This information has been shared to provide reproductive health considerations specifically for trans and gender diverse people to make informed decisions about their overall reproductive health and wellbeing.
Preventing Pregnancy
- Condoms, birth control pills, and other contraceptive methods remain top suggestions
- Testosterone does not prevent people with uteruses from getting pregnant, even after their menstruation has stopped
- While hormone replacement therapy (HRT) is known to affect fertility, the extent to which fertility is affected is difficult to determine
Abortion
Abortion is an evidence-based healthcare procedure which allows people to permanently terminate an unwanted pregnancy. Abortion is essential for upholding the bodily autonomy of those who are able to become pregnant. General approaches to abortion include:
- Within the first 10 weeks of pregnancy: oral mifepristone
- Within 10-14 weeks: dilation and curettage, in which the vagina and cervix are dilated, and the fetus is mechanically removed
- Within 14-24 weeks: induction of labour
It is important to note that abortions are provided on a case-by-case basis and that the most appropriate technique will be decided on by experts.
Healthcare and service providers can take free training from Community-Based Research Centre’s Queering the Compass online learning series to enhance knowledge and skills to better serve 2S/LGBTQIA+ seeking sexual and reproductive healthcare.
Connect with Pro-Choice YQL for more information about accessing abortion services in Calgary and Edmonton, as well as the following in-person and virtual locations:
Calgary
- Surgical abortion up to 20 weeks
- Medical abortion up to 10 weeks
- Miscarriage services
- Contraceptives (IUD and Depo shots can be given during your appointment)
- Surgical abortion up to 20 weeks
- Medical abortion up to 9 weeks
- Abortion counselling
- Birth control counselling
- IUD insertion
- STI testing and treatment
Sexual and Reproductive Health Clinics
Locations: Sheldon M. Chumir Health Centre, South Calgary Health Centre, Summit: Marian & Jim Sinneave Centre for Youth Resilience
- Sexual Assault Response Team
- Birth control information, prescription, and free supplies
- IUD and contraceptive implant (Nexplanon) insertions and removals
- STI testing and treatment
- STI treatment for contacts
- Emergency contraception (including emergency copper IUD insertion)
- Pregnancy testing and options support (parenting, abortion, and adoption)
- HIV pre-exposure prophylaxis (PrEP) prescriptions
- Pap tests
- Post-abortion check-ups
- HPV vaccination
Centre for Sexuality (formerly Calgary Sexual Health Centre)
- HIV and STI testing
- Pregnancy options, sexuality, and gender counselling
- Workshops for parents
- 2SLGBTQ+ and youth programs
- STI testing and treatment
- Pregnancy testing & options
- Contraception options
- LGBTQ2S+ supports
- Prenatal and parenting programs
Edmonton
- Surgical abortion from 5-20 weeks
- Medical abortion up to 9 weeks
- Abortion counselling
- Endometrial biopsy
- Pap smear
- STI testing
- IUD insertion and removal
- Emergency contraception IUD insertion
- Nexplanon® insertion and removal
- Depo Provera® injection
- Sterilization referral
Community & Choice Reproductive Health Clinic
- Birth control
- Contraceptive implant
- Gender affirming care
- IUD
- Medical abortion
- STI test
- Vasectomy
Virtual Options
- Virtual appointments
- Systems navigation
Alberta Medical Abortion Clinic
- Virtual, telephone, and in-Person appointments
- At-home medical abortions
Becoming Pregnant
There is a limited amount of data that suggests reversal of infertility due to HRT is possible. For the best chances of being able to give birth, it’s recommended people “bank” or cryopreserve their genetic material (known as gametes, sperm, or eggs) before HRT or surgery. Doing so currently comes at a cost to transgender people, but is covered for people undergoing chemotherapy and radiation. If planning a pregnancy after HRT or surgery, it’s best you work with a fertility clinic that offers in vitro fertilization (IVF).
Referrals
Fertility preservation is uninsured in Alberta, and there are private clinics
- Calgary
- Edmonton
Referrals should be made with as much info as possible (e.g. legal name, preferred name, pronouns, goals, if okay to say name or leave message, current hormone status, whether or not the referent has siblings, any family history of fertility struggles)
- 3 months waitlist on average
- Minors must be present at meeting, parents are welcome
- Any partners are encouraged to come
Preserving Sperm
- To provide sperm for cryopreservation, one will need to have gone through puberty. Puberty blockers such as Lupron can prevent someone from being able to provide sperm.
- Low sperm counts happen as early as 3 months after starting HRT; sperm takes 3 months to develop in testicle, and takes another 3 months after stopping HRT to come back.
- HRT can impact the quality of the sperm. It is unsure if HRT may result in DNA issues in the future and affect a future child; its true effects are not known.
- The best chances at preservation are to bank before starting HRT.
Preserving Eggs
- To preserve eggs, one will need to have gone through puberty.
- Migration of eggs into the uterus and complete hormonal cycle may be possible while taking testosterone, but the quality of the eggs may be impacted.
- Preserving eggs requires internal/vaginal ultrasound monitoring
- It is generally recommended to be off testosterone for 3 months leading up to egg retrieval for best results, and ideally menstruate ahead of time.
- Banking eggs tends to be quite a bit more expensive than banking sperm.
Initiating Pregnancy
- Options include intrauterine insemination or in vitro insemination
- Costs can be up to $12,000, depending on which options you go with
- It is more common for employer benefits to cover some things related to fertility treatment. Private clinic consultations are covered by Alberta Health, and Generations of Hope can sometimes help with some costs, but are often limited.
- Imprinting of eggs and sperm can be completed to avoid genetic conditions
Additional Considerations
- Some STBBIs can cause infertility, such as untreated chlamydia and gonorrhea
- Some STBBIs can affect newborns
- Newborns are at risk of getting an HIV infection or hepatitis B
- Gonorrhea can infect the eyes and cause blindness in newborns
- Syphilis can lead to newborns having anemia or abnormalities in their liver, spleen, and bone
- Herpes (congenital or neonatal HSV) and syphilis can present in newborns as severe infectious disease (sepsis, seizures)
