Transitioning is the process of changing your gender presentation in society, that can include social, medical or surgical changes. Usually, any time a penis or semen come in contact with the vaginal area, there’s a risk of pregnancy. If the testicles or uterus and ovaries have been removed, there’s no risk of pregnancy. If you are going through hormone treatment or genital surgery, it’s important to speak with your specialist about fertility, if birth control is needed and what type would be safest.