Contraceptive uptake among gender-expansive individuals in the HER Salt Lake Contraceptive Initiative

Abstract

Objectives: We examined differences in contraceptive uptake and discontinuation between gender-expansive individuals and cis-women in the HER Salt Lake Contraceptive Initiative.

Study design: We used self-reported survey data to assess associations between gender identity, contraceptive uptake, and discontinuation.

Results: Of participants (n = 4289), 178/4289 (4%) identified as gender-expansive with 157/178 (88%) reporting recent sexual activity with men. Selection of IUD or Implant was most common, with 109/178 (61%) of gender-expansive individuals choosing these options. We observed similar methods selected (p = 0.2) and discontinuation rates at three years between participants (OR: 0.93, p = 0.8).

Conclusion: Gender-expansive individuals had similar method selection and discontinuation rates as cis-women.

Implications: Our finding of no difference in the uptake of contraception between cis-women and gender-expansive individuals should empower providers to openly discuss contraception with patients regardless of gender identity.

Keywords: Contraception; Contraceptive uptake; Gender identity; Gender spectrum; Gender-expansive.