Birth Control and Trans

I recently received a question, via email, from a young person about birth control.

“I am a 17 year old closeted trans guy who is looking for ways to mitigate dysphoria. I have access to binders, but I am physically unable to use one for health reasons. I have moderate to severe acne and have been recommended that I start estrogen-based patch birth control to mitigate it. However, my friend told me that the hormones included in patch birth control could have “feminizing” effects, such as breast growth. I looked on the internet to see if this was true, and there seems to be a lot of conflicting information. Some sites even said that taking birth control could lessen the effects of female-to-male hormone replacement therapy (FtM HRT) later down the road. I plan to start testosterone later in life. It’s not safe for me to come out to my doctor, so I can’t ask for help from a medical professional. Is there anywhere I can find reliable information about potential “feminizing” effects of birth control originally designed for cis women?”

So I asked a trans friend who is an RN, and who gave me this amazing resource and information:

Lots of great clinically sound information in this document: Birth control is appropriate and people taking or planning to take testosterone can use most any method. The methods that typically help stop bleeding would be the progestin pill, implant, IUD or the depo shot. Sometimes these methods are specifically used to stop bleeding, even if the patient does not desire it for birth control properties. Progestin does not interact with testosterone. Sometimes patients choose to avoid the methods that contain estrogen such as the pill, patch, or ring, due to the lack of clarity if estrogen interacts with testosterone, which sounds like it would be something important for this individual. I would say we have a fairly large handful of patients on T that get the Depo-Provera shot every 3 months. For some, it is to help control any potential bleeding that testosterone has not stopped, for others it is for birth control and for some it is for both reasons. The copper IUD might also be an option as it does not contain any hormones but could potentially have some light bleeding associated with it prior to starting testosterone. A final note, testosterone is a very potent hormone and has very little, mostly no issue, overpowering estrogen.