Vasectomy for Trans and Nonbinary Patients | Dr. Theodore Cisu

The short answer: Yes. Dr. Cisu provides vasectomies for trans women and nonbinary people assigned male at birth, and you will be called by your name and pronouns. Feminizing hormone therapy is not birth control, you usually don't need to stop your hormones for a vasectomy, and it's worth thinking about sperm banking first if you might want biological children.

Written by Theodore Cisu, MD, board-certified urologist. Based on the American Urological Association (AUA) Vasectomy Guideline (2026). Last reviewed November 2026.

Ready to talk it through? Book a telehealth consultation with Dr. Cisu. No referral needed.

You are welcome here

A vasectomy is permanent birth control for anyone whose body makes sperm. That includes trans women and nonbinary people assigned male at birth. The procedure, the risks and the follow-up are the same for you as for anyone else.

What should also be the same is the respect. Tell us your name and pronouns, and we will use them, in the visit and in how we talk with you. You don't have to explain your reasons for wanting a vasectomy beyond what you would share anyway. If something we say or do doesn't feel right, please tell us so we can fix it.

Hormone therapy is not birth control

This is the most important point on this page. Estrogen and testosterone blockers often lower sperm production, but they don't reliably stop it. Some people on hormones still make enough sperm to cause a pregnancy, and there's no way to know without testing.

So if you have sex that could lead to pregnancy, hormones alone aren't enough protection. A vasectomy is one permanent option. Condoms are another, and they also lower the risk of sexually transmitted infections, which a vasectomy does not.

Do I need to stop my hormones?

Usually not. A vasectomy is a short office procedure done with local numbing, and hormone therapy doesn't generally need to be paused for it. At your consultation, share your full medication list, including hormones, blood thinners and supplements. Your specific instructions come first, and Dr. Cisu will tell you if anything needs to change.

Think about sperm banking first

A vasectomy should be treated as permanent. Dr. Cisu does not perform vasectomy reversal, and reversal is never a sure thing. If there is any chance you might want biological children someday, consider banking sperm before your vasectomy.

This matters more for people on hormones. Hormone therapy can lower sperm counts, and its effect on fertility may not fully go away if you stop. Producing a sample good enough to freeze may mean pausing hormones for a while, which is a decision to make with your hormone prescriber and a fertility clinic. There's no wrong answer here. It's just easier to think it through now than later. For more on permanence, read Is a vasectomy reversible?

Vasectomy vs. orchiectomy: different surgeries

People sometimes mix these up. A vasectomy blocks the vas deferens, the small tubes that carry sperm. Your testicles stay in place, and your hormone levels don't change. Its only job is preventing pregnancy.

An orchiectomy removes the testicles. It is a larger operation with different goals, often related to lowering testosterone as part of gender-affirming care, and it is planned separately. If orchiectomy is what you are really considering, say so at your consultation, and we can talk about how that differs and where to start.

What the visit is like

The first step is a consultation, usually by telehealth from home or work. A partner is welcome to join. You'll go over your health history, your goals and your questions, including anything about hormones or fertility.

On procedure day, only the small area being treated is uncovered, and the rest of you stays draped. Dr. Cisu uses a no-needle numbing method and a no-scalpel technique, with one tiny opening and no skin stitches. The procedure itself usually takes about 10 minutes. You can read the full walk-through in Your vasectomy, start to finish.

About three months later, a semen test confirms there are no sperm. Use other birth control until you are cleared.

Frequently asked questions

Will you use my chosen name and pronouns?

Yes. Tell us your name and pronouns at scheduling or at the start of your visit, and we will use them.

Can I skip a vasectomy if my sperm count is low on hormones?

A low count is not zero. Unless testing shows no sperm, hormone therapy alone should not be relied on to prevent pregnancy.

Will a vasectomy change my hormone levels?

No. A vasectomy only blocks the tubes that carry sperm. It does not change hormone levels or interact with your hormone therapy.

Do I need a referral or a letter?

No referral is needed for a vasectomy consultation. You can book directly.

Do you see people who don't have children?

Yes. Adults without children are welcome. Read more in Childfree by choice.

Sources

• American Urological Association. Vasectomy: AUA Guideline (2026).

This article is for general education and isn't a substitute for medical advice. Questions about hormones, fertility and timing are good ones to bring to a consultation.