Germany

OVERVIEW

Germany is renowned for its sexual openness and LGBT community. However, there are some roadblocks to certain health care options. To obtain contraception, including emergency contraception, you must first receive a prescription. Furthermore, while abortion is permitted, there is a mandatory "counseling" session, which has made some women feel guilty, ashamed or incredibly uncomfortable (see "Abortion" section for details). On the positive side, there are some absolutely fantastic hospitals and doctors, as well as a wealth of resources specifically geared toward the LGBT community. The transportation system is rather efficient and English is spoken by most locals.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Germany, you need a prescription to obtain hormonal contraceptives ("verhütungsmittel" in German), such as the pill, IUDs, etc. So you will need to arrange an appointment with a gynecologist ("frauenarzt" in German) to obtain the prescription. If you a prescription from another country, there is a good chance that the pharmacy will accept the prescription and issue you the medication.

The majority of women (of reproductive age) in Germany are using some form of contraception. In the 1990s, it was calculated that 74.7% of German women were using contraception with 58.60% of these women on the pill.

Condoms are available in nearly all drug stores or pharmacies.

What to Get & Where to Get It

If you already have a prescription, you can visit a pharmacy ("apotheke"), which is typically open from 9:00-18:00, Monday to Friday, and 9:00-12:00 on Saturdays. If you do not yet have a prescription, you'll need to arrange an appointment with a doctor.

Costs

For women under 18 years, birth control pills are free or can be purchased with a 5 euro copay (as of 2015). For women over 18, they will need to pay the full price, which will vary based on the brand. But a one month supply of Desofemine cost 15 euro in 2015.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

To access emergency contraception, you will need a prescription.

What to Get & Where to Get It

Note: The longest-lasting EC is currently ellaOne. It lasts up to 5 days (120 hours) after unprotected sex, and it's available in Germany.

Once you have a prescription, you can find emergency contraception in public sector clinics, private clinics, pharmacies and emergency rooms. Some Catholic hospitals may refuse to prescribe or issue EC, but this is not very common. For dedicated EC products, there's ellaOne, an anti-progestin, and you should take 1 pill within 120 hours after unprotected sex. There's also PiDaNa, a progestin, and you also should take 1 pill within 120 hours after unprotected sex. As for contraceptives used as EC, there are a variety of contraceptives in Germany, and instructions for how many to take will vary according to the pills. For more details, visit the Princeton EC website, where you can find all possible combinations accessible in Germany.

Further Reading:

• Interesting Article On Getting EC in Berlin (IndieBerlin, May 2015)

Costs

LNG: € 17, as of 2013; UPA: € 35, as of 2013.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

If you are interested in long-term residency or citizenship in Germany, some regions (for example, Bavaria) require an HIV test before your approval. Furthermore, if an insurance claim is filed in Europe, the test results aren't necessarily protected/confidential. So it is advised to seek anonymous testing, if you would like to keep this information truly private.

There are many STD testing facilities in Berlin, though many of them are exclusively or almost exclusively for MSM (men who have sex with men). For this reason, it is best to confirm that a facility can test you in advance. We have provided a list below of facilities that test women (either all the time or on specific days).

What to Get & Where to Get It

• Check city pages, like the Berlin page, for local recommendations.

Support

• AIDS-Hilfe Dortmund e.V.
• AIDS-Hilfe Dresden e.V. - Dresden organization providing HIV/AIDS information and many social programs and counseling for people with HIV.
• AIDS-Hilfe Frankfurt e.V. - Provides information on HIV/AIDS and a variety of practical services to people with HIV, including counseling and care.
• AIDS-Hilfe Hamburg e.V. - HIV/AIDS information in Hamburg, providing counseling and assistance finding help for people with HIV.
• AIDS-Hilfe Leipzig e.V. - HIV/AIDS information in Leipzig, providing free counseling, discussion groups and prevention education.
• AIDS-Hilfe NRW e.V. (North Rhine-Westfalia)
• AIDS Aufklärung - Provides anonymous counseling by telephone or e-mail, HIV testing and information about prevention, transmission and living with HIV.
• AIDS Finder - Searchable German-language database of AIDS information and organizations.
• Aktionsbündnis Gegen AIDS - Provides advocacy, organizes fundraisers and publishes a newsletter related to HIV policy.
• All Around Aids e.V. - Support organization for people with HIV, providing information and forums on HIV.
• Berliner Aids-Hilfe e.V. - Provides many services to people with HIV, such as counseling and emotional support and activities for people hospitalized with HIV/AIDS-related illnesses.
• Deutsche AIDS-Gesellschaft e.V. (DAIG) - Provides research and advocacy.
• Deutsche AIDS-Hilfe e.V. - Extensive information regarding HIV.
• Deutsche AIDS-Stiftung - Provides emergency financial help to HIV-positive individuals, but does not offer on-going financial support. Also funds a variety of HIV projects in * Germany and internationally.
• Gesundheits-Amt Dortmund AIDS Team - Provides HIV education, clinical services and support in Dortmund.
• Gib AIDS keine Chance - Provides information on HIV and its transmission, telephone and e-mail counseling, answers to FAQs about HIV and a comprehensive list of AIDS organizations across Germany.
• HIV Net - Extensive information on HIV treatment, with a section devoted to the latest developments
• Kinder-AIDS-Hilfe Deutschland - Helps children affected by HIV/AIDS, providing a clinic for treatment, and many social programs.
• Projekt Information - Site containing information on HIV/AIDS, including translations of recent medical publications and coverage of HIV/AIDS conferences.
• Staying Alive- An international campaign which promotes HIV prevention and encourages people to fight HIV-related discrimination.
• Telefonberatung der Bundeszentrale für gesundheitliche Aufklärung - AIDS and STD Hotline run by German government's health information center, also provides some information online regarding HIV.

Costs

All Germans and legal residents are required to have health insurance, so they may be covered through their insurance. For those who are uninsured, STD tests can vary from 200 euro (for consultation to testing and lab results) to 10 euro (for budget options). If you're looking for the cheapest option, go to Center for Sexual Health and Family Planning, which is run by the city and keeps costs low.

Medications & Vaccines

What to Get & Where to Get It

The HPV vaccine was introduced to Germany in 2007. There's no PreP availability in Germany, as of 2015.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

You can easily find pads and OB tampons. Tampons with applicators can be found in select shops but it's much more difficult. For DivaCup, visit the Berlin location of Globetrotter (Schloßstraße 78-82, 12165 Berlin, Phone: 030/85 08 92 0, Website: www.globetrotter.de/). You can also buy online on German websites like Biogarten (http://www.biogarten.de/), MEDintim (https://www.medintim.de/), Washbaer (https://www.waschbaer.de/shop/), etc. The Mooncup is sold in Berlin the following locations: Lifelines (Bundesallee 117, 12161 Berlin, e-mail@Lifelines-berlin.de, Telephone: +49 30 85401548), Lebensfluss (Boxhagener Straße 13,10245 Berlin Phone: 030-60982382, www.lebensfluss.de) and Vielfalter (Brunnenstraße 147, 10115 Berlin Phone: 1787 610663).

Gynecological Exams

Laws & Social Stigmas

In Germany, every woman over the age of 20 is covered (either by private or public insurance) to receive a gynecological exam. These exams include a pap smear, pelvic exam, etc. If you go to a doctor in Germany and ask for an annual exam, they'll know what to do.

What to Get & Where to Get It

In German, "gynecologist" is "frauenarzt."

Pregnancy

Laws & Social Stigmas

From InterNations: "It is important to note that ob/gyn care in Germany distinguishes clearly between gynecologists and obstetricians (Geburtshelfer). In case you are going to have a baby, you will have your pre-natal checkups at your usual gynecologist in Germany; but they will only be present during the birth if they happen to work as an obstetrician at your hospital of choice as well" (Source: Women's Health in Germany, Internations).

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Germany, abortion is permitted in Germany for the first trimester. But there's one hard restriction: a woman must first seek counseling before getting an abortion. The goal of counseling, according to German law, is to "protect the unborn life. The counseling should encourage the woman to continue the pregnancy, and should help her see the opportunities of bringing up a child." After the counseling, the woman must observe a three-day "consideration period" during which she must decide if she wants the abortion. If she does want the abortion, she can proceed to do so, and the counselor will typically refer her to a clinic or hospital.

Despite these restrictions, abortion in Germany, especially in Berlin, is very common. In the first trimester, legal reasons for an abortion include: to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, fetal impairment, economic or social reasons, and available on request. After the first trimester, abortions can be performed if the woman has mental/health problems or if there is potential risk to the fetus. But this is an exception, not the standard, and a case must be made.

Before German reunification, West and East Germany had very different abortion policies. In East Germany, abortion was legal and common. Under the socialist government, abortion was seen as part of women's socio-economic equality. In West Germany, abortion was only permitted in certain scenarios, such as when there was a serious threat to the woman's life or child's health, or in instances of rape or incest. In some cases, women were allowed abortion due to extreme socio-economic distress, but this determination could not be done by the woman; it was decided upon by a third party. When the country was reunified, a new abortion policy needed to be made to accommodate the country. The compromise between the laws of East Germany and West Germany brought the abortion laws of Germany today.

While Berlin is a generally progressive city, some patients have reported unfriendly treatment at certain facilities. So, as always, it's important to research in advance. There are some Catholic hospitals that refuse to prescribe the abortion pill, even though it is legal, as well. However, Berlin has the most abortions out of any city in Germany each year, and it is reportedly much more tolerant toward abortion than more conservative regions of the country, such as Bavaria.

What to Get & Where to Get It

• For detailed recommendations, please check out city pages.
• ProFamiia Berlin - Can provide the necessary counseling (legally required) before an abortion. Need to confirm if they also provide abortion service or just referrals after the counseling. Details: "Pro Familia is the leading non-governmental service and consumer organization for sexual and reproductive health and rights in Germany. Founded in 1952, it is a charity with a Federal structure. As a founder member of the International Planned Parenthood Federation (IPPF) it is closely linked to international developments and activities in the field of sexual and reproductive health and rights." Address: Beratungsstelle Berlin, Kalckreuthstr. 4, 0777 Berlin, Phone: 030 39849898, Email: berlin@profamilia.de. Website: http://www.profamilia.de/index.php?id=909

Costs

In 2010, the average cost of a medical abortion was 300 euros. The average cost of a surgical abortion is 460 euros.

Advocacy & Counseling