Sex

There are a number of ways you can make sure you get the most pleasure out of your sex life while reducing the risk of getting or passing on a sexually transmitted infection.

Condoms

• Whether a penis is the ‘standard issue’ type, surgically-constructed or bought in a shop, the safest option is to always use a condom.
• Condoms are available in a wide range of sizes, shapes and materials. If you have trouble finding one to fit, you can always ask your partner to wear a Femidom. This is a condom worn inside the body of the partner being penetrated and can be used in the vagina or anus (if the top ring of the Femidom is removed).
• The best information we have is that Femidoms are the safest option for those with a metoidioplasty (a type of genital surgery that creates a small penis) or enough testosterone-enhanced clitoral growth for penetration.
• Dental dams are a sheet of latex which can be used for vaginal or anal oral sex. The sheet of latex is used to cover the genital area and provides a barrier which can prevent the transmission of STIs.
• Always change condoms between partners, as infectious fluids can transfer on the surface of a condom. Never use the same condom from anus to vagina, even with the same partner, as bacteria in the rectum can cause vaginal infection.
• If you’re having sex for more then half an hour, change the condom for a fresh one, as the longer you use a condom, the greater the chance of it breaking.
• If a condom breaks, you can always consider accessing PEP to help prevent an HIV infection from taking place.
• Condoms and gloves are available in both latex and non latex varieties for people who have allergic reactions to latex.

Lubricant

• Use water or silicone-based lubricant with condoms to reduce the risk of damage to the skin during sex and reduce the chance of the condom breaking.
• Avoid using oil-based lubricants (such as Vaseline, baby oil or moisturisers) with latex condoms, as these can damage the condom and cause them to split.
• Avoid using silicone-based lubricant with silicone sex toys as it can degrade the surface of the toy.

The NHS Freedoms website sells a wide selection of condoms and lube at low prices.

Safer sex and T

Testosterone (or ‘T’) can change vaginal lubrication, so some transmen find they just don’t produce enough. Some also report more thrush or cystitis. While there is no conclusive proof, this may be because the natural acidity in the lubrication has changed, making them more vulnerable to infection. This change seems to be more of an issue during the first few years on testosterone.

Reduced levels of oestrogen affect the thickness of the walls of the vagina, which may result in tiny unnoticed tears happening more easily during sex. Some also report the walls of the rectum are affected in the same way. This makes it even more important to use condoms and lube.

You will be able to access PEP at your nearest sexual health clinic. 

Discovering your male sexuality can be really exciting. Wherever you are in your transition, you are entitled to have sex that is safe and enjoyable. You should never be pushed into anything that you feel uncomfortable with.

Anal and Vaginal sex

• The highest risk for getting a sexually transmitted infection (STI) or HIV is through unprotected anal or vaginal sex.
• The best way to protect yourself and your partner is to use a condom or Femidom (female condom) for vaginal or anal sex.
• Use water-based or silicone-based lube with your condom or Femidom.
• Some infections (such as herpes, genital warts and syphilis) can be transmitted through regular skin-to-skin contact.
• Using a barrier method - such as a condom, dental dam (a latex square placed over the genital or anal area) or a latex glove - will reduce the risk but will only protect the covered area.

Oral sex

• Oral sex is a lower risk sexual activity than penetrative anal or vaginal sex, but it is still possible to get or pass on STIs in this way.
• It is possible to get HIV from oral sex but it is relatively much less risky than penetrative anal or vaginal sex. It is more likely that you will pick up bacterial STIs (such as herpes, syphilis or gonorrhoea) from oral sex.
• Bleeding gums, ulcers, a sore throat or recent dental work can make it easier for an infection to get into the body. Avoid oral sex in these circumstances.
• If someone gives you oral sex when you have recently had lower surgery, any unhealed wounds could provide a way for STIs or other infections to get into your body or theirs.
• To reduce the risk from oral sex, avoid letting a partner ejaculate in your mouth. You can also use flavoured condoms or dental dams for oral sex.
• If you give someone oral sex, don’t clean your teeth or use mouthwash beforehand as your gums may bleed, providing a route into your body for an STI or HIV.

Sex Toys:

• Infectious fluids can transfer on the surface of sex toys, so always clean them thoroughly using warm soapy water before using them with different people.
• Alternatively use a new condom to cover the sex toy for each new person, or avoid sharing sex toys.
• Sex toys can cause tiny unnoticed tears during sex to the skin lining the vagina or the anus, making vaginal and anal sex especially risky unless you use condoms and lubricant.

Fingering:

• When fingering, make sure you don’t have any cuts on your hands or fingers, keep your nails short and use plenty of lube.
• Infectious fluids can transfer on the surface of fingers, so always clean them thoroughly using warm soapy water before fingering a different partner.
• Alternatively use a new condom to cover the finger, or avoid fingering more then one person.

Rimming:

• Rimming is licking someone’s anus.
• It’s extremely low risk for HIV but it is possible to pick up hepatitis A or bacterial infections (such as shigella or gonorrhoea) from rimming.
• These risks can be reduced slightly with good personal hygiene, or more effectively by using a dental dam to cover the anus.

Frottage:

• Frottage involves rubbing genitals together without any penetrative sex.
• It is low risk generally but there is a chance that skin-contact bacteria or viruses could be transferred (such as herpes, syphilis or genital warts).
• Parasites (such as scabies or crabs) can also be passed on via skin contact.
  

Discussing healthy, safe sex for transmen means recognising that transmen can have partners of every gender and a variety of body types. Your sexual preferences, if you are sexual, may include being a receptive partner in anal, oral or vaginal sex. Equally, you may enjoy being a penetrative partner in those situations.

You may be submissive or dominant, or be able to switch between the two. Your ideal may be a heavy bondage session or simply affectionate cuddling. The key thing is that the sex is healthy, safe and what you want and are comfortable with.

You may encounter some preconceptions when negotiating the sex you want – for example, that all transmen like women, that all transmen want to receive or give anal sex or that no transmen are comfortable using their vagina, if they have one. Whether or not any of these are true for you, aiming to practise good consent (keeping sexual activity consensual and respectful of your limits and preferences) means that your sex will be safer and more likely to meet your expectations. All of this means that you are more likely to enjoy it.

Being aware of the preconceptions mentioned, discuss things with your partner beforehand to ensure that you both understand what you’d like to do and what is off-limits. This doesn’t have to be overly formal but it can be fun, eg: ‘What I really enjoy is…’, ‘I don’t like to... but I do want to…’, ‘I don’t want to try that now but would you like to try…’ etc.

It’s absolutely fine to call a halt to things if you stop enjoying them. Anyone who doesn’t respect your request is not respecting you and may be committing a sexual offence. You might use a ‘safe word’ – a word or phrase that instantly calls a halt to things, commonly used in the bondage (BDSM) community.

Gender dysphoria can make intimacy difficult, particularly if you find getting erections upsetting or triggering (causing you to re-experience emotional distress). So making sure your partner will be sensitive to your needs is essential.

If your partner does not respect your wishes or practise good consent, this may be abusive. Even if you do not feel that ‘abusive’ is the correct term, if the way they interact with you sexually makes you upset or uncomfortable, you can access support and advice from LGBT charity Broken Rainbow.