Abstract
Objective
To describe use of three types of longer-acting contraception—intrauterine devices,
subdermal contraceptives, and depot medroxyprogesterone—among transmasculine and cisgender
women patients.
Study Design
A repeated cross-sectional study using electronic medical records of patients, age
18 to 45, receiving care within Kaiser Permanente Northern California between 2009
and 2019. Variations in demographics, clinical characteristics and contraception method
uptake were assessed using t tests for continuous variables and chi-square tests for categorical variables for
patients enrolled in 2019. A linear trend test for each group was used to assess the
age-adjusted uptake of contraception methods by study year.
Results
The transmasculine group was younger, with a mean age of 27.3 years (±7.2) vs 32.5
years (±7.8) years, respectively p < 0.001. The transmasculine group used more tobacco, alcohol, and illicit drugs.
The uptake of these contraception methods increased from 2009 to 2019 for both groups
(transmasculine: 0.7% to 4.1%; cisgender: 5.6% to 6.7%) with a positive linear trend
for both groups (p = 0.003 and p < 0.001, respectively). The change in uptake of any intrauterine device from 2009
to 2019 was greater for the transmasculine group (0.3% to 2.3% vs 3.3% to 3.5%). Etonogestrel
implant uptake had a positive linear trend from 2009 to 2019 for both groups (transmasculine:
0% to 0.5%, p = 0.02, and cisgender 0.1% to 1.2%, p < 0.001).
Conclusion
Annual uptake of these contraception methods increased significantly for both transmasculine
and cisgender groups, and this increase was greater for the transmasculine patients.
Uptake of these contraception methods was higher in the cisgender population.
Implications
These findings suggest an improvement in use of long-term contraception and menstrual
suppression medications for the transmasculine population. Further research is needed
to understand these differences and identify a possible unmet need for intrauterine
and subdermal contraceptives and depot medroxyprogesterone use among this often-marginalized
population.
Keywords
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Article info
Publication history
Published online: November 27, 2021
Accepted:
November 11,
2021
Received in revised form:
November 10,
2021
Received:
May 3,
2021
Footnotes
Conflict of Interest: There are no conflicts of interest to declare. This study was made possible by funding from Kaiser Permanente Northern California Graduate Medical Education Department. All authors were involved in the formulation of the research question, choice of study design, data collection, analysis and decision to publish.
Identification
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