Investigating the LGBTQ+ Community’s Contraceptive Needs

This blog post is by Brittany Chambers, a 2020 MCI intern from North Carolina Central University.

In the words of Pablo Picasso: “There is only one way to look at things, until someone shows us how to look at them with different eyes.” This quote exemplifies my experience in my internship at Male Contraceptive Initiative (MCI) because it made me take a moment to realize the value of picturing yourself if you were in someone else’s shoes.

​During senior year as an undergraduate at North Carolina Central University, students in the Department of Public Health Education are required to complete an eight-week internship with a public health agency. I chose to complete my internship at MCI, a local non-profit organization based in Durham, North Carolina that focuses on facilitating research and development of male contraceptives and building awareness of and advocacy for male contraceptive methods. I chose this organization because I’ve been learning about unintended pregnancies since I first entered into the Department of Public Health Education. Focusing on understanding the female side of contraception to help prevent unintended pregnancies made me curious about understanding the male side of contraception. While completing internships, students are required to develop a special project that demonstrates the roles and responsibilities of a health educator. After a few brainstorming sessions, I became interested in understanding the unmet contraceptive needs and family planning options of the LGBTQ + community. This population is of interest because I have family, peers, and co-workers who are all members of the LGBTQ+ community. 

My original plan was to conduct focus group discussions with members of the LGBTQ Resource Center on NCCU’s campus to understand their views on unintended pregnancy. However, due to the COVID-19 pandemic and social distancing requirements, I was unable to conduct face-to-face interactions. After discussing with my preceptor, we came up with the idea to develop a survey questionnaire that could be administered via email as a substitute for my focus group discussion. The target audience for my survey was LGBTQ+ individuals between the ages of 18-30. After several attempts to email organizations to distribute my survey, I was unfortunately unable to field my survey due to needing approval and a crunch for time. Although I was unable to field my survey, my preceptor and I decided that I could still work through the process of field testing the survey, synthesizing results, and conducting an evaluation of my survey tool to learn how I might make it better. So once again, I changed my approach to conduct a field test of my survey by sending it out to a group of my friends. This allowed me to fully utilize the software I used for the survey, Qualtrics, and see how my results might look. 

Based on my field testing results, I believe we received good responses. I felt that in order to get better responses, breaking the questions down and providing more follow up questions could help participants provide more accurate responses while completing the survey questionnaire, potentially helping improve response rates. Instead of asking, “What contraception do you use?” we could have also provided a multiple choice selection with a follow up asking “what contraceptive options does your health care provider offer?” Also, if I rephrased some of the questions to best fit the aim of the question it may  help probe for the responses I hoped to receive from the questions asked. For example, I asked “How can developers of male contraceptive methods involve the LGBTQ+ community in their efforts?” when I could rephrase to ask “What family planning services/ resources are addressed to you? And follow up with “What resources do you need to be reproductively healthy?”

Through field testing, I was able to gain insight into how developing a strong survey tool that MCI and the male contraceptive field more broadly may use to develop methods that take into account the needs of LGBTQ+ individuals. The results may improve the health and health care experiences of LGBTQ+ individuals.  While I was unable to collect actual survey data during my internship, I still believe that understanding the unmet needs of the LGBTQ+ community when it comes to family planning and contraception is important and can help shift social norms and spur inclusion of the LGBTQ+  community. I learned that there are important unmet contraceptive needs in the LGBTQ+ community; for example, including transgender men who may be able to conceive, and whose reproductive health needs are understudied. Transgender men often use contraception and can experience pregnancy and abortion, even after transitioning socially and biologically (Francis, 2018).  “While much attention is given to fertility preservation and the parenting intentions of transgender individuals, pregnancy prevention and the contraceptive needs are important for people along the transmasculine gender spectrum (transgender men and gender-nonbinary persons who were assigned female at birth)” (Boudreau, 2019). Counseling and care regarding reproductive health, including contraceptive use is needed amongst this population. 

In the near future, we should plan to have more discussion around contraception and family planning options that are inclusive of all walks of life, giving everyone the proper education and resources to support their desired reproductive futures. Until then, I hope that scholars around the world will have more conversations about the unmet needs of this community. As my internship comes to an end, I believe my work at Male Contraceptive Initiative shined a light on an important population facing significant barriers in the contraceptive world. I have high hopes that one day I will be able to witness a change in the mix of contraceptive methods that will be inclusive of all gender identities.

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References 

Boudreau, D., & Mukerjee, R. (2019, July). Contraception Care for Transmasculine Individuals on Testosterone Therapy. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30997955

Francis, A., Jasani, S., & Bachmann, G. (2018, July 13). Contraceptive challenges and the transgender individual. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297942/