Reproductive health · 2025
Contraceptive care for transgender and gender diverse individuals from the perspective of healthcare providers in Germany: a qualitative study.
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Barton Charlotte, Werner Marie, Herrmann Lena, Pohontsch Nadine Janis, Bindt Carola, Becker-Hebly Inga
Аннотация
BACKGROUND: Gender-affirming hormones do not completely suppress fertility in transgender and gender diverse individuals, highlighting the need for counseling on pregnancy risk and contraceptive options. However, research on current contraceptive care is limited. Studies from the US have identified several barriers to care as well as facilitators, but no studies on this topic have yet been conducted in Europe. This study examined transgender and gender diverse contraceptive care in Germany from the perspective of healthcare providers, assessing its importance and their roles in it, as well as exploring barriers and facilitators.
METHODS: Thirty semistructured qualitative interviews with German healthcare providers were conducted between December 2023 and February 2024. The interview guide included questions on contraceptive care for transgender and gender diverse individuals. Data were analyzed using structuring qualitative content analysis (Kuckartz) with deductive and inductive category development.
RESULTS: Most interviewees highlighted the need for contraceptive care, depending on various factors such as the type of gender-affirming care applied, sexual practices, and transgender and gender diverse individuals' desire for pregnancy prevention. Half of the interviewees also offered contraceptive care (depending on their specialization). Numerous barriers to contraceptive care, such as a lack of awareness of contraceptive needs, insufficient research and training programs for medical staff, have been reported, highlighting the importance of facilitators for care such as the implementation of contraceptive counseling as a standard protocol.
CONCLUSION: To improve contraceptive care for transgender and gender diverse individuals, the establishment of clear structures and responsibilities, more research, and qualifications among the involved specialties are needed. To gain a comprehensive understanding of the care situation, future research should include the perspectives of transgender and gender diverse individuals.
TRIAL REGISTRATION: We obtained the approval of the Hamburg Medical Council ("Ärztekammer Hamburg") to conduct our study by means of a "scientific case" (2023-300381-WF, September 11th 2023).
METHODS: Thirty semistructured qualitative interviews with German healthcare providers were conducted between December 2023 and February 2024. The interview guide included questions on contraceptive care for transgender and gender diverse individuals. Data were analyzed using structuring qualitative content analysis (Kuckartz) with deductive and inductive category development.
RESULTS: Most interviewees highlighted the need for contraceptive care, depending on various factors such as the type of gender-affirming care applied, sexual practices, and transgender and gender diverse individuals' desire for pregnancy prevention. Half of the interviewees also offered contraceptive care (depending on their specialization). Numerous barriers to contraceptive care, such as a lack of awareness of contraceptive needs, insufficient research and training programs for medical staff, have been reported, highlighting the importance of facilitators for care such as the implementation of contraceptive counseling as a standard protocol.
CONCLUSION: To improve contraceptive care for transgender and gender diverse individuals, the establishment of clear structures and responsibilities, more research, and qualifications among the involved specialties are needed. To gain a comprehensive understanding of the care situation, future research should include the perspectives of transgender and gender diverse individuals.
TRIAL REGISTRATION: We obtained the approval of the Hamburg Medical Council ("Ärztekammer Hamburg") to conduct our study by means of a "scientific case" (2023-300381-WF, September 11th 2023).