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How Can Transgender People Have Safer Sex?

satisfied-looking lube cartoon with safer sex gloves

Transgender people have sex in many different ways. This means there are lots of different ways for them and their partners to practice safer sex!

Some transgender people transition physically while others don’t. If someone physically transitions, that means they take hormones, have surgery, or both to change their bodies. Some trans people think of their transitioning going from from male to female (FTM), others from female to male (MTF). Other trans people might transition, but not like these terms. Some might transition in other ways, or not physically transition at all! This means that every transgender person’s body is different.

Because trans people’s bodies and how they have sex can be very diverse, talking about it before you start is important!

How transgender people can talk about safer sex

Talking about your boundaries and desires is an important part of any relationship. Transgender people often have words that they use for themselves or their body parts. You can talk with your partner about which words or pet names you each prefer. This is a great way to help everyone feel comfortable and safe. Having this conversation before you start having sex can take some of the pressure off.

Sometimes people don’t know what words or names work for them and that’s okay too! Playing around with different words can be fun, but it’s important to set and respect boundaries. If a word makes you or your partner uncomfortable, you can stop using it. It isn’t ok to use words that someone doesn’t like.

Transgender people might have parts of their bodies where they don’t want to be touched. This could be for a lot of different reasons. Some transgender people get stressed and uncomfortable when a partner touches certain body parts, while others don’t. Also, if someone’s had surgery, those body parts may be sensitive, or still healing. Talking about this before having sex can help everyone feel safer.

A transgender person may have a particular body part or use a particular word for it. But you can’t assume they want to have a particular kind of sex. For example, a trans woman with what she calls a penis may or may not want to use it for penetrative sex.

You can ask your partner what they like and talk about what you enjoy. This lets everyone learn about their desires and their partner’s. As long as everyone’s excited about what they’re doing, there’s no right or wrong way to have sex!

How transgender people can prevent STIs

There are many ways people protect themselves from STIs (sexually transmitted infections). These can depend on the kinds of sex they want to have and the body parts that are involved. Whatever you do, you can help protect yourself and your partners by getting tested regularly.

People can also protect themselves by using condoms for front hole (what some call vaginal) or rear hole (what some call anal) sex. They can also use external condoms on a penis or dildo to prevent STIs from penetration or oral sex. Internal condoms are another option. They are inserted into front or rear holes before penetration. Since these kinds of sex also have a high risk for HIV, people can also take Pre-Exposure Prophylaxis, also known as PrEP. This is a pill you take every day to lower your risk.

You can use a dental dam for oral sex. This square of latex can go between someone’s mouth and their partner’s front hole, rear hole, or other parts. You can make one by cutting off the closed end of a condom and making a slit down one side. Dental dams are also an option for people who aren’t comfortable using an external condom for oral sex.

If you’re touching or penetrating with fingers, you can use gloves. For a big clit enlarged by testosterone (a neophallus), you can make a barrier for oral sex by cutting off the fingers, cutting up the side without the thumb, and sliding the thumb over it.

Cleaning any sex toys you use often and storing them can help prevent STIs and make your toys last longer. Avoiding sharing toys can also lower your risk for STIs. You can also use condoms or dental dams with toys or sterilize toys between partners.

How transgender people can prevent pregnancy

To get pregnant, a body needs to have a uterus. This is where a fetus can develop in the body. A transgender person with a uterus can get pregnant. The risk is less if someone’s taking testosterone, but it’s possible. Even if someone isn’t bleeding monthly, they may still have a chance for pregnancy.

There are many options for birth control that don’t use estrogen:

  • Condoms, which are cheap and also prevent STIs
  • The estrogen-free mini-pill, which won’t interfere with testosterone
  • The Depo Provera shot
  • The copper IUD, which works for many years. IUDs are also fairly easy to get in Montreal.

A transgender person with parts that produce sperm can also make someone pregnant, even if they’re taking estrogen.

Emergency contraception for transgender people

If you’ve had front hole sex without birth control, there are ways to lower your risk. There’s an estrogen-free emergency contraception pill. You can get this pill at any pharmacy with a RAMQ card or at clinics like Head and Hands.

Doctors often give estrogen-free emergency contraception to people taking testosterone. The copper IUD doesn’t have any hormones and it can also act as emergency contraception. It can also help to talk about emergency contraception with a doctor or pharmacist.

More info:

  • Trans Summer School – Scarleteen

    A series of articles focusing on everything trans, from sex to dating to physical transition to discovering gender identity.

  • Male-to-Female Gender Changes and Sexual Functioning

    Explains how people can undergo sex changes with surgery and hormones, and some of the specific body functions that change as a result.

  • Sexual Health for Trans Women

    A pamphlet from the Center for Excellence in Transgender Health explaining sexual health concerns for transgender women, including birth control, STIs, maintaining erections on hormones, breast cancer, and concerns around tucking (tucking testicles into the body and compressing external genitals) and pumping (injecting silicone to develop a more feminine body shape). 

  • Sexual Health for Trans Men

    A pamphlet from the Center for Excellence in Transgender Health summarizing sexual health concerns for trans men, including vaginal wall thinning, pregnancy prevention, and chest and cervical cancers.

  • Head & Hands Health Services

    Head & Hands is a health clinic for youth ages 12-25 near the Vendome metro station. They offer free, anonymous STD testing, even if you’re not covered by RAMQ. Head & Hands also has a lot of other services, including medical check ups, getting contraception, transitioning, and more.

    They offer a walk-in clinic on most Tuesdays and Thursdays starting at 4:45pm. Everyone who comes in for the clinic is given a name card and entered into a draw. At 5:00pm, they draw 10 names to decide who sees the doctor.

    They recommend bringing your Medicare card if you have it, but you can still see someone if you don’t have it.

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