Trans Sex Ed: What You Need to Know!

By Leslie Massicotte, Teens Climb High Program Assistant

Believe it or not, some people who have a penis aren’t a guy and some people who have vaginas aren’t a girl. Confused?

Being transgender means that your sex assigned at birth does not match your gender. That means, for example, that even if you have a vagina, you might not identify as a girl. (Check out our post on the difference between sex and gender here to learn more.) According to a 2016 study, 1.4 million adults in the USA identify as transgender.

Trans folks are ordinary kids and adults who can live ordinary lives, despite the pervasive stigma against transgender folx. Don’t believe me? Check out this story of Jazz Jennings, a now 17-year-old transgender teen:

Jazz’s other videos explore some specific sexual health considerations for trans folks, including hormone therapy and gender affirming surgeries. We want to highlight some of these sexual health considerations here, because although they are an important part of sexual health, they don’t often show up in your typical sex ed classroom. Not all trans people do all of the things listed below, but here is some basic trans sex ed we hope is helpful:

1. Finding trans friendly medical providers (and therapists!) is super important.

Sadly, a lot of transphobia (or hatred and fear of transgender people) exists in the world and finding a supportive doctor can be tricky. If you’re trans, you want to find someone who’s knowledgeable about trans care and is supportive of your choices. Check out this resource for LGBTQ+ friendly providers.

2. Puberty blockers

Some individuals, like Jazz, know that they are trans at a young age. Sometimes when they start to go through puberty, trans youth choose to start puberty blockers, which are medicines used to stop puberty-related hormones from changing the body to develop into distinctly male or female. Puberty blockers won’t stop all puberty related changes but can be used to pause the particular male and female changes like breast and testicular development. Puberty blockers are not permanent; if you stop them, your body will develop according to your sex assigned at birth. Hormone replacement therapy is an option to continue making physical changes towards your gender. (Check out this site to learn more about puberty blockers.)

3. Hormone replacement therapy

Some trans individuals decide to take estrogen or testosterone (two sex hormones we all have in our bodies) to make more permanent changes in their bodies that match their gender identity. These hormones can cause physical, emotional, and sexual/reproductive changes. A supportive doctor can help explore these options and monitor the process.

4. Gender-affirming surgeries

For folks who want their body parts to match their gender identity, many types of surgeries are available to change the chest and genitals. After surgery, body parts might look a little different than what you see on “typical” reproductive anatomy posters but healthy genitalia are awesome no matter their size, shape, color, or function. Having a supportive doctor is key to answering all your questions about the surgeries out there.

**It’s important to note that not all trans people choose to transition, using puberty blockers, hormone replacement therapy, or gender-affirming surgeries, and that’s great!

5. Access is an issue.

Accessing puberty blockers, hormone therapy, and surgeries all cost money, and many health insurance plans do not help cover the costs. That’s why, even if some transgender individuals want to access medical interventions, they can’t. Therefore, we must advocate for everyone to have access to comprehensive, inclusive sexual and reproductive health services--it can save their lives.

6. Pregnancy and STI prevention are still important!

Even if you identify as a guy, if you have a uterus and all the other necessary parts, you can still get pregnant. And protection from sexually transmitted infections is important for anyone engaging in oral, anal, or vaginal sex or any skin-to-skin genital contact, regardless of if you’re trans or not!

As your community sex educators, our job is to make sure everyone has the information they need about their bodies to make informed sexual and reproductive health choices that are right for them. Know your body and your health care options, however you identify!