Background : Although use of the intrauterine device (IUD) is increasing, the prevalence and satisfaction among transgender and gender diverse individuals is unknown. Our goal is to determine the reasons these individuals are choosing IUDs and rationale for removal.
Methods : Transgender and gender diverse individuals ages 18-64 participated in an online survey about their experiences with an IUD.
Results : 104 surveys were completed. The mean age was 26.2 (SD 4.8). 21 (20%) identified as transgender, and 83 (80%) identified as genderqueer or non-binary. 26 (25%) were bisexual, 8 (8%) gay/lesbian, 28 (27%) pansexual, and 32 (31%) queer. The majority (84%) was white and had a college education (59%). 88 (85%) were sexually active, and 77 (88%) were at risk for pregnancy. 84 (81%) currently have an IUD. 66 (79%) have a progestin and 17 (20%) a copper IUD. Most common reasons for choosing a specific IUD were menstrual manipulation (66%), duration (67%), and to avoid side effects experienced with other contraceptive methods (49%). 36 (35%) had an IUD in the past. Of these, 20 (56%) did not choose another IUD. 6 (30%) disliked side effects, 3 (15%) initiated testosterone, 2 (10%) experienced expulsion, and 2 (10%) had a hysterectomy. 2 (10%) became pregnant with an IUD. 1 (5%) desired pregnancy.
Conclusions : IUDs are an excellent form of contraception and menstrual manipulation for transgender and gender diverse individuals, with few desiring removal for side effects. Providers should counsel this population about the benefits of an IUD.