Trans and non-binary sexual health
What's being sexually healthy?
- Know your own comfort level with sex
- Know how to create a safe relationship with sex
- Understand the risks and benefits of the type of sex you want to have
Whether you’re exploring your identity, have already or decided to transition, have surgery or take hormones or not, you’re entitled to have sex that is happy and healthy.
Hormones can cause changes in your sex drive. You might want to explore and try out new things with different people. Whatever your situation, there are more ways than ever to protect yourself and your partner/s.
Navigating happy, healthy sex
Being sexually healthy means having the confidence and skills to ask for the sex that makes you feel good, in a way that is mutually consensual between you and your sexual partner(s). Communicating with your partner before and during sex can sometimes be awkward, but it’s the best way to ensure you are both happy and comfortable with what’s happening. Remember, you can change your mind at any point and stop.
Checking in before sex is also a great time to decide on what barriers and protections you are going to use.
Learn more about navigating sex and consent tht.org.uk/trans
HIV
Some trans people are at higher risk for HIV, according to some global studies.
It’s a good idea to test for HIV at least once a year if you’re sexually active, or more often if you have more than one sexual partner, when you have a new sexual partner or have been diagnosed with an STI.
HIV medication can be tailored so that it won’t interact with any hormone treatment you may be taking. It’s better to know your status and start treatment early to prevent serious illness.
Scientific evidence has shown that people living with HIV who are on effective treatment cannot pass the virus on to anyone else.
Visit tht.cymru/test for further information.
There are lots of ways to test for HIV. You can even test in your home and get instant results.
PrEP
PrEP (pre-exposure prophylaxis) is a pill taken by an HIV negative person before and after vaginal/frontal and/or anal sex.
It’s highly effective at stopping HIV from being transmitted when taken correctly.
Dosing choices depend on the type of sex you are having.
- PrEP will not interact with your hormone treatment.
- PrEP does not protect you against any other STIs or unplanned pregnancy.
- You can get PrEP for free on the NHS from a sexual health clinic.
- PrEP can be bought from a reliable source.
Find out more at:
Condoms and dams
Condoms can stop STIs from being passed on when used correctly. Use a new condom for each partner and never use the same one for anal and vaginal/front hole sex.
They come in a variety of sizes and it’s important to use the right one for you and your sexual parts. Use only water-based or silicon-based lubes and not oil based lubes or lotions which weaken latex.
A dental dam is a sheet of latex used as a barrier in oral-vaginal/front hole and rimming which can prevent the transmission of STIs.
STIs
Sexually transmitted infections (STIs) can affect anyone and are easily passed on from all types of sex with all types of body parts and sex toys.
Condoms and dams are the best way to protect against STIs.
STI screening is quick, free, and painless and you can take your own samples from the body parts you use for sex.
Not everyone will show symptoms so it’s important to test regularly and after each new sexual partner. Most STIs are easily treated with antibiotics.
What about alcohol, drugs and sex?
Mixing alcohol or drugs and sex can heighten your mood and lower your inhibitions which can affect your judgement and mean you might take risks during sex that you wouldn’t otherwise.
Whether you want to cut back a bit, be safer or quit entirely, getting some help can really make a big difference. Friends and family can be a great source of support and there are local services which can help too.
If you’re concerned about the sex you have whilst under the influence of drugs or alcohol you can find support by visiting tht.org.uk/transresources
Trans and non-binary sexual health
Information about sexual health and PrEP is also available at
tht.org.uk/transfemprep
tht.org.uk/transmascprep
tht.cymru/protects
tht.cymru/test
tht.cymru/cy/prawf
shwales.online
Find support for domestic abuse at galop.org.uk
Surgery and hormones
If you have recently had gender-affirming surgeries and have unhealed skin, this could make it easier for you to acquire or pass on HIV.
Taking hormones can also increase the risk of bleeding during penetrative vagina/front hole and anal sex. Use plenty of lube and condoms, and regularly check for any tears.
Testosterone can cause vaginal/front hole symptoms such as dryness, pain and bleeding on having sex, and discharge which can be easily mistaken for symptoms of some STIs.
Find out more at tht.org.uk/trans
How and where to test
There are lots of options for HIV testing.
It’s easy, fast, free and confidential.
- a sexual health clinic
- an HIV testing centre, including those run by Terrence Higgins Trust
- a GP/family doctor
- home-order self tests online – search for free online HIV testing services in your area
For more information on sexual health clinics for trans, non-binary and gender variant people visit tht.org.uk/transresources
PEP
Whereas PrEP is taken before sex, PEP (post-exposure prophylaxis) is taken after sex to stop HIV taking hold if it has already entered the body. PEP must be taken within 72 hours, and ideally within 24 hours after an event where you might be at risk of HIV transmission.
If you think you’ve been exposed to HIV, visit a sexual health clinic or A&E to discuss whether you might need PEP.
Contraception
Testosterone is not a contraceptive. You should discuss with your doctor what suitable contraceptive options are available for you.
If you are worried about unplanned pregnancy, you can get the emergency contraceptive pill from your sexual health clinic or pharmacy.
Emergency contraception will not interfere with your testosterone regime.
Dating apps
If you’re planning on meeting up and maybe having sex with someone you don’t know or met on a dating app, let a friend know your plans. Talk about what you’re comfortable doing. You have the right to change your mind when you meet them. Remember to have condoms and lube and/or dams on hand in case you do decide to have sex.
Living well services for people living with HIV
Work and Skills
Supporting people with HIV who are unemployed and looking to get back into work through online workshops, online mentoring and connections to volunteering and employment opportunities. tht.org.uk/workandskills
Before 96 Peer Support Group
A monthly online peer support group for long term diagnosed people to discuss topics important to them. Second Tuesday of the month 4 – 5:30pm via Zoom. tht.org.uk/livingwell
Common Bond Peer Support Group
A monthly online peer support group for women living with HIV (inclusive of trans women and non-binary people living with HIV) to meet others and learn and grow together. Third Tuesday of the month 7 – 8:30pm via Zoom. tht.org.uk/livingwell
My Community Forum
A peer-led online forum for people living with HIV where people with HIV can chat “live” via group chat or private chat with members or volunteers. tht.org.uk/forum
HIV testing
For HIV testing, please visit the Singleton Clinic by appointment only or order a free test online from Sexual Health Wales.
Counselling for people living with HIV
Our counselling service supports people who are living with HIV to explore what it means to them – from diagnosis, to relationships, to medication adherence, to starting a family, to living with other illnesses, and everything in between.
Our counsellor aims to provide you with a safe space, without judgement, where you can learn to deal with your HIV and to live a healthy and fulfilling life.
Our counselling service also offers people an opportunity to work toward understanding themselves in terms of their sexual identity, gender identity, and dealing with chemsex issues.
Please note that counselling is by appointment only. To discuss whether counselling is right for you and to make an appointment only, please email [email protected].
