Yes, birth control can matter for surgery and anesthesia, mainly because some medicines used during surgery can affect hormonal contraception. Sugammadex is one example. It can lower progesterone, so if you use hormonal birth control, you should use a nonhormonal backup method for the next 7 days after it is given.

For most other common anesthesia medicines, there are no known clinically significant drug interactions with puberty suppression or gender-affirming hormone therapy. Also, the sources do not show strong evidence that hormone therapy must always be stopped before surgery. For testosterone, there is not enough evidence to routinely stop it. For estrogen, the decision is less clear and depends on individual risk factors, such as smoking or a personal or family history of blood clots.

Before surgery, bring a list of all your medicines, including prescriptions, over-the-counter drugs, vitamins, herbs, and supplements. Some medicines and supplements may need to be stopped or changed before surgery, and examples include aspirin, ibuprofen, blood thinners, fish oil, vitamin E, garlic, ginseng, gingko biloba, and St. John’s Wort.