Fertility and Fertility Preservation

Some trans men choose to have children. Others don't. The choice is up to you. But planning is important.

If you have a uterus and ovaries and haven't had a sterilization procedure, you can still get pregnant if you have vaginal sex with cisgender men. This is true even if you take testosterone or have irregular or no periods. Although testosterone might lessen your chance of pregnancy, don't rely on testosterone therapy for contraception. Pregnancy remains possible until menopause.

To prevent pregnancy, use a barrier form of birth control, such as condoms. If you aren't using masculinizing hormones, an intrauterine device that contains the hormone progestin (Mirena) can serve as birth control and decrease menstrual bleeding. You also might talk to your doctor about permanent birth control. If you are using masculinizing hormones, you might want to avoid birth control that contains the female hormone estrogen, including combination birth control pills and the birth control patch.

If you want to become pregnant, talk to your doctor. If you take testosterone, you'll need to stop. Talk to your doctor about how your hormone use may have affected your fertility. Procedures are available that make it possible to carry a pregnancy or to collect and freeze unfertilized eggs or ovarian tissue for future use. Methods might involve medication or surgical procedures and are typically available at specialized fertility centers. However, these procedures are often expensive. If possible, make decisions about children before you start hormone therapy or have genital surgery.