Reproductive health care can be an important part of many people’s lives, whether trying to get pregnant, prevent pregnancy, manage a pregnancy, or terminate a pregnancy. Separate from pregnancy concerns, it’s also important to take care of our whole body, including reproductive organs. For more information on this, please check out our Sexual Health page!
This section will use medical terms for body parts for clarity. Please use the language for your body that best resonates with you.
If you have a uterus and have the kind of sex that could result in pregnancy and don’t want to get pregnant, there are different options for preventing pregnancy. During penetrative vaginal sex, your partner can wear an external condom, or you can insert an internal condom. While you should never “double up” with condoms, you can double up on your contraceptives by using condoms with another birth control method. There are many to choose from, and some people use hormonal contraception as a part of gender-affirming care. Talking to an affirming healthcare provider can be helpful to find your right fit.
Important note for people who take testosterone: hormonal birth control methods that contain estrogen may not be a good fit for you, but those that are progestin-only might be a good fit! In Maine, minors do not need parental permission to take contraceptives.
Contraceptive options
Birth control pills. These can be a combination of hormones (estrogen and progestin) or single hormone (just progestin). Birth control pills are taken daily, and most users will take them for three weeks, followed by a week of placebo pills during which they’ll have their period. It’s an option to take birth control pills continuously and not menstruate.
Hormonal Intrauterine Device (IUD). A hormonal IUD is small, T-shaped, and inserted into the cervix. It slowly releases progestin to prevent pregnancy. Because it is a continuous release of hormones, hormonal IUDs can stop menstruation. They’re effective for 3-6 years.
Copper IUD. This is also small, T-shaped, and inserted into the cervix. The copper IUD works by making any sperm that makes their way to the uterus unable to move and reach an egg. This method does not contain any hormones.
Birth control patches. This is a hormonal contraceptive that is stuck to the body. It contains both estrogen and progestin. The birth control patch needs to be changed weekly.
Birth control ring. This hormonal method is a ring that is inserted into the vagina. The specifics of how to use this varies between brands. Birth control rings contain estrogen and progestin.
Nexplanon. This is very similar in function to the hormonal IUD. It is a piece of plastic that’s roughly the size of a matchstick, and it is inserted into the upper inner arm. The Nexplanon implant is progestin-only, and lasts 3-5 years. Like the hormonal IUD, this method can stop menstruation.
Depo-Provera. This is an injection given every 3 months and is a hormonal method that is progestin-only.
Emergency contraception. This is a pill taken soon after (within 72-hours) penetrative vaginal sex that could result in pregnancy.
Gender-affirming hormone therapy and fertility
Taking hormones can decrease fertility, but it isn’t a guaranteed way to eliminate it. Even if a person with a uterus is taking testosterone and stops menstruating, it’s possible they could become pregnant. Similarly, while taking estrogen can significantly decrease fertility in people with penises, it shouldn’t be considered a definite contraceptive method.
Gender-affirming hormone therapy and trying to get pregnant can be complicated, but not impossible! There is mixed information available on the long-term effects of estrogen on sperm count/viability, so talk to a trusted healthcare provider if this is important to you. People with a uterus who take testosterone are advised to stop testosterone for a period of time before pregnancy, and it is not safe to take testosterone during pregnancy. If you get pregnant and decide to continue a pregnancy, you deserve affirming prenatal care. If you are trying to get pregnant and struggling to do so, please speak with a qualified healthcare provider to explore your options, which can include Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), etc.
For a variety of reasons, some people who want to parent will adopt or foster children. These are complicated systems that are often plagued by the problems in the rest of our world, and can be ethically nuanced to engage in.
Abortion care
Abortion care is a normal part of healthcare, and that is true for our community as well. All of the abortion providers in Maine (Mabel Wadsworth Center, Maine Family Planning, and Planned Parenthood) also provide gender-affirming care. If you need abortion care, you deserve to work with an affirming provider.
There are two types of abortion: medication abortion and surgical (in-clinic) abortion. The best option for you will depend on your preferences and how far the pregnancy has developed. Both options are safe. In the state of Maine, minors can access abortion care without parental permission.