Helping Trans Clients With Their Sexuality

Recently I presented at the TransLife Professional Symposium here in Sonoma County, a conference for professionals who provide services to transgender individuals.  There were physicians, psychotherapists, educators, and lawyers in attendance and the workshops represented the various medical, psychological, educational, and legal needs of the trans population.  I presented on how to talk to your trans clients from a sex-positive perspective.  It was an honor to be part of such a progressive conference.

Our society has come a long way in a relatively short amount of time to support, validate, and make legal the diverse trans experience.  We (I think?) have a greater understanding of gender identity versus sexual orientation.  We (I think?) understand the importance and in many cases necessity of hormone therapy and gender confirmation surgeries.  We (I think?) understand that if one is transgender, not respecting this can lead to mental health issues including trauma, substance abuse, anxiety, depression, and suicide and all of those have public health implications.  All of this (I hope?) feels greatly affirming to trans people.  But where my profession still has a growth edge is in talking to transgender folks about their sex lives.  It’s yet another taboo subject under the bigger taboo umbrella of “Talking About Sex In Therapy”.

A good portion of your sexuality involves your feelings about your own body both in general and regarding specific body parts.  For example, cis-gendered folks have told me “this body part is too big” or “that body part is not big enough”.  These are feelings of inadequacy, insecurity, and shame and also involves fears of judgement and rejection by others based on those body parts and their perceived deficits.

For a trans-identified person, this aspect of their sexuality is often made more complicated.  In addition to the feelings I stated above (and others), sexual organs and erogenous zones can be full of emotional turmoil for additional reasons: perhaps those body parts represent a rejection — not by others but by themselves “this is not me”.  Perhaps those body parts symbolize a disconnect from the body they were born with versus the body they want and need to feel authentic and whole.  Or perhaps a certain body part represents sadness or anger because they do not have the resources to change it to what they envision and need.  For many trans individuals, their bodies do not feel like home.  Add to that the fact that those very parts are often where body-based sexual pleasure is obtained and sex is now made more confusing and emotionally messy.

Most people tell me that when they can receive sexual pleasure from their partner(s) they feel loved, accepted, and seen.  Sounds amazing, right?  But when a trans person has understandably conflicted and unresolved feelings about their own body, using that very body to engage in sexual activity can feel risky, scary, and downright unsafe - not necessarily because of their partner (although that’s true too), but because of themselves.  Perhaps you can now see why it’s common for a trans individual to feel intensely uncomfortable with their own sexuality.

Trans folks have unique challenges when it comes to having sex, too, and my profession needs to support them in better understanding their sexual selves.  Helping trans folks better integrate their sexuality — not just their gender identity — into themselves and their sense of place in the world, and learning how to be a sexual being with their body, is another important aspect of the transitioning process.