What do I need to know about sexual health as a trans or nonbinary person?

How do I have sex as a trans or nonbinary person? 

You can have sex whatever way you and your partner or partners want! What’s important is that everyone involved feels comfortable, has given their consent to have sex, and can enjoy themselves.

Sex isn’t one type of activity. You get to define what sex is for you. Sexual activities don’t even have to involve genitals. And you also don’t have to want certain kinds of sex — or any sex at all — in order to be real in your gender.

Masturbation — sometimes called “solo sex” — is a way to explore pleasure safely. It can help you figure out what will feel good with your partner or partners.

What about gender dysphoria and sex?  

Gender dysphoria can make sex — both solo and partnered — feel complicated for trans and nonbinary people. And for some trans and nonbinary people, sex can be an exciting way to explore or create gender euphoria.

If you experience dysphoria around sex, here are some tips:

• Be kind to yourself. Gender dysphoria around sex is common. Wherever you are in your transition or gender journey, you deserve a sex life that feels good. 
• Find ways and words to talk about your body parts that work for you. If some body part names don’t match for you, use words that feel better — whether or not you’ve had or want gender-affirming surgeries.
• If certain pronouns and other gendered language feel good, try them with your partners. Some trans and nonbinary people incorporate gender-affirming language into sexy talk or foreplay.
• Wear what makes you feel like you. Clothing and sex toys or prosthetics, like a strap-on or pack-and-play, can be gender-affirming and used for sex. 
• Have the sex that feels most affirming for you. Trans or nonbinary people may feel dysphoric with some body parts or sexual activities. Remember, sex doesn’t have to be certain activities or involve specific body parts, like genitals. By yourself or with others, explore what feels best and safest for you. 
• Connect with or read work by other trans and nonbinary people who are talking about sexual health, pleasure, and gender euphoria.
• Have a plan for what to do if gender dysphoria comes up during sex. Is there a safe word you’d like to use to pause or stop? Is there something that your partner can do to help? A plan  can make it easier to respond and feel better sooner — whether or not you want to keep having sex.  

Remember that people of all genders like all kinds of sexual activities. People also have different levels of sexual desire or interest in sex.

What about safer sex? 

Safer sex is about taking steps to protect yourself and your partners from sexually transmitted infections. Almost all sexual activities carry some risk of pregnancy and/or sexually transmitted infections.

Here are some things to know about STDs, pregnancy, and safer sex as a trans or nonbinary person:

• Gender-affirming hormones aren’t birth control. Gender-affirming hormone treatment (GAHT) can reduce your period or how much sperm your body makes. But it’s still possible to get pregnant even if you’re on hormones. Learn about birth control options. 
• Gender-affirming hormones don’t reduce your risk of getting an STD. Different infections spread differently, like through skin-to-skin contact or through body fluids. Learn about how sexually transmitted infections spread and how they’re treated. 
• Barrier methods for birth control and safer sex — like external condoms, dental dams, and internal condoms — are good tools for trans and nonbinary people. Learn about barriers and safer sex. 
• Trans, nonbinary, and intersex people have developed barrier methods especially for their bodies. For example, a con-dam is a barrier made out of a latex or nitrile glove that’s been cut to function as a dental dam with a small external condom attached. Con-dams can help prevent STDs during oral sex for someone who has a vulva and smaller erect anatomy that wouldn’t fit in a standard external condom.  
• Lube can help reduce your risk of getting an STD. It does this by reducing friction, which can cause tears where STDs can get into your body. Lube is especially important for some kinds of penetrative sex when a person’s body part can’t lubricate itself. People who have a vulva and had a vaginoplasty or have been taking testosterone commonly have little or no lubrication in their vagina or front hole.   
• Gender-affirming surgeries can reduce the possibility of pregnancy, depending on the surgery. For example, a hysterectomy, vaginectomy, or orchiectomy would prevent pregnancy permanently. 
• Talking about safer sex with a partner can feel challenging or awkward. Check out these tips. 

The Safer Sex for Trans Bodies guide from the HRC Foundation and Whitman-Walker Health can be another helpful resource.

What sexual and reproductive health care may I need?

For trans and nonbinary people, sexual and reproductive health care might include:

• preventative care, like a Pap test or prostate exam;
• birth control;
• STD screening and treatment, including PrEP and PEP;
• treatment of sexual or reproductive concerns, like pelvic inflammatory disease or a urinary tract infection; 
• pregnancy care; and 
• abortion care.

What should I know before going to the doctor?

For many transgender and nonbinary people, accessing sexual and reproductive health care can feel complicated or dysphoric. Sometimes care is gendered and doesn’t feel good — like if a trans man is sent for reproductive health care in the “women’s health” department. A trans woman might not be able to get her needs met there either.

You deserve sexual and reproductive health care that respects your body and your gender identity, without discrimination or harassment. Nurses and doctors should use your chosen name, correct pronouns, and call your body parts what you’d like them to be called.

What sexual and reproductive health services can Planned Parenthood give me if I’m transgender and/or nonbinary?

Planned Parenthood health centers are open to people of all genders. You can visit your local Planned Parenthood health center for STD testing, birth control, physical exams, other sexual and reproductive health services, and referrals. Find your nearest Planned Parenthood health center and learn about the services it offers.