Sexual Health Week – Transgender

It’s worth defining sexual health as a first step. The World Health Organisation (WHO) says it ‘is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence’.

So, is ‘Trans sexual health’ any different to anyone else’s?

In terms of the WHO definition, then the answer is ‘no’ but there may often be issues that put obstacles in the path of achieving ‘good’ sexual health. There are plenty of statistics showing HIV infection rates among gay men, or men who have sex with other men, but currently in the UK there are no statistics showing similar trends amongst the Trans community. This might be seen as being ‘no big deal’ but it’s worth remembering that globally, transsexual women are 49 times more likely to be infected with HIV than any other adult group.

What particular issues may arise with Trans people in regard to sexual health? For example, a Trans woman who has not had surgery but has been on female hormones for many years may find difficulties in attaining an erection so if taking part in sexual activity may be the ‘receiver’, if penetrative anal sex is involved. Condoms (and importantly, lube) may well be used but if not this is the most risky sex act in terms of HIV transmission. (The same risk scenario would apply to a transman having condomless, penetrative anal sex).

I think it’s fair to say that a transman who is taking testosterone may find their libido kicking into overdrive, and the urge to scratch that particular itch may prove over whelming, and that does carry its own risks (and, it has to be said of course, its own rewards).

With regard to a trans woman who has had surgery to ‘create’ a vagina, it should be borne in mind that the ‘created’ vagina will not self-lubricate so it is crucial to use lube if having penetrative sex. And deploying a condom should still be on the list of things to do!!

Accessing mainstream health services let alone sexual health services can be a challenge for Trans people. From being misgendered, having incorrect pronouns being used, to being met with ignorance and a lack of knowledge as to anything to do with a Trans identity, it can be an emotionally and psychologically traumatic process to go through. If you have that experience say at your GP’s it may well be the case that you would not want to repeat it, so visiting a sexual health clinic may fall off the list of things to do. This could prove to have some negative consequences as to one’s own sexual health and also to any sexual partner.