Erectile Dysfunction Among Pre-op Transwomen Desiring Sex.


In the past, gender transition has been considered a linear process with the end goal in mind of completing surgical transition. 

Complete surgical transition means an individual has achieved the physical body of a desired gender via surgical modification. 

Gender confirmation surgery, known as “bottom” surgery, would often be the final step in the surgical transition.  

Gender diverse people today teach us that gender is much more than just two binaries. 

They remind us of the diversity inherent in various gender expressions, including one’s presentation of physical characteristics of gender.  

As the expression of one’s gender shifts, clinicians specializing in this field have begun to witness a shift in gender transition as well. 

While some trans women desire to undergo full surgical transition to a desired gender, many do not. 

More and more trans women undergo female enhancing surgical procedures such as breast augmentation and facial feminization, but decide to not have bottom surgery. 

This is often a personal choice based on various factors such as one’s gender expression, sexual preference, or sexual orientation.  

Trans women are sexually active.  And if they are not, they ought to be as sex has many healthy benefits apart from achieving pleasure. 

The problem arises when one is unable to acheive and maintain an erection due to an estrogen and anti-androgen regimen. 

The problem becomes even bigger for trans women who desire to have bottom surgery but, for personal reasons, are unable to. 

These individuals tend to be extremely dysphoric about their genitals, understandable so.  They are also sexually active and would like to bypass the feeling of dysphoria in order to have a healthy sexual life.

I had the privilege to sit down with a sex expert, sex therapist, and incredible colleague of mine, Tim Norton LCSW. 

Tim specializes in sex therapy and hosts a podcast, HARD Conversations, discussing erectile issues. 

During one of our luncheons, while discussing erectile issues among men, the conversation drifted into discussion of erectile issues among pre-op trans women. 

As we talked, we realized this was an important subject needing further discussion, especially in helping sex therapists to better address erectile dysfunction among pre-op trans women desiring sex.

Listen along, as Tim and I discuss issues of erectile dysfunction among pre-op trans women on HARD Conversations.