Trans Sexual Health

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Lower surgery and condoms

Condoms for penises come in different sizes, shapes and materials (including latex-allergy free) so you should be able to find one suitable for you to ensure you’re being as safe as possible.

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.

Not all trans women can use internal condoms – it will depend upon the depth of your vagina.

Lube is important for good sex!

Lube not only makes sex more enjoyable, but it also reduces the risk of a condom breaking. Some people with vaginas can find the hormones they are taking as part of their transition may reduce the natural lubrication the vagina makes, so lube is good to ensure sex is comfortable in these situations.

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.

Sharing sex toys and strap-ons

STIs and other bacterial infections can be passed on through sharing sex toys, so you should use a condom on any sex toys you may be sharing. If a condom can’t be used on the toy you should wash thoroughly between each use.

Lower surgery and HIV

If you've recently had lower surgery and have unhealed skin, this could make it easier for you to acquire or pass on HIV, as bleeding can provide a route into or out of your body. Avoid sex if you have any open wounds or sores, but if you do have sex, use a condom and try to make sure it’s not too rough to reduce your risk.

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.

Do I need to use condoms if I'm on PrEP?

You still need to use condoms if you're taking PrEP, it only protects against HIV, so you’re still at risk of catching other STIs.

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 lgbt@mpft.nhs.uk.

Generally speaking, to test for chlamydia and gonorrhoea we will ask people with a penis to provide a urine sample and people with a vagina to provide a swab sample, which you may be able to do 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 happens if an STI isn't treated?

Untreated STIs can lead to serious health problems (including damage to your heart, brain and eyes), so it’s worth getting checked out between each sexual partner.

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.

Dams protect against STIs too!

Dams (sometimes known as dental dams) are a latex sheet that can be used for oral sex on a vagina or anus (rimming) to protect against STIs.

Remember to only use one side of the barrier; don’t flip it around and use the other side.

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. Some things like Thrush and Bacterial Vaginosis 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?

We understand that in the heat of the moment you may have unprotected sex (without a condom) or a condom you are using may split. If this happens and you’re concerned you may have contracted an STI, visit your nearest sexual health clinic.

If you are worried about HIV following unprotected sex orif a condom breaks, you may need to get PEP (see below). If there is a risk of unplanned pregnancy, we advise that you access emergency contraception.

How often should I get an STI test?

Public Health England recommends that people should have a full sexual health check-up once a year. If someone is having sex with different partners, it's advised they get a check-up every three months.

Don't forget about consent!

It can be exciting 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.

Where can I get a full STI test?

The sexual health clinic at Cobridge Community Health Centre is the main sexual health clinic in Stoke-on-Trent. You may be able to get a test at another clinic or order a free STI test online if you don't have any symptoms.