Trans Men and Pregnancy Prevention

A reader asks,

I’m a trans guy who sleeps with bio guys. I hear about Thomas Beatie.  Can I get pregnant?

Trans folks have an understandably difficult task at hand when it comes to thinking about sexual health. You look, feel, and present as a dude, but what if you still harbor a vagina? When people like Thomas Beatie, a trans man who became pregnant, have their stories plastered all over the media, obviously you’re going to panic.

Instead of freaking out, let’s break it down: What kind of sex are you having? What kind of protection are you using? These are two essential questions you must contend with no matter your gender identification.  If you’re having penis in vagina sex, have not had a hysterectomy and are not on hormonal birth control/using condoms, then yes, you can get pregnant.

You should talk to a doctor to figure out what kind of birth control works for you, especially if you’re transitioning and using hormones. You absolutely must find a healthcare provider who understands and respects your bodily integrity. There’s no compromising on that one, no matter how rural your town. has some helpful tips on finding providers and health information for the trans community. You can also check out the Gay and Lesbian Medical Association who, despite their name, also cater to the trans community. If neither of these prove helpful, call the National Gay & Lesbian Helpline and they should be able to refer you to a provider in your area who won’t raise her eyebrows when you say the word “trans.”

Have a question about safe sex? Email Steph at


  1. Shanman 2000 says:

    Great post!

    Some guys have gotten pregnant while on T. It might be good to use a condom even after menstruation has stopped or at least until you have not menstruated for a number of months.

  2. freewomyn says:

    Question for Shanman or Steph- how does birth control interact with testosterone shots? If a transguy is on T, does he really need to be taking birth control? Wouldn’t T function as birth control itself?

    Not disagreeing about the condoms – you need to prevent STI’s, not just pregnancy.

  3. Shanman 2000 says:

    From ftmaustrailia: “MYTH 8 I can’t get pregnant if I’m on testosterone.

    While your levels of testosterone are low or your body is still adjusting to testosterone, your ovaries can still produce eggs. Vaginal sex with a fertile male could mean pregnancy.

    The only way you can ensure you don’t get pregnant is to have your female reproductive organs completely removed.”

    From the Castro-Mission Health Center in San Fran:
    “Testosterone should not be used to prevent pregnancy. Even if you have stopped having periods you should still use birth control (practice safe sex!) if you are having sex where your partner’s semen could contact your vagina.”

    You wouldn’t want to take birth control pills or an IUD with hormones because it would screw up the effects of your T.

    Basically if you still have ovaries then there is a chance that you could get pregnant.

    At one of the conferences I attended I met a couple of guys who accidently got pregnant even though they had been on T for a year and were not having periods.


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