Is it all about Sex?
Sometimes it can feel like the whole world is always talking about Sex and when, how and who we should be doing it with! Alongside this we often get messages abour how scary sex is and told how it can go wrong leading to really awful consequences. The reality is that most people who are sexually active do not have an STI and for a great many people sex is fun, pleasurable and part of healthy relationships. However, it's worth thinking about just taking a few simple steps to maximise pleasure and minimize any risks. This page is designed, with young people identifying as part of the LGBTQ+ community, to make sure your experiences are pleasurable, safe and fulfilling.
But Sex is a really personal thing and for some people it's just something they will only do if they have a really strong connection with someone, or not at all. This is perfectly fine and if you feel this way you are definitely not alone, and no-one should ever pressure you into changing who you are. Talking to someone you can trust to help you navigate decisions around sex and relationships can be a good idea to help us reflect on what we want and need.
What is Sex?
A question that can be quite hard to find the answer to for LGBTQ+ folks. A lot of the info or representation that is out there about sex can be very heteronormative. Often sex is spoken about as if it’s just a penis going in a vagina, and any other type of sex is dismissed as foreplay. This is how some people like to have sex, and that’s totally cool. But for some of us, there might not be both a penis and a vagina present in sex, or penetration might not be what we’re into, and that’s totally fine too!
Simply put any type of touch that brings us or our partners pleasure, that feels nice, turns us on or helps us feel connected can be thought of as Sex, or sexual activity. However, there are a number of terms out there which you may have heard such as;
Oral sex - Stimulating the vulva/clitoris, penis, or anus with one’s mouth or tongue
Sex involving hands/fingers - Stimulating the vulva/clitoris, penis or anus using one’s hands, fingers or a sex toy
Penetrative sex - penetrating the vagina or anus using a sex toy, fingers or one’s penis
Other types of sex - stimulating the penis or clitoris/vulva using the body in ways that feel pleasurable, e.g. scissoring, frottaging, tribbing.
Masturbation - touching your own genitals/body, in private, in a way that feels good to you
Virtual/online sex - including sexting, swapping nudes, webcam sex
Sex may also include kissing, snogging, caressing, stroking and flirting.
Terminology can sometimes be confusing, especially if you have not had much sexual experience and language also changes over time to further confuse things! but some common terms include;
Oral Sex; stimulating someone’s genitalia with mouth or tongue. Eg this could include stimulating the clitoris, or penis with the mouth.
Vaginal Sex; Often means sex where a penis enters a vagina, however this can also include two people who rub their vagina’s together, or use of sex toys.
Anal Sex; Often means sex where a penis enters the anus, but can include use of toys inserted into the anus.
Touching / Stroking, especially around the genitals can be very pleasurable, however massage / touch on other parts of the body can be pleasurable and understanding your own body, your likes and dislikes is really important.
Masturbation, (aka solo sex) describes activities where someone can bring themself to an orgasm. Mutual masturbation would be when someone and ther partner stimulate each others genitals
Sex toys have grown in popularity in recent years and they come in a wide variety of sizes, shapes and functions! Many individuals use these in solo sex (eg masturbation), or as part of sexual activity with others.
Virtual sex can include things like on-line (eg video-calling), sexting or talking. However, the online world carries a high degree of risk, particularly where images are created and sent, and you can never be 100% sure these images will not be sent elsewhere. Unfortunately, images can be used against you even by people you are or have been in a relationship with. For more information on online support and information take a look at CEOP
It is important to remember you are never obliged to do something you don’t like just to keep someone else happy, and there is no shame to exploring what you like, or how you respond to different stimuli.
Consent
Consent is a really important aspect of any kind of relationship wether it is sexual or not, and laws around consent are there to help keep people safe. It is especially important that before any kind of sexual activity you ask for consent, and you make sure consent has been given by the other person before sexual activity takes place.
Consent is when someone agrees by choice and has capacity and freedom to make that choice.
Any kind of sex which is not consensual, is sexual assualt, harrassment or rape and against the law. Practising consent means we avoid harming others and helps make sure that if you do decide to have sex this is about pleasurable experiences for both you and your partner. If you feel you have been subjected to sexual assualt then it is important you talk to a trusted adult who can help you get the support you need.
For more information on consent have a look through the questions below;
What is the age of consent for someone who is part of the LGBTQ+ community?
The age of consent is 16 regardless of gender or sexuality and any sexual activity under this age would be unlawful. However, the purpose of the age of consent is to protect young people from adults who may exploit them and not to criminalise young people.
In practice this means that if two people aged 13-16, of a similar age both freely agree to sexual activity then it is very unlikely they would be in trouble or at risk of prosecution. If someone is under 13 then this agreement cannot be taken into account and it is very likely the police will become involved. It is worth remembering that even though people can sometimes look older than they actually are, the law will only look at actual age, not how old someone might look.
However, it is important to remember 16 is the age at which the law decides you can consent to sex, it does not mean that you have to have sex. Everyone will have their own timescale for when it feels right for them, for some that may be quite early eg 16, but for others they may feel it is never right for them. The only person who can decide for you, is you.
Does age of consent matter when online?
Yes. In the uk individuals are legally recognised as Children until the age of 18 so taking and distribution images of people under 18 would be illegal. However, how the law applies will vary depending on circumstances.
For example if two 17 year olds shared images of themselves, didn't pass those images on to anyone else and deleted them if they break up it is unlikely that there would be legal consequences for either person.
But if one person was pressuring or forcing someone to share images, distributing images of their partner or former partner or uploading them onto websites, or there was an age gap (particularly where one person was legally and adult and the other legally a child)this would be treated much more seriously.
Also sending nude pictures (ie unsolicited 'dick pics') can be very distressing and be viewed as sexual harrasment so again would be treated more seriously.
What does Capacity to consent mean?
Capacity means our ability to make an informed choice, in other words are we in the right frame of mind to make the choice to engage in sexual activity. Things that can affect our capacity to consent include;
Alcohol / other substances; too much can mean we lose the ability to know whats happening and/or what's happening to us.
Mental ill health; this can be temporary or longer lasting and can prevent us being able to understand what is happening and make an informed choice
Drowsiness / unconciousness; where we simply are unaware of whats happening to us at the time
Age/maturity; which is linked to understanding and our ability to make an informed choice.
If we are wanting to have sex with someone, and we’re not sure if they have capacity or not, for example, we’ve both had a couple of drinks, or the other person is very sleepy, then it is better to not do anything sexual and wait until another time. Otherwise, we risk waking up the next day, and someone feeling like they were harmed or their boundaries were violated.
What does Freedom to consent mean?
Freedom means that we are having sex purely because we want to, and we know that if we were to say ‘no’ or change our minds, that absolutely nothing bad would happen and there would be no negative consequences.
Things that mean someone might not have freedom and it will not be consensual:
Being threatened in any way, e.g.
“I’ll tell everyone you’re gay if you don’t do this”
“I’ll hurt you if you don’t do this”
“I’ll tell everyone at school you’re a slut”
Being put under pressure in any way, e.g.
“Come on, you can’t leave me like this!”
“Come on, don’t be such a tease”
Asking someone after being told no, or on repeat, until they give in.
How do we know if we have consent?
The easiest way to get consent is to ask and check. It’s really important that we check in with our partners before and during sex. This can be verbal (e.g. “Can I kiss you?” “is this okay?” “does this feel good?” “how do you want me to touch you?”) and non-verbal (e.g. checking that someone’s body language and face looks like they’re enjoying themselves, are present, are responding/reciprocating our touch).
Remember you or your partner can change their mind if something doesn't feel right, and it is really important we respect this and reassure them that it's ok (e.g. “that’s okay, want to cuddle instead?” “Want to watch a show instead?”).
Sometimes someone will make it obvious by saying "No" or " Stop"’, but they may be more likely to communicate this by making excuses, like ‘I’m too tired” or “My mum’s coming home in half an hour so we can’t” or “can we do another night”. They might also just look disengaged or spaced out, not reciprocate our touch, have closed off body language, be avoiding our eye contact, or backing away from us.
If we respond to any signs of ‘no’ by putting any pressure on our partners, e.g. “Oh come on, but I’m turned on now”, “You said you wanted to before”, then this will make someone feel like they have to have sex, when they don’t want to. This is not consent.
Questions about Neurodiversity
Within the queer community we know there is a big crossover with those who have some sort of neurodiversity (i.e. autism, ADHD) and identify as LGBTQ+ and therefore this can be an important factor to consider when it comes to sex. In fact, there is research to suggest that a high percent of people who are on the autistic spectrum identify as queer too! As sex usually involves physical touch and reading body language, it can mean sex for those who are neurodivergent, can be a tricky thing to navigate. It’s important to remember whoever you are, whether neurotypical or neurodivergent that there is no rush, you should always take it at a pace that feels right for you and your partner and communicate in ways that make you feel empowered and heard.
Neurodiversity encompasses a broad spectrum and different people will be affected in different ways, but some things to consider include;
Sex can be all about the senses, but for some folk this can be way too overstimulating so you may need to consider and plan how you can set up a comfortable feeling environment. Thinking about whether you may want music/lighting/other sounds/what textures of bedding or clothing may feel comfortable/whether skin to skin contact may feel good or too much/what kind of pressure on your body feels good. There is no ‘right way’ so it’s a good opportunity to explore what feels right for you and your partner.
Lube! For some people the texture of lube may be very off-putting, it’s a good idea to do your research and find something that works for you. Factors to consider could be sticky-ness or the smell of lube, there are lots of different types and brands out there so doing your research and being prepared will make you feel most at ease. A key thing to remember is that where condoms are involved all Lube should be water-based.
Reading body language may be more difficult. For example some people eye contact can feel extremely uncomfortable and therefore the ‘signs to look out for’ when it comes to consent might be a little different for someone who is neurodivergent. To ensure that everyone is feeling comfortable and consents you should make sure you and your partner are aware of what a ‘no’ and a ‘yes’ might look or sound like. If it’s helpful you could also discuss a strategy for communicating non-verbally, eg. ‘a double tap on your left shoulder would mean stop if I can’t verbalise it’
Sex can feel overwhelming! It’s absolutely okay to say you may need to take a break! To ensure everyone is on the same page it would be a good idea to communicate this before any sexual activity begins. A break during might also be a good time to check in with your own body as often the signals in our bodies don’t always reach our brains – Do you need water? A toilet break? A snack? A movement break? To stim?
Sexually Transmitted Infections
Sexually Transmitted Infections are a particular group of infections including Bacteria, Viruses, Parasites and Fungi that are passed from one person to another during sexual activity. Many are curable, but not all, and for those which cannot be cured there is usually very effective treatments.
Whilst there are over 30 different infections which can be passed on through Sex the majority of infections come from a relatively small number of different types such as;
- Chlamydia
- Gonorrhoea
- Genital Herpes
- Genital Warts
- HIV
Brook has produced some really useful resources on STI specific factsheets
Other links you may find useful are;
NHS Page for Lesbian and Bisexual Women
In Egnland in 2023 over 400,000 infections were diagnosed with young poeple under 25 being disproportionately affected so in your lifetime it is quite likely you will come into contact with someone who has an STI, and be at risk of acquiring an infection.
Will I be able to tell if me or my partner has an infection?
Many STI's, including the most common (Chlamydia), usually don't have symptoms so you won't know. The only way to check would be through taking a test either at one of our clinics or through our Home testing service which would be able to test for Chlamydia and Gonorrhoea.
We would reccomend taking a test every year, or when you have a new sexual partner.
How can I protect myself and my partner during Sex?
One way we can prevent getting or passing on STIs is by using protection. Protection is a literal barrier that stops skin or bodily fluids coming into contact with someone else’s skin or bodily fluids. This includes condoms and dental dams.
External condoms can be put on a penis or a sex toy during any kind of penetrative sex, such as if the penis or sex toy is being put inside a vagina or anus, or if someone is performing oral sex on a penis.
Internal condoms can be put inside a vagina or anus if that person is going to be penetrated by a penis or sex toy during sex. This can be helpful especially for if the penetrating partner is trans masc/ trans man as has smaller bottom growth, or if someone wants to be in control of their sexual health, as you can put an internal condom in a couple of hours before sex.
Dental dams are squares of latex that can be held over a vulva or anus during oral mouth-vulva or mouth-anus (rimming) sex
Is the risk of STI's from different Sexual Activities the same?
The following table highlights some of the risks of STI transmission during different sexual activities, more detailed information is included in the links at the bottom of this section. Also, sexual activities which involve the Anus will also carry a risk of passing bacteria which can cause sickness and diarrhoea.
However, taking reasonable precautions such as using condoms or dental dams, latex squares which form a barrier between mouth and Vagina or Anus, will significantly reduce any risks leaving you free to enjoy your sexual relationships.
Penetrative Sex;
| Generally unprotected penetrative sex carries the highest risk of STI transmission, eg Chlamydia and Gonorrhoea are relatively easily passed from one person to another this way.
HIV can also be passed this way, although an individual on effective treatment cannot pass HIV onto their sexual partner.
Risk from sex toys comes from these being passed from one person to another, without being cleaned or condoms being used.
Condoms and water-based lube, to reduce risk of condom splitting, will significantly reduce the risk of STI transmission during penetrative sex
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Use of fingers;
| This is low risk and it is generally uncommon for infections to be transmitted this way. Important to practice good hygiene when touching someone’s genitals and especially when touching someone’s anus, as this can transmit bacteria. It is extra important to wash your hands between touching someone’s anus and vagina as this can lead to STIs, thrush, and BV. Also important to be careful if you have cuts on your hands and fingers as this can increase risk slightly |
Oral Sex including;
| Some infections, eg Genital Warts and Herpes can be passed this way if one partner has an active outbreak of Warts or Sores. Other STI’s such as Chlamydia, Gonorrhoea are possible although the risk would be low. Cut / inflamed / bleeding gums may increase the risk of transmission.
Dental Dams will reduce risk of STI transmission |
Vulva on Vulva (aka scissoring) | It is possible to catch infections such as Chlamydia and Gonorrhoea through this activity, but risk is low. It is also possible to pass infections such as Genital Warts and Herpes this way during an active outbreak, ie if a blister / sore or wart is rubbed again your partners vulva.
Thrush or BV can also pass between partners this way so best to avoid until this has cleared up. |
Vulva on leg (aka Tribbing) Penis on Leg (aka Frottaging) | No practical risk of STI transmission Important to practice good hygiene when touching someone’s genitals and especially when touching someone’s anus, as this can transmit bacteria. It is extra important to wash your hands between touching someone’s anus and vulva as this can lead to STIs, thrush, and BV. Also important to be careful if you have cuts on your hands and fingers as this can increase risk slightly |
Hand on penis (aka Handjob) | No practical risk of STI transmission. |
People tend not to restrict themselves to a single way of having sex and people often engage in different activities during a single sexual encounter or over several, and risk will also be influenced by other things. For example; polyamorous / monogamous relationships may change level of risk. How often someone tests for STI’s. For example, if couples test for STI’s before engaging in Sexual Activity this will influence risk of STI’s within the relationship. Open and honest communication about sexual history between partners helps individuals make informed choices about their protection. Regardless of sexuality, screening is recommended for individuals who are sexually active and frequency will very much depend on the type of sexual activities engaged in, number of sexual partners and whether or not protection is used. Check out the links for other sources of information or you can contact the service to discuss your sexual health needs, including testing for STI’s where a doctor or nurse can offer support and advice. Useful Links; NHS Page for Lesbian and Bisexual Women NHS Page for Gay and Bisexual Men Terence Higgins Trust page for Trans and non-binary people
| |
What medicines and treatments are available for STI's
There are lots of treatments for STI's and these are usually very effective. As a general rule bacterial infections like Chlamydia, Syphilis and Gonorrhoea can be cured with antibiotics quite easily, but Gonorrhoea is becoming more resistant to these drugs so is becoming harder to treat.
Other treatments are used to prevent the infection so some types of the Human Papillomavirus (HPV) which cause Genital Warts are treated through vaccination provided in secondary schools.
HIV is another important infection where treatments have progressed and medications like PrEP can be taken before sexual activity to prevent someone catching HIV. If someone has HIV then they will live with the virus for the rest of their life, but medication can suppress the virus in the body so they don't experience symptoms and the amount of virus in the body fluids is so low it becomes undetectable. At this point it is not possible to pass the infection on to sexual partners, this is known as U=U (Undetectable equals Untransmissable).
Do I need to inform my current partner(s) or previous partner(s) if I have an STI
If you have an STI it is good practice to inform your partner(s) so you can have a discussion about what that means for you both in terms of sexual activity that would be pleasurable and prevent transmission of the infection.
Where you have sought treatment from a sexual health service they will be able to offer support in a couple of ways;
Firstly they will be able to contact previous and current partners to explain that they may have come into contact with a known case of an STI so they can be offered testing and treatment.
Secondly they will be able to offer advice on what sexual activities would be safe and/or how long you may need to wait before engaging in certain activities before it would be safe to restart.
There is unfortunately still a lot of stigma, shame and embarrassment around having STIs and while they can be unpleasant, there’s nothing wrong about having them, nor does it say anything about us! Sometimes this shame and judgement stops people getting tested and treated, which then makes the problem worse. So its important we accept that when we’re having sex, STIs can be something that sometimes happens, but we just need to get help, and communicate clearly with our partners.
Contraception and Pregnancy
If people are having penis-in-vagina sex, or sex where there is a chance that semen (sperm) will come into contact with the vagina, there is a chance of pregnancy. One way that we can reduce this risk is using contraception.
Contraception types include longer term types, sometimes referred to as Longer Acting Reversible Contraceptivs (LARC) that are fitted by a doctor or nurse, such as a hormonal or copper coil, or hormonal implant, injection. Shorter-term types include the combined or progesterone only contraceptive pill, or using temporary methods such as condoms or Femidoms. Visiting a sexual health service will give you the opportunity to talk about the different types and work out which method would be most effective and suitable for you. More information on different types can be found on the Brook Website
You can access hormonal contraception and condoms at sexual health clinics for free. In addition to this condoms are widely available, for free, through youth services or can be bought at most pharmacies and supermarkets.
What if I forget to use contraception? or something else goes wrong?
If someone forgets to use contraception, or a condom fails, people can get emergency contraception to prevent pregnancy.
This includes Emergency Hormonal Contraception (EHC) (sometimes called ‘morning-after pill’) which can be taken up to 3 days or 5 days after unprotected sex depending on which type is used. If EHC is not suitable for any reason the copper coil can be fitted up to 5 days after unprotected sex. As a general rule accessing emergency contraception as soon as possible after unprotected sex (ie penis to vagina sex without a condom) is advised.
Emergency contraception is provided free at sexual health clinics and we can be contacted at our clinic at Broad street on 01422 261370.
There is also provision in Calderdale for people under 16 to access emergency contraception free at selected pharmacies. Take a look at our webpage to find out more about this provision.
It is also possible to purchase Emergency Hormonal Contraception at pharmacies, however this can be expensive.
I am a person with a vagina on Testosterone therapy, do I still need contraception?
If someone with a vagina is on testosterone, this does not fully remove the risk that that person could get pregnant if they are having penis-in vagina sex. For someone on T who is having P-I-V sex it would be a good idea for them to speak to their sexual health service about contraception options.
What can I expect from Sexual Health Services?
Calderdale sexual health services are here to support you to have pleasurable and safe sexual experiences, and make sure if something does go wrong you get the most appropriate treatment and care to meet your needs.
We strive to welcome everyone in to our service and ensure your experience is as smooth and comfortable as possible. More information on when you can access us can be found on our opening times page
We've also pulled together some more questions you may have in the tabs below.
How do I access the sexual health service?
We offer a range of walk-in and appointment clinics, including an under 19’squeue and wait clinic on a Monday. For more details on when we are open please see our opening times page
We will always work to provide the most appropriate healthcare possible to ensure your needs are met. We understand sharing your sexuality might not be easy, but it does allow us to provide you the best and most appropriate care possible. However, you will not be forced to share information you do not wish to.
Will I be judged for my sexuality and will this affect how I am treated?
No. Our staff offer a non-judgemental and inclusive service for anyone who needs us irrespective of sexuality or gender identity. Please be assured that our role is to make sure you receive high quality care that meets your needs and this applies to all.
Will I be “outed” if I attend the service?
No. We understand for many LGBTQ youth coming out can be a long process and individuals will ‘come out’ to different people at different times. Any information you share with us regarding your Sexuality or Gender will be treated in the strictest confidence.
My parents do not know about my sexuality, will they find out?
We would not share information on your sexuality with parents.
Our aim is to make the experience as comfortable as possible and we will always try and make sure the services we offer are appropriate to your needs. If you could let us know when making an appointment or the clinician know of your neurodiversity at the start of the appointment we can better meet your needs.
If you could give us as much information as possible prior to, or at the beginning of an appointment, this will help us use terms that you are comfortable with. This can be stated, but of course we understand this may be difficult so a list of comfortable terms can be written down and provided to the clinician at the start of your appointment.
No. Our role is to ensure you are provided with the most appropriate healthcare to support your sexual health. This may involve discussions around contraception, testing and treatment for Sexually Transmitted Infections (STI’s), and reducing risks of acquiring an STI. However, your choices, including who your sexual partners are, will be fully respected.
Who will be able to see my information?
The only people who will be able to see your patient information are those directly involved in your care, and even in these circumstances they will only see the information which is relevant to the care they are providing at that time.
Are there any circumstances you would share my information?
We would only share information, ie break confidentiality, where a member of staff providing your care believes you are risk of significant harm. In these situations a member of staff would explain what their concern is, why they are worried about you and what the next steps would be. Information shared would be related to the concern they have. Any safeguarding concerns would initially only be raised with a safeguarding lead within our service.
Can I bring someone else in to the consultation room?
Yes. We may ask to spend a few minutes with you privately to make sure you are comfortable with someone else in the room. There are also practical reasons, eg room space, which would limit the number of people in the room at any one time. However, we want you to be able to access services and be as comfortable as possible whilst doing so bringing along a friend, carer, parent etc is fine.
I am more comfortable talking to a male nurse/doctor can this be accommodated? or I am more comfortable talking to a female nurse/doctor, can this be accommodated?
Unfortunately we cannot guarantee the gender of your clinician. However, if you would like to explain your preference when you attend one of our walk-in clinics or make an appointment we can try make sure you are seen by someone who is your preferred gender.
Will my consultation be confidential if I am under 16.
Yes. You have a right to confidentiality so unless a clinician believes you to be at risk of significant harm the information you provide and the details of your treatment will not be shared. If you attend the service on other occasions in the future then the doctor or nurse may access previous notes to ensure you are provided with the most appropriate care.
However, if you are under 13 and we believe you to be sexually active then we are obliged in these circumstances to make a safeguarding referral so confidentiality would need to be broken.
What happens if I am not happy with service I received?
Feedback is really important for us to offer a good service and make sure we put things right if we don’t offer the quality of service you deserve. After your appointment you will be given the chance to complete a short questionnaire anonymously, which is referred to as a ‘friends and family test’. This is an opportunity to let us know what we did right and more importantly what we need to improve.
Other sources of help, advice and information
Hopefully this page has been useful in answering some of your questions about sexual health, but being LGBTQ+ is way more than being just about sexual health so you might want to have a look at these other organisations and webpages which can offer help and guidance.
This local organisation offers a wide range of support but what might be particularly useful is their youth support where you can meet and socialise with other young people who identify as LGBTQ+ in a safe space.
This is a national organisation that works to promote and support the sexual health of young people, including those who identify as LGBTQ+.
Webpages which offer a whole range of support from choosing a career path to mental health support and much more besides.
Organisation which can offer help to LGBTQ+ young people, including support for young people who are worried about or experiencing abuse. This site includes contact details for services that can provide practical support and help, alongside information which helps to support well-being.
Webpages with lots of resources to help LGBTQ+ young people.
Trans identities and Sexual Health
Gender dysphoria can make sex quite a difficult area to navigate, and discuss with a partner. However, if having a sex life is important to you, as it is for many people, then there a few things to consider.
Remember Sex is not limited to a narrow range of activities and anything that we get sexual pleasure from can help us feel good and connected to another person.
Understanding what we enjoy is important so taking time to understand what feels good / not so good when it comes to our own bodies is a really good idea.
Talking to your sexual partner about boundaries, preferences and language you are comfortable with can all help make sexual activities and experiences more pleasurable. It may also be useful to have a safe word / gesture so if you do experience gender dysphoria during sex you can safely stop and take some time out.
The questions below may help with some questions you may have but Terrence Higgins Trust has a comprehensive website which goes into a lot more detail which may be useful. Terrence Higgins Webpages
Getting an STI can be particularly upsetting for Trans and Non-binary individuals as it may trigger feelings around body dysphoria and mean engaging with body parts you do not wish to engage with. We understand this can be difficult and if there is anything we can do at the service to make this easier then please let us know.
Condoms, internal condoms, and dental dams remain the most effective ways of reducing risk of STIs whilst being sexually active.
Information For Transmales
Testosterone therapy will suppress the menstrual cycle and lead to fewer periods and longer gaps between them, and at higher doses of testosterone can stop periods altogether. This is something you can discuss with your clinician at the service when accessing your regular contraception.
Should I think about HPV and Hep A&B vaccines?
Currently, and for the last few years all school children have been offered the HPV vaccine which protects against the strains of HPV implicated in cervical, anus, throat and mouth cancers. Men and Trans men/women who have sex with men are also at a higher risk of contracting Hepatitis A and B so it is important that trans-males discuss this with their healthcare provider, or with Sexual Health services to ensure that you are vaccinated against these infections.
Do I need Cervical Screening?
We recognise that trans masculine people may experience barriers when accessing cervical screening. However, as trans masculine people are at the same risk of cervical cancers as cisgender women, its important that they are still accessing cervical screening after age 25. Anyone with a cervix is eligible for cervical screening, including Transmen, and people should be invited for routine screening between the ages of 25 and 64 but if this does not happen then it is advisable to contact your GP.
I am a transman on T (testosterone therapy) do I still need contraception?
Being on testosterone will reduce fertility, but it is not an effective form of contraception so considering contraception is a really good idea. The sexual health service is able to support and advise which contraception treatment would be the most suitable for you.
Do I need to think about PrEP?
PrEP is a highly effective medication that can prevent the transmission of HIV, and is safe to use regardless of any gender affirming treatment or surgery someone may have. PrEP is available through Sexual Health services so if you have any concerns about coming in to contact with HIV then please discuss this with our team.
Is it important to use lube during penetrative sex?
Any penetrative sex is a relatively high risk compared to other types of Sex, but condoms / femidoms can significantly reduce risk. T Therapy can also cause changes to your Vagina / Front hole which can reduce the amount of natural Lubrication. Using Lube not only reduces risk of STIs through reducing likelihood of skin tears, but is likely to make penetrative sex much more comfortable and pleasurable.
Where can I get more information
Terence Higgins trust has some great information for Trans Masculine individuals;
Information for Transwomen / Trans-feminine people
Penetrative sex, including Penis to Vagina or Penis to Anus sex, carries a relatively high risk of transmission of STIs when compared to other forms of sex. However, where someone has had lower surgery there are a couple of other things to consider;
Different types of surgery can have an impact on your susceptibility to STIs. If your Vagina was made from part of your colon this may increase risk of STIs, whereas if penile and scrotal skin was used this means you may be less vulnerable to STIs.
Use of Lube is really important as your Vagina may not lubricate naturally. A lack of lubrication will increase risk of skin tearing and transmission of STIs. Using Lubrication will also make penetrative sex more comfortable and pleasurable.
If you are using a dilator to help stretch the vaginal skin after surgery, this can cause bleeding which can leave you more susceptible to STIs.
Do I need to consider Prostate Cancer as a risk?
The risk of prostate cancer is lower in trans-women than Cismales due to the effect of feminising hormonal treatments. However, most cases of prostate cancer are in people over 50 so whilst it isn’t something that is likely to affect you now or in the near future it is something to bear in mind in later years
Where can I get more information
The Terence Higgins trust has some great information for Trans Feminine people;