What You Need To Know About Birth Control
Think queer people don’t have to worry about birth control? Think again. Queer folks have every type of body and sex imaginable, and some of us have to consider pregnancy prevention as a regular part of our sex lives.
- Birth control comes in many forms and may also be used for hormone regulation
- Finding the right birth control may take some trial and error; work with your medical provider to figure out which one best suits your needs
- Trans and gender-nonconforming people deserve competent, affirming reproductive care
- Abortion, like all reproductive care, is a human right
What is Birth Control?
Birth control or contraception is a tool used to prevent pregnancy. These tools, particularly birth control pills, can also be used to treat other health issues such as PMS and PMDD, hormonal acne, endometriosis, and more. While most of the onus for birth control typically lies with people with uteruses (because, you know, patriarchy) there are also a few birth control options for people who produce semen.
Types of Birth Control
There are many different options for birth control, each with its own benefits, side effects, and efficacy rates.
Hormonal birth control works by preventing ovulation, thickening cervical mucus, or both. The most common form of hormonal birth control in the US is the oral contraceptive, aka the pill. First released in the 60s, the pill is often seen as one of the most important feminist advances of the 20th century. In addition to preventing pregnancy, the pill can reduce the side effects of PMS, reduce the frequency and/or painful side effects associated with periods, and reduce the size of ovarian cysts. It is highly effective with correct usage and may be the right choice for you if you are good at taking daily pills.
Other common forms of hormonal birth control include the implant and the hormonal IUD (intrauterine device). The implant, a medical device inserted in the upper arm, is the most effective form of hormonal birth control and lasts up to three years.
The patch delivers hormones through the skin and is replaced weekly, while the ring is placed inside the vagina (three weeks on, one week off) and delivers estrogen and progesterone internally. These may be good options for people who are interested in less frequent dosage than the pill, but a less invasive option that the implant or IUD. Another option is the progestin-only shot, which is administered once every three months.
Some people prefer non-hormonal birth control for a variety of reasons, including that they are avoiding potential side effects associated with hormonal birth control. Other than avoiding penetrative penis-in-vagina sex, the most effective reversible method of non-hormonal birth control isthe copper IUD, which works by releasing copper ions that create an inhospitable environment for sperm and can be used for up to 10 years.
Condoms are also an extremely accessible method of birth control, often used in conjunction with another method for added protection.
Other options with varying efficacy rates include devices like sponges, cervical caps, and diaphragms that work with spermicide to prevent pregnancy, as well as the fertility awareness method aka tracking your cycle and withdrawal aka pull-out method. The latter two options are two of the oldest methods in the book and may work when done perfectly, but have a higher failure rate with typical use.
The only birth control methods that also prevent the transmission of STIs are internal and external condoms. External condoms (more commonly known as male condoms) are extremely accessible and can be found in most drug and convenience stores. As a non-hormonal, easy-to-use option, external condoms are one of the most birth control methods. Internal condoms are a good option for those with latex allergies and add a layer of control, particularly for those with vaginas. (They can also be used for STI prevention during anal sex). Unfortunately, there is only one FDA-approved maker of internal condoms in the US, and they can be obtained online (for a relatively hefty price) or at certain doctor’s offices and community centers. Prescriptions for internal condoms are covered by some insurance plans.
Sterilization is an option for people who are sure they don’t want children. For people who produce semen, a vasectomy is a simple procedure that usually takes about 20 minutes. People can usually have sex a few days to a week after a vasectomy and recovery time is minimal. About three months after a vasectomy, the semen will no longer contain sperm.
For people with utereses, sterilization is a little more invasive. Some people may opt for tubal ligation (blocking or removing the fallopian tubes) and others may choose a hysterectomy (removing the uterus entirely.) Tubal ligation is more common and has a quicker recovery time, while a hysterectomy requires 6–8 weeks for full recovery. People often choose a hysterectomy primarily for reasons other than birth control, such as endometriosis, some cancers, severe fibroids, and as part of gender affirmation.
Emergency contraception pills areavailable in most drug stores for those whose other birth control methods have failed — such as through a broken condom, a missed birth control pill dose, or unprotected sex. They work best when taken as soon as possible and within 72 hours of the birth control failure. You can also have a copper IUD inserted within five days of birth control failure. This is the most effective form of emergency contraceptive. It works just as well on day 1 as it does on day 5, and works for people of all weights (Plan B and other emergency contraceptives may have reduced efficacy for people over 155 pounds — helllloooo medical fatphobia.)
Every body is different, and every method of birth control has potential side effects. Common side effects include irregular periods (especially at the beginning of starting a new method), weight gain, acne, breast pain, and changes in libido. In some cases, blood clots may occur. Talk with your medical provider about what side effects to look out for, and ask them to go over any potential drug interactions (some birth control pills, for example, may interfere with anti-depressants.)
Where to Get Birth Control
In addition to a traditional gynecologist or primary care physician you can also get birth control (at a low or no cost) from clinics like Planned Parenthood or your local LGBTQIA+ center and from online subscriptions. You may also be able to access free birth control through Medicaid programs and local programs in your area.
Trans, Non-Binary, and Intersex Reproductive Health Care
Despite the prevailing narrative around reproductive health, not everyone who needs birth control is a cis woman. How do you find a gynecologist who is competent and affirming? It’s not easy to find providers that go beyond being “LGBT-friendly” to those that are actually knowledgable and skilled in working with queer people, but a good place to start is your local LGBTQIA+ center, and through word of mouth on places like local queer facebook groups. A few online directories include Lighthouse, World Professional Association for Transgender Health, and Outlist.
Things to pay attention to when vetting a potential doctor’s office include the way they talk about gender on their website and intake forms, if they specifically mention LGBTQIA+ care, and how they answer direct questions about the way they affirm trans patients. Trust your gut, if you’re getting “run” vibes, you’re probably right. It sucks that trans and gender nonconforming people have to put in more legwork to get the medical they need. Discrimination and lack of medical competence are a major reason why LGBTQIA+, and especially trans people avoid the doctor all together.
A Note On Abortions
At Kiki, we are firmly pro-choice. We believe in your right to have sovereignty over your body and reproductive health. We realize abortion rights are under attack in states all over the country. A few organizations working to keep abortion safe and legal include Yellowhammer Fund, Planned Parenthood, and the ACLU.
The Bottom Line
The options for birth control can feel overwhelming. Try your best to stay patient if the first option doesn’t work. There is birth control method out there for you. Reproductive rights are human rights.