Trans and non-binary sexual health

What’s being sexually healthy?

  1. Know your own comfort level with sex
  2. Know how to create a safe relationship with sex
  3. 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.

There are lots of ways to test for HIV. You can even test in your home and get instant results.

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

tht.cymru/test

For more information on sexual health clinics for trans, non-binary and gender variant people visit tht.org.uk/transresources

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.

  1. PrEP will not interact with your hormone treatment.
  2. PrEP does not protect you against any other STIs or unplanned pregnancy.
  3. You can get PrEP for free on the NHS from a sexual health clinic.
  4. PrEP can be bought from a reliable source.

Find out more at:

tht.org.uk/transfemprep

tht.org.uk/transmascprep

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.

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.

Find out more about STIs and how to test

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

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.

Further reaources

 

Information about sexual health and PrEP is also available at

Speak to someone

We’re open:

10am to 6pm, Monday to Friday
Our phone number is 0808 802 1221.

This is free to call from all UK landlines and most major mobile networks. It won’t appear on your telephone bill.

Live chat

We’re trialling a new live chat service to offer you support without the need to make a phone call.

The chat is open Monday to Friday at the following times:

  • 11am to 1pm
  • 3pm to 5pm

Live chat is anonymous and confidential. We’re offering it alongside our phone helpline, initially at the times given above.

At the end of your chat session, you’ll be directed to an online survey about your experience. Please take a few minutes to fill this in as it helps us to understand how live chat is working. We’ll use this feedback to develop the service further.