A third of trans men can ovulate after gender-affirming treatment, study finds

A new study into ovarian tissue has discovered that a third of trans men who have undergone gender-affirming treatment are able to ovulate. This could mean that they can go on to get pregnant. 

Some trans men and non-binary people opt to take testosterone as part of gender-affirming treatment, and find that their voice deepens, their body’s fat and muscle distribution alters, their hair growth increases, and their periods stop. 

Do trans men on testosterone ovulate?

A study published on 22 February in Cell Reports Magazine shows that one-third of trans men continue to ovulate, despite their menstrual cycles seemingly halting. 

In the study, Joyce Asseler, PhD candidate at Amsterdam UMC, examined the ovarian tissue of trans people who went on to have their ovaries removed as part of their gender-affirming care. All the candidates were prescribed testosterone for at least one year prior to the time of the procedure, and 17 out of 52 study participants (33%) showed recent signs of ovulation in their ovarian tissue.

“Our examination of their ovarian tissue shows that 33% of them show signs of recent ovulation, despite being on testosterone and no longer menstruating,” said Asseler of the study. 

“Testosterone apparently has a heterogenous effect on ovarian tissue. We don’t know why one person ovulates and another person doesn’t. In any case, we cannot explain this difference by the type of testosterone, or how long someone has been taking testosterone,” said Asseler.  

These findings could better equip trans men and non-binary people on testosterone to prevent or plan for the possibility of pregnancy and highlight to medical teams that contraceptives are for everybody — not just Cis women.

“This study is further evidence to support what we already know: Testosterone isn’t a contraceptive,” said Beth Cronin, an obstetrician and gynaecologist at Brown University’s Warren Alpert Medical School, as per Science Magazine.

Cronin was not involved in the study, but said that regardless of a person’s gender identity, “Everyone needs access to contraceptives.”

“It’s important that transmasculine populations and their caregivers … open up and speak about contraceptives, since reproductive health care isn’t available to all trans people, especially globally,” Asseler added. 

Trans activist Logan Brown — who famously appeared as the cover star of Glamour Magazine — previously opened up on navigating an unplanned pregnancy as a trans man. 

“It was like my whole world stopped. That everything, all my manlihood [sic] that I’ve worked hard for, for so long, just completely felt like it was erased,” Brown, who has since gone on to welcome his healthy baby Nova, told the outlet at the time.

Eventually, Brown said, he realised: “I’m never gonna get this opportunity again’ to – as a queer couple – have a baby that’s biologically both ours. Which is really special to me, and eventually, something just clicked.”

If you’re worried about the possibility of becoming pregnant whilst on testosterone, book an appointment with your GP or through your NHS gender dysphoria clinic.

If this story has affected you, visit the BPAS website or call 03457 304030 between 7am-6pm Monday to Friday, 8am-4pm Saturdays and 9.30-2.30pm on Sundays.