Trans-Masculine Sexual Health
Transition and enjoying sex
During your transition, you may not feel comfortable with your body. How you feel may change over time, and it’s important to be kind to yourself.
You may find that the person you’re having sex with enjoys parts of your body that you don’t like. Everyone has the right feel happy during sex, no-one should be pressured to do things that makes them uncomfortable.
Your sexual preferences might change; you might want to try anal, oral or vaginal sex. You may also want to experience new things with different people and different genders.
Masturbation is a good way to find out what feels good for you, there are lots of things to try, including different lubes and toys. If you’ve recently had surgery, check with your healthcare professional to see how soon you can masturbate.
Everyone is different and you may feel shy, excited or curious about how something may feel. Take your time to find out what feels good for you. Having sex with someone you feel comfortable with can make it more relaxing and enjoyable.
Lower surgery and condoms
If you’ve had a metoidioplasty (a type of genital surgery that creates a small penis) or enough testosterone-enhanced clitoral growth for penetration, an internal condom is the safest barrier method for you to use with your partner. You can use internal condoms for vaginal or anal sex; remove the top ring for anal sex.
Lube is important for good sex!
Lube not only makes sex more enjoyable, but it also reduces the risk of a condom breaking. Lube can make sex more comfortable, particularly if taking T is reducing the amount of lubrication you produce, or if you’re having anal sex.
Avoid oil-based lube as this can erode condoms and make them break. Silicone-based lube is good for anal sex as it lasts quite a while, but it shouldn’t be used with sex toys which have silicone in them as this can damage the toy. Water-based lube is good to use with condoms and sex toys so it’s a great all-rounder! You can get this from our groups, C-Card packs and sexual health clinics.
Lower surgery and STIs
If you've recently had lower surgery and have unhealed skin, this could make it easier for some STIs, like HIV, to be passed on. Speak to your healthcare professional for advice on sex after surgery. Terrence Higgins Trust have lots of useful information about hormones, surgery and safer sex, take a look at their website.
Visiting a sexual health clinic
When you visit one of our sexual health clinics, you will be asked to fill in a registration form. We ask for your gender at birth as well as your gender identity. It’s important to ask both of these questions as gender at birth can help us determine which tests to run, and gender identity can help us identify which pronouns you’d like us to use. We can help support you to attend the clinic if you’re worried, get in touch with us to discuss this by emailing .
To test for chlamydia and gonorrhoea we will ask for a urine or swab sample, depending on the type(s) of sex you’ve had. You may be able to do this yourself. If you tell the clinician you see about any genital surgeries you’ve had, this can help them determine the best way to collect your sample. Testing for HIV and syphilis is a blood test so this is the same for everyone.
What is PrEP and where can I get it?
PrEP (pre-exposure-prophylaxis) is a pill that protects you from HIV which is taken before and after sex. When taken this way, it’s highly effective at blocking HIV, if it gets into your body.
It’s safe to use for trans-masculine people and doesn’t affect or interact with your hormone treatment.
You still need to use condoms if you're taking PrEP, it only protects against HIV, so there is still risk of catching other STIs. See information on types of sex and staying safe here.
To access PrEP, call your local sexual health on 0300 7900 165.
Find more information on PrEP at tht.org.uk
Testosterone/T and sex
Taking Testosterone (or T) can change the amount of lubrication your body produces, so make sure you have plenty of lube handy for sex.
Reduced levels of oestrogen cause changes in the genitals, which may result in tiny unnoticed tears happening more easily. Making it even more important to use condoms and lube.
Being on testosterone will decrease your fertility and usually stop your periods within a few months.
However, testosterone is not an effective form of contraception. If you don't want to get pregnant, you can use condoms or discuss other contraception options with your local sexual health team. Many contraception methods are safe to take with testosterone.
Why should I use condoms?
If you’re having sex with someone, condoms are your best defence against sexually transmitted infections.
External condoms (for penises) and internal condoms (for vaginas or bums) are both available from our groups and local sexual health clinics. An internal and external condom should not be used at the same time. To use internal condoms in the anus the top ring of the condom needs to be removed.
Condoms come in different sizes, shapes and materials (including latex-allergy free) so you should be able to find one suitable for the type of sex you’re having.
What are common STI symptoms?
Some signs you may have an STI include:
burning when peeing
lumps, bumps or sores around anal/genital area
discharge from the penis, or unusual discharge from the vagina
itching around genitals
Remember: some STIs have no symptoms, so it’s worth getting a regular sexual health check-up.
If you have some of these symptoms, it doesn’t always mean you have an STI. Other infections can cause similar symptoms so it’s worth visiting your GP or nearest sexual health clinic if you're worried.
What happens if the condom breaks or if I don't use one?
If you have unprotected sex (without a condom) or a condom you are using breaks, call your nearest sexual health clinic for advice and for information on how and when to get an STI test.
If you are worried about HIV following unprotected sex or if a condom breaks, you may need to get PEP (see below).
If there is a risk of unintended pregnancy, we advise that emergency contraception can be accessed for free.
What is PEP and where can I get it?
PEP stands for post-exposure prophylaxis and is a treatment that can stop a HIV infection after the virus has entered a person’s body. It needs to be accessed within 72 hours and is for emergency use only. You’ll need to speak to a sexual health clinic or A&E to find out if you need to take PEP.
Read more about PEP on tht.org.uk.
Don't forget about consent!
It can be exciting to try different things with regards to sex, but one thing should never change and that is consent.
Consent must be given for each sexual act by everyone involved. You shouldn’t feel pressured to do something you’re not comfortable with because someone assumes that’s what you should be into because of your sexuality or gender identity.