Sexual Health, Reproductive Rights, and Care in Germany

Sexual and reproductive health isn’t just a medical concern—it’s a matter of personal freedom,  dignity, and well-being.

Yet, for many (especially non-German speakers), understanding how to access care can still feel confusing.

Whether you’re seeking contraception, STI testing, fertility support, or guidance during pregnancy, the type of insurance you have plays a significant role in what’s covered.

In this guide, you’ll learn:

• How to find gynecologists, urologists, and sexual health clinics
  
• What’s covered by public vs. private health insurance
  
• How contraception, pregnancy care, and abortion are regulated
  
• Where to get STI tests and support for menstrual or hormonal conditions
  
• What resources exist for teens, expats, and LGBTQIA+ individuals

How do Germans feel about sexual health?

Germany approaches sexual and reproductive health as a matter of personal rights and public education, not just medical care. 

This progressive perspective is supported by two key systems: education and legal protection.

1. Sex education

Sex education begins early in German schools. 

Children are taught in age-appropriate ways about:

• Anatomy
  
• Reproduction
  
• Contraception
  
• Sexually transmitted infections (STIs)
  
• Consent
  
• And emotional well-being

The goal is to empower students with facts, not fear. This open, informed approach helps reduce stigma and misinformation.

As a result, Germany has one of the lowest teen pregnancy rates in Europe: just 6 births per 1,000 women aged 15–19, down by half since 2000.

2. Strong legal protections and rights

Germany’s laws uphold sexual and reproductive rights:

• Social Code Book V ensures that public health insurance covers contraception, prenatal care, and key screenings, without discrimination.
  
• Pregnancy Conflict Law allows abortions within the first 12 weeks, following a required counseling session. Exceptions apply for medical or criminal cases.
  
• Penal Code Sections §218–219 regulate abortion: While technically restricted, it’s permitted under specific conditions. A 2022 law change also allows doctors to share factual abortion information freely.

Finding clinics, gynecologists, and urologists

You can locate gynecologists (Frauenärzte), urologists, and clinics through:

• Jameda – A site for doctor reviews and bookings. Filter by specialty, language, and patient feedback.
  
• Doctolib – Offers multilingual appointment booking with many doctors.
  
• Kassenärztliche Vereinigung (KV) – The official public health provider directory.

These platforms show if the doctor speaks English or other languages, and what insurance they accept.

Learn more about how to find a doctor in Germany.

Regardless of your health insurance, you do not need a referral to a gynecologist or urologist. However, private health insurance typically helps you get an appointment faster. 

Anonymous treatment and confidential consultations

Many city public health offices (Gesundheitsämter) often offer anonymous or low-cost STI tests.

By law, anyone seeking pregnancy counseling has a legal right to anonymity and confidentiality. This includes minors and people without legal residence status.

These protections also extend to:

• Emergency contraception (like the morning-after pill): No ID is required to purchase it from a pharmacy.
  
• Confidential birth (“vertrauliche Geburt”): Allows women to give birth anonymously while still receiving medical support.

Pregnancy counseling centers such as Pro Familia and Donum Vitae offer non-judgmental support, including anonymous consultations and help with navigating unplanned pregnancy.

Health insurance coverage: Public vs. Private

Public health insurance covers most essential sexual and reproductive health services with minimal or no co-payment. 

Private insurance often reimburses at even higher rates and can offer broader or faster access to specialists. However, it usually requires the patient to pay upfront and claim reimbursement afterward. 

Still, please note that coverage details vary by provider and contract in private health insurance.

With that out of the way, let’s examine what German health insurance covers regarding sexual health:

1. Contraception

Fully covered by public health insurance until age 22: Birth control pills, hormonal IUDs, vaginal rings, patches, and other prescribed methods are free.

After age 22, coverage stops unless there’s a medical reason (e.g., hormonal disorders, endometriosis).

In general, private insurers cover contraceptives only if they are prescribed for a medical reason (e.g., endometriosis). Purely contraceptive use is typically not covered.

2. Preventive gynecological and urological care

With public health insurance, women can receive:

• An annual cervical cancer screening, starting at age 20.
  
• Manual breast exams from the age of 30.
  
• Combined Pap + HPV test every 3 years from age 35 onwards.

Men can get an annual prostate and genital exam starting at age 45 for cancer screenings.

These preventive exams are also covered by private health insurance, and usually waive any of the age-based restrictions mentioned above.

3. STD testing and treatment

With both public and private health insurance, STD testing and treatment are covered only when medically necessary. That means only if either:

• Symptoms are present
  
• A doctor orders it during a check-up.

The only exception is one annual chlamydia test for women under 25.

Routine screenings (e.g., HIV, syphilis, gonorrhea) without symptoms are generally not covered.

Private insurance usually reimburses for other tests, but patients should check policy terms or contact their insurance directly. 

Learn more about STD & STI testing in Germany.

4. Pregnancy and maternity care

Public health insurance offers extensive prenatal care, including:

• Monthly checkups (biweekly in the final 8 weeks)
  
• Blood tests, urine tests, and blood pressure monitoring
  
• Ultrasound scans (one per trimester)
  
• CTG to monitor fetal heartbeat and contractions
  
• Infection screenings and Rhesus factor testing

Private health insurance will reimburse more scans and tests, and can even cover private-room stays (depending on your plan).

5. Fertility support

Public health insurance offers partial coverage for fertility treatment if:

• The couple is legally married
  
• The woman is aged 26–39; the man, 26–49
  
• They use their sperm and egg (no donors; that’s illegal in Germany)
  
• There’s a medical diagnosis of infertility and a favorable prognosis

If you fulfill these requirements, you are eligible for up to 8 cycles of insemination (IUI), and 3 cycles each of IVF, ICSI, and GIFT.

A treatment plan must be submitted and approved in advance. Coverage typically includes 50–65% of costs; couples pay the remainder. 

Private coverage varies (as per usual). Some plans reimburse more, others exclude fertility care entirely. 

For example, at Feather, only our Plus and Premium plans offer fertility treatments coverage. 

6. Abortion

Abortion is legal in Germany within 12 weeks of conception (about 14 weeks after your last period), but counseling is required first. This session (fully confidential) happens at certified centers like Pro Familia. They won’t try to sway your decision. 

After counseling, you’ll receive a certificate and must wait three days before proceeding.

Two abortion methods are available:

• Medical (pill): possible up to week 9
  
• Surgical (vacuum aspiration): possible up to week 12

Costs range from €300–600 unless your health or a crime is involved. Low-income individuals can apply for full coverage. Pro Familia can help here.

Learn more about abortion in Germany.

Contraception and family planning

Birth control options available in Germany

If you’re considering hormonal birth control, here are the main types available for women:

• Pill: To obtain a prescription (which is required to buy the pill), you must see a gynecologist, family doctor, or a Pro Familia counseling center.
  
• IUD (Intrauterine Device): Hormonal or copper. Inserted by a gynecologist.
  
• Implant: Inserted under the skin; effective for up to 3 years.

Barrier methods are another accessible form of contraception:

• Condoms: Widely available in stores and vending machines. No prescription needed.
  
• Diaphragm: Less common; must be fitted and prescribed by a gynecologist, your family doctor, or a Pro Familia counseling center.

Some people choose natural methods, though they tend to be less dependable and not covered by insurance:

• Fertility tracking apps
  
• Temperature methods
  
• Cervical mucus monitoring

Emergency contraception (Plan B and others)

Since 2015, emergency contraception has been available without a prescription. Pharmacies (Apotheken) sell two types:

• Levonorgestrel (e.g., Postinor): Works up to 72 hours after unprotected sex. Less effective after 24 hours.
  
• Ulipristal acetate (e.g., ellaOne): Works up to 120 hours. More effective, especially closer to ovulation.

Accessing family planning counseling services

Pro Familia, Diakonie, Caritas, and public health offices (Gesundheitsämter) offer free or low-cost sessions. You can discuss topics like:

• How to choose between contraception methods
  
• How to plan for fertility or address fertility challenges
  
• Discuss complex relationship or parenting questions.

Pregnancy, birth, and postpartum care

Germany offers structured, well-supported care throughout pregnancy, birth, and postpartum. Here’s a quick overview of what to expect.

Confirming a pregnancy

Start by booking an appointment with a gynecologist or your Hausarzt. They’ll confirm the pregnancy and issue your Mutterpass, a booklet for tracking all medical info relevant to your pregnancy.

Once confirmed, health insurance immediately covers nearly all routine prenatal care.

Notify your insurance and employer as soon as possible to start the process for parental leave benefits.

Prenatal care and maternity leave

Routine prenatal care is fully covered and tracked in your Mutterpass: bloodwork, ultrasounds (one per trimester), urine tests, and fetal monitoring from week 32.

Mutterschutz (maternity leave) starts 6 weeks before the due date and continues 8 weeks after birth (12 in case of premature or multiple births)

You are guaranteed job protection and receive your full wage during this time. You are also entitled to part-time or flexible return options upon request.

Choosing a hospital

You can give birth in a hospital (Klinik), birthing center (Geburtshaus), or at home. All are covered by insurance.

Hospitals handle most births, including complications and C-sections. Birthing centers and home births are for low-risk pregnancies and are attended by midwives.

Book your spot early (around 30 weeks into your pregnancy), especially in major cities. To prepare, take birth preparation classes (which are often covered).

STI testing and treatment

Sexually transmitted infections (STIs) are common and treatable, but many go unnoticed. Testing helps protect your health and others’. 

For full details, check out our complete guide to STD & STI testing.

Where to get tested for STIs (free & paid options)

Public health offices (Gesundheitsämter) offer free, anonymous STI testing, including HIV.

Pro Familia can offer low-cost tests based on your income, but it may not be available in every city.

If you need fast results, private labs and clinics are the way to go, but expect to pay €50–150 per test.

Finally, general practitioners or gynecologists can order STI tests, typically only if symptoms are present. 

Menstrual and hormonal health

Diagnosing and treating period-related issues

If you’re experiencing painful, heavy, or irregular periods, book a visit with a gynecologist. Be specific when describing your symptoms—note how often, how severe, and how they affect your routine.

You may be eligible for these treatments depending on the underlying condition and your symptoms:

• Hormonal contraceptives: Pill, IUD, or patch to regulate cycles or reduce bleeding
  
• Pain relief: Ibuprofen, mefenamic acid (prescription), or heat therapy
  
• Iron supplements for period-related anemia
  
• Further testing is needed if thyroid or hormonal imbalances are suspected

PCOS, endometriosis, and menopause care

Diagnosing and treating PCOS, endometriosis, menopause, and their symptoms requires a visit to a specialist:

• PCOS (Polycystic Ovary Syndrome): Diagnosed through ultrasound + bloodwork. Symptoms include irregular cycles, acne, and hair changes.
  
• Endometriosis: Often confirmed via laparoscopy. Look for chronic pelvic pain or pain during sex.
  
• Menopause: Managed through hormone therapy, lifestyle counseling, or symptom-targeted care.

Public and private insurance cover exams, labs, and treatments if medically necessary.

Sexual wellness and intimacy issues

Erectile dysfunction, low libido, and other concerns

Issues like erectile dysfunction (ED) or low libido can have physical or psychological causes, often both. 

If you’re experiencing intimacy issues, follow these steps:

1. Book a visit to a Hausarzt or urologist
   
2. Request bloodwork to check testosterone, thyroid, or cardiovascular health
   
3. Request a referral to a psychotherapist or sexologist if you think emotional factors are the root cause.

Sexologists (trained therapists or doctors who specialize in sexual health) and couples therapists offer targeted help.

Drugs like Viagra (sildenafil) are available with a prescription from a doctor. 

Youth sexual health services

Young people in Germany have the right to access sexual health information, care, and counseling, often without parental involvement. 

Here’s what teens and parents should know:

Confidentiality rules for minors

Minors aged 14 and older can access contraception, STI testing, and counseling with utmost confidentiality, and without parental consent.

However, doctors assess a teen’s capacity for informed decision-making on a case-by-case basis. If the person is deemed capable, no parental involvement is needed.

Parental consent could be required for specific procedures under age 14 or if ongoing care involves significant risk.

Resources for teens

The Youth Health Services (Jugendgesundheitsdienste) offer free exams, advice, and vaccinations.

Zanzu.de offers extensive information on your body, rights, and relationships, in simple terms and many languages.

LGBTQIA+ sexual and reproductive health

Finding knowledgeable, trans-inclusive healthcare services is key, but can be challenging. 

These clinics and networks specialize in gender-affirming care and support:

• TransInterQueer e.V. (Berlin): Counseling, peer support, legal aid
  
• Queermed Deutschland: A growing directory of LGBTQIA+-friendly doctors
  
• Kompetenzzentrum Transgender (Munich): Medical and psychosocial services
  
• Counseling centers of the German Society for Transidentity and Intersexuality (Beratungsstellen der dgti): Available nationwide, offering extensive information and referrals.

Hormone therapy and reproductive planning

There are two main ways to access hormone treatment in Germany:

• Psychiatric evaluation model (still most common): You’ll need 1–2 psychological assessments and a formal diagnosis, usually “transsexualism” under ICD-10.
  
• Informed consent model: Becoming more common, especially in private or progressive clinics, but still rare in the public system.

Be aware that many gender affirming treatments have long waitlists (6–18 months), and that not all states offer the same quality of care.

Fertility preservation (e.g., sperm or egg freezing) is possible, but rarely covered unless your doctor finds it medically necessary. You should ask for details from your endocrinologist or fertility clinic early.

Conclusion

Understanding sexual and reproductive health in Germany means understanding your rights, your options, and how the healthcare system supports your choices. 

This isn’t just useful: it’s empowering. 

Whether you’re navigating contraception, pregnancy, or gender-affirming care, knowing what’s covered helps you make confident, informed decisions. 

Want help figuring out your insurance options? 

Visit our comparison of all health insurance options in Germany.