This page provides information about the various infections that you want to be aware of to
better manage your sexual health. If you have any questions, please feel free to
post them in our Trans Health Forum or
send us a message with what you need to know! If we don't
have the answer, we will try to get it.
Some general issues related to risk for trans persons include the effects of hormone adjustments and genital surgery on risks. Trans men who take hormones or have had a hysterectomy or oophorectomy (removal of the ovaries) may be at increased risk of contracting HIV and STIs if they engage in sex using their front hole because decreased levels of estrogen (and possibly increased levels of testosterone) can cause the inner lining to become more fragile and more susceptible to skin breakage, allowing infections easier pathways to the bloodstream. Some trans men have tried local application of estrogen creams or insertable rings, but there have been no studies about how effective this practice is. Trans men should note that the external skin of their penis is likely also more subject to tears and breakage than is the external skin of a cisgender man's penis. This may be less of an issue for trans men who have undergone phalloplasty due to the locations from which skin grafts are taken.
Trans women who take estrogen might find the skin of an original clit, especially along folds, to be more delicate and subject to breakage than it was prior to starting hormones. Any broken skin can leave one more at risk for acquiring HIV or STIs. Trans women who have had genital surgery using the inversion method may have inner vaginal tissue that is stronger and less subject to tearing than that of a cisgender woman's inner tissue, and the skin cells may be somewhat more resistant to HIV and bacterial infections for at least some time, although reportedly after a few years the difference becomes minimal. Other methods, such as colovaginoplasty, which uses a segment of the colon, may have different risks (bacteria love mucus membranes such as those of the colon). Care should be taken during rough sex or large-object insertion as the inner tissues may not stretch as much and scar tissue can be subject to damage. Questions and comments about risk and experience are welcome at our Trans Health Forum, and you can submit comments by email at our contact page.
Much of the information on this page comes from the Centers for Disease Control and Prevention's (CDC) "Sexually Transmitted Diseases Treatment Guidelines, 2014". Additional information was drawn from the pages at Planned Parenthood's discussion about STDs. Last, the CDC's 2015 STD treatment guidelines were just released at the end of June 2015.
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