Queering Birth Control

In Connecticut, we are lucky that birth control is relatively accessible compared to many other U.S. states. We can get condoms, birth control pills, and emergency contraception over the counter, and abortion rights are protected under state law. However, legal access does not always mean equal access for all groups. The LGBTQ+ community in particular is severely overlooked in discussions on birth control access. Healthcare providers and laypeople alike overwhelmingly assume that queer people do not need birth control. This betrays a very limited social view of gender and sexuality. Not sure what I’m getting at? Let me explain.

When talking about LGBTQ+ folks, the first thing that pops into many people’s minds are same-sex relationships. Two cis men or two cis women in a relationship are obviously not at risk of unplanned pregnancy. Gay couples have long been the poster children of the American LGBTQ+ movement. But L and G are not the only letters in the acronym. We have B for bisexual, T for trans, Q for queer/questioning, and a plus sign to signify an expanse of genders and sexualities.

Bisexual folks’ need for contraception is probably the easiest to conceptualize. People under the bisexual+ umbrella are attracted to people of more than one gender. This means a bisexual person may have relationships that could lead to pregnancy. For example, a bi woman who is having sex with a man is going to need access to birth control if she doesn’t want to get pregnant.

Transgender people also use birth control. While gender-affirming hormones may reduce a person’s fertility, they don’t always eliminate it. Besides, not all trans people take hormones. Depending on who a trans person is having sex with, they may need contraception—for example, if a trans woman is sexually active with a cis woman. The bottom line: If a person with ovaries has penis-in-vagina sex with a person with testicles, birth control is likely in order.

In addition to pregnancy prevention, hormonal contraception can medically help people with certain reproductive disorders. Heavy periods, endometriosis, and polycystic ovary syndrome are commonly treated with birth control. These issues can affect anyone with a uterus, regardless of gender and orientation.

Unfortunately, these misconceptions are not just the result of public ignorance. Many healthcare providers also disregard LGBTQ+ people’s need for contraception. A 2019 study published in the American Journal of Public Health found that queer women seeking reproductive care were routinely presumed by providers to be straight, but if they disclosed their LGBTQ+ identity, they risked assumptions that they didn’t need information on contraception. Given that the majority of messaging on the subject is targeted toward straight women, it’s no wonder that healthcare providers have trouble thinking of queer folks as needing birth control.

Some participants in the 2019 study also reported negative attitudes on birth control from their peers within the queer community, especially for bisexual women who have sex with cis men. Gatekeeping in queer communities is an unfortunate reality that can stop conversations on pregnancy prevention in their tracks. The idea that contraception isn’t “queer” extends to LGBTQ+ communities and acts as a social barrier to access for people who could benefit from it. Queer folks may internalize these attitudes and not even consider contraception an option.

Some of these obstacles are formidable, but they need not stop you from getting the reproductive care you need! Start by educating yourself on the types of birth control available. A comprehensive overview of contraceptive methods would require a separate article, but I highly recommend conducting your own research before talking to a provider. Each form of contraception has pros and cons, so carefully evaluate each method’s efficacy, potential side effects, ease of use, and accessibility. Planned Parenthood’s website is an excellent source of information on birth control.

Once you’ve learned about your options, arrive at your medical appointment armed with information and ask as many questions as you need. Be assertive with your healthcare provider. Don’t let them change the subject or gloss over it. Demand to be heard and have your concerns addressed without prejudice. If you aren’t happy with your healthcare provider’s response, you are under no obligation to see them again. You know your own needs better than anyone, and your healthcare provider should respect that and advocate for you.

—Kim Adamski