What to Expect from Sex (and Intimacy)

Female-To-Male, Male-To-Female, FamilyDr. Michele Angello

For most people, sex and intimacy are important aspects of life. As a transgender person embarks on a medical transition, these concepts can appear scary and maybe even impossible to deal with. Some trans-women, previously accustomed to having a testosterone-driven sex life, have to find new ways to get turned on since the estrogen and anti-androgen (Spironolactone) diminish the simplicity of becoming aroused or maintaining an erection prior to surgery. Trans-guys are usually surprised by the drastic increase in arousal with the introduction of testosterone. Regardless of whether or not hormones are involved, feeling an intimate connection is much more complicated when you’re trans!

Everyone’s journey will be different and unique, but one thing I like to do with my clients—especially those who are just beginning their journey—is to call out a few of the common challenges. This can help people feel like they have a roadmap for some questions and feelings to expect. From there, I hope to offer words of wisdom that may help the transition in this definitionally vulnerable area of life feel a little less scary…

1. Getting used to a new body takes time, so be patient.

Recognize your impatience, frustration, or whatever emotions come up around the notion of your transition as a process. Put simply, it will get easier. I have noticed that much of my clients’ discomfort when it comes to sex and intimacy in particular comes from the expectation that things will feel “normal” right away now that they are being honest about their self-expression. In reality, though, I often liken transitioning to puberty…and remember how impetuous and awkward we all felt then?

Adolescents experiencing their own bodies as sexual are usually shocked, frightened or even intrigued by the ways in which their bodies respond to fantasy or actual sexual intimacy. They don’t necessarily know what is going to feel good to them. Eventually, they figure it out and even if it’s less than ideal, it serves a sexual purpose. That’s what makes intimacy so complicated when an adult transitions. Most people, regardless of the level of gender dysphoria, find creative ways (through fantasy, creative partnering or other means) to get their sexual needs met as adults. When you find yourself with a new body, one that functions very differently from the one you’refamiliar with, it’s like beginning puberty all over again. And, getting used to these new sensations is just the beginning.

2. Discussing a new body/bodily sensation with a current or prospective partner can be intense, and that’s OK.

Even though we’re sexually saturated as a culture, this level of vulnerability is unique. If the person who is transitioning is already in a relationship, it can feel challenging to the non-transitioning partner to request that things be done differently. If they are coming out to a new sexual partner, it’s a different, but often equally awkward conversation. For the latter, the transitioning person will end up revealing personal matters that those of us who are cisgender never have to talk about. For example, a pre-operative person’s partner will likely want to know if the partner’s turned on by genital stimulation or if that area is to be avoided. Lots of trans folks come up with creative ways to get turned on that have nothing to do with genitals.

3. “Role play” often takes on a new meaning. Explore!

Some people in the midst of transition also enjoy role-playing to “try on” their new gender role and identity. This can be an incredibly fun, creative and empowering way for people to explore what kinds of dynamics they find appealing now that they are in a different place with regard to their gender expression. Note that this also warrants a conversation with regard to how much to divulge and when to do so—so establishing norms about communication at the beginning of sexual play may be a good idea.

Unfortunately, I have found that many people who are transitioning believe that they should just appreciate anyone who wants to be sexual with them. I often say that the dating pool shrinks when you’re trans, but the good news is, you’re left with the keepers. People who are willing to engage you in an honest conversation about intimacy and see you for your authentic self are the ones we all should be looking for!