gender identity.

There are different kinds of hormones people may use as part of gender-affirming treatment.

– Puberty Blockers

• Puberty blockers help prevent progression through puberty. They are reversible, which means if they are stopped a person will start going through puberty again.

– Hormone Therapy

• Estrogen or testosterone can be used to help develop sex characteristics that align with a person’s gender identity.

Hormone Therapy and Fertility

The use of estrogen or testosterone as part of gender-affirming treatment may lower a person’s ability to get pregnant (or get their partner pregnant). However, their use does not lower the pregnancy risk to zero. If a pregnancy is not desired then you should consider using a form of birth control.

How to Prevent a Pregnancy

Abstinence is the only 100% way to prevent pregnancy. If you decide to have vaginal sex there are many ways to help prevent pregnancy.

– Methods for people assigned male at birth (AMAB):

• Condoms
• Sterilization (this is permanent)

– Methods for people assigned female at birth (AFAB):

• Barrier methods: internal condom, spermicides, cervical cap, contraceptive sponge, and diaphragm
• Hormonal methods: implant (in the arm), injectable shot, intrauterine device (IUD), pills, patch, vaginal ring, and emergency contraception
• Other methods: non-hormonal intrauterine device, sterilization, fertility awareness method

People AFAB on gender-affirming hormones can still use birth control. It’s important to speak with a healthcare provider so that they can help them choose the best option for them.

And remember, condoms and dental dams are the only way to help prevent sexually transmitted infections from sexual contact.