Can I access abortion care or emergency contraception while on gender-affirming hormones?

Written By Nikki Vinckier

Yes—you can access both abortion care and emergency contraception (EC) while on gender-affirming hormones. These forms of care remain safe and effective, and your hormones do not block or cancel out their effects.

LET’S BREAK IT DOWN:

Emergency Contraception (EC)

Emergency contraception helps prevent pregnancy after unprotected sex or contraceptive failure. You can safely use EC while on gender-affirming hormones, and it’s important to know the options:

  • Plan B (levonorgestrel)
    Available over-the-counter without a prescription, Plan B works best when taken within 72 hours. It’s safe to use while on testosterone, but may be slightly less effective for people over a certain weight.

  • Ella (ulipristal acetate)
    Prescription-only, ella is often more effective than Plan B, especially for people with higher body weight. It also works up to 5 days after sex. It does not interact with testosterone.

  • Copper IUD (Paragard)
    The most effective form of EC (over 99%), a copper IUD can be inserted within 5 days after unprotected sex. It also serves as long-term birth control and is safe for transmasc and nonbinary people who have a uterus.

Important note: Emergency contraception works before pregnancy begins. It prevents ovulation or fertilization—it does not cause an abortion.

Abortion Care

If you're pregnant and choose to end the pregnancy, both medication abortion and procedural abortion are safe and effective—even if you’re currently taking testosterone.

  • Medication abortion (mifepristone + misoprostol): Safe and commonly used up to around 10–12 weeks of pregnancy. Hormone therapy does not reduce its effectiveness.

  • In-clinic (procedural) abortion: Performed by a provider in a clinic setting. Your hormone regimen will not interfere with the procedure or its safety.

Some people choose to pause hormone therapy for emotional or physical reasons during abortion care, but this is not medically required. The decision is personal and should be guided by what feels right for you.

Finding Affirming Care Matters

Many trans and nonbinary people face bias or misgendering in healthcare settings, especially around reproductive health. You deserve care that acknowledges your identity, uses your correct name and pronouns, and supports your decisions without judgment.

Look for clinics or providers that:

  • Explicitly state they are LGBTQ+ inclusive or gender-affirming

  • Use gender-neutral intake forms

  • Offer trauma-informed care

Bottom line:

Being on testosterone doesn't block you from preventing or ending a pregnancy. Emergency contraception and abortion are still fully accessible—and effective—for people on gender-affirming hormone therapy.

You deserve reproductive care that supports every part of who you are. Always.

Nikki Vinckier
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