Exploring Male Birth Control: What You Should Know Today

When it comes to birth control for people with a penis and testicles, options remain quite limited. Meanwhile, those with a uterus, ovaries, and vagina have a wide array of contraceptive methods available. However, it's important to understand that not all men fit into traditional anatomical categories, and many nonbinary individuals with male anatomy also seek effective contraception.

Quick Overview of Birth Control Options by Anatomy

Here’s a concise table showing which methods suit different anatomies and hormone treatments:

Birth Control Options for Those with Penis and Testicles

Currently, male birth control methods are limited primarily to external condoms and vasectomy.

External Condoms

Condoms remain a popular choice because they are the only contraceptive method that also protects against sexually transmitted infections (STIs). Available in various sizes and textures, they can enhance pleasure while providing a barrier against pregnancy. When used perfectly, condoms are about 97% effective, but with typical use, effectiveness drops to around 86%, largely due to human error.

Vasectomy

Vasectomy is a highly effective, minimally invasive surgical procedure that blocks sperm from reaching the ejaculate. It’s considered a permanent form of contraception, although reversals exist but are not guaranteed. After the procedure, a confirmation test is needed three months later to ensure no sperm remain. Until then, alternative birth control is necessary.

Note: Withdrawal (pullout method) is unreliable. Even with perfect timing, about 22% of users relying solely on withdrawal experience unintended pregnancy due to pre-ejaculate fluid and timing challenges.

Why So Few Male Birth Control Options?

Since the 1960s, when the female birth control pill revolutionized contraception, the focus has largely remained on pregnancy prevention methods for those who can conceive. Research into male contraceptives has progressed slowly due to biological complexities and social factors.

Fortunately, promising methods are in development, including hormonal pills, gels, and injectable options, aiming to expand male contraceptive choices soon.

Emerging Male Birth Control Methods

• Male Birth Control Pill: Clinical trials have shown pills that suppress sperm production and testosterone with good tolerability, though market availability is years away.
• Topical Gels: Applied daily to reduce sperm production, these gels are in advanced testing phases.
• Injectable Gels: Non-surgical alternatives to vasectomy, such as Vasalgel and RISUG, block sperm flow and are undergoing clinical trials.

Abstinence and Outercourse: These methods are only effective if strictly practiced, preventing any penile-vaginal penetration or ejaculation near the vagina.

Birth Control for Individuals with Uterus, Ovaries, and Vagina

Those with this anatomy have numerous contraceptive choices, many of which remain effective even when taking testosterone hormone therapy.

Internal Condoms

Inserted into the vagina or anus before sex, internal condoms offer dual protection against pregnancy and STIs. They are 95% effective with perfect use and 79% with typical use.

Diaphragm

This reusable silicone device is used with spermicide to block sperm from entering the cervix, with effectiveness ranging from 88% to 94% depending on usage.

Sponge

Containing spermicide, the sponge covers the cervix and remains in place for at least six hours after intercourse. Effectiveness varies between 76% to 88%, influenced by factors including childbirth history.

Cervical Cap

Similar to the diaphragm, the cervical cap is filled with spermicide and fits snugly over the cervix, offering 71% to 86% effectiveness.

Spermicide

Available as gels, foams, and suppositories, spermicide alone has about 72% effectiveness and can be used in conjunction with other barrier methods.

Hormonal Methods

• Shot: A progestin injection every 90 days with up to 99% effectiveness.
• Ring: A vaginal ring replaced monthly that prevents ovulation, with 91% to 99% effectiveness.
• Patch: A weekly skin patch delivering hormones, effective between 91% and 99%.
• Combination and Mini Pills: Daily oral contraceptives containing hormones, with typical use effectiveness around 91%.
• Implant: A small device inserted under the skin providing over 99% effectiveness for up to three years.

Intrauterine Devices (IUDs)

• Copper IUD: Hormone-free, over 99% effective, and can last 10+ years.
• Hormonal IUD: Releases progestin, effective for up to 7 years with over 99% effectiveness.

Surgical Options

Tubal Ligation: A permanent procedure to block or cut fallopian tubes, highly effective but generally irreversible.

Fertility Awareness Methods: These natural methods have a success rate of about 75%, making them less reliable compared to other options.

Finding LGBTQIA+ Friendly Healthcare Providers

Locating knowledgeable and supportive healthcare professionals is critical. You can:

• Ask for recommendations from trusted LGBTQIA+ community members.
• Use directories like OutList or the WPATH provider directory.
• Consult local health departments or sexual health centers.

For more insights, check our comprehensive guide on LGBTQ-friendly healthcare resources.

Final Thoughts

Male birth control options currently remain limited but promising research is underway. Those with a uterus and ovaries have diverse methods to choose from, including hormone-based and barrier options. Consulting with healthcare professionals can help tailor contraception choices to individual needs and lifestyles.

Adrienne Santos-Longhurst is a Canadian freelance writer specializing in health and lifestyle topics, blending research with engaging storytelling. When not writing, she enjoys beachside adventures with her family and dogs.

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