Gender incongruence is not a mental health condition. While some transgender people seek medical or surgical transition, others do not. Any social, psychological, behavioral, or medical (including hormonal treatment or surgeries) interventions designed to support and affirm an individual’s gender identity can be termed “gender-affirmative health care”(6). Some transgender or gender-diverse people retain the reproductive capacity of the sex they were assigned at birth; for instance, a transgender man may require female contraceptives, cervical screening, and antenatal care. In accordance with the human rights principles underpinning family planning, all transgender and nonbinary individuals should be able to access contraception, while having their gender identity respected.
Specific considerations are important for family planning providers to bear in mind:
- Affirm your client’s gender identity, including, for example, by using their preferred name (whether or not it aligns with the name on their official documents) and pronouns.
- Be aware of possible specific family planning needs; for example, interactions with hormone usage. Acknowledge any gaps in your knowledge regarding these needs and provide a referral to specialized care if necessary.
- Obtain informed consent and pay attention to sensitivities surrounding physical examinations for gender-transitioning clients.
- Do not to reveal a person’s gender history without their consent, including, for example, by listing gender transition surgery or other surgeries/treatment that would indicate their gender prior to their transition on medical records unless relevant to obtain a method.
- Account for gender inequalities and social determinants that might affect the client’s capacity and agency for decision-making about their reproductive health and other related issues (this is especially the case given that “transgender and gender-diverse people [often] live within social, legal, economic and political systems that place them at high risk of discrimination, exclusion, poverty and violence” ).
The list of references for this section can be found here.