Can you do an abortion with pills when taking masculinizing hormones?

Here you can find guidance for trans people and the people who love them on how to end an unwanted pregnancy. Women on Web is available to all people who need help with preventing and ending unwanted pregnancies.

• These recommendations are relevant for trans men, genderqueer or nonbinary people who were assigned female at birth, or anyone using masculinizing hormones who have an unwanted pregnancy.

• To end an unwanted pregnancy, you can choose to do an abortion with pills, either at home or in a clinic. Alternatively, you may choose to do a surgical abortion in a healthcare setting.

• Mifepristone and misoprostol are the medicines used to safely do an abortion with pills. You can read more about this process here.

• Neither misoprostol nor mifepristone, an anti-progesterone, interfere with masculinizing hormone therapy. These medicines can be safely used to do an abortion when you are taking testosterone (T) and/or gonadotrophin releasing hormone (GnRH) analogues.

• An abortion with pills entails vaginal bleeding, which may cause distress to some people. You can read more about what to expect with regards to bleeding here. 

• For a safe abortion, it is important to know how long you have been pregnant. The duration of a pregnancy is calculated by counting from the first day of your last menstrual period. You can use the calculator here. If you do not menstruate, you may need an ultrasound to help date your pregnancy.

• One reason that a trans person may choose an abortion with pills at home is that they have difficulty finding trans-inclusive services. Some abortion clinics may have ‘women-only’ policies that may be distressing for people attending these facilities.

• Surgical abortion may be more difficult than an abortion with pills if you are taking testosterone. This is because testosterone can cause vaginal atrophy, though this is less likely if you are having regular vaginal penetration.