Sexual Health for Transgender Teens
As a teenager, visiting a sexual health clinic for the first time can be very daunting. For a transgender teenager these feelings may be exacerbated due to concerns you have about your personal history, the terms used to describe your body parts or the feeling of being judged. However, as knowledge and acceptance of trans specific issues is increasing, so it better levels of care for trans teenagers.
Why is transgender sexual health so important?
Your sexual health has been described by the World Health Organisation as:
“a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”
As you grow up, you face important decisions about your sexuality, relationships and sexual behaviour. By making sensible decisions and taking care of your sexual health, this can help to improve your overall health, self-awareness, build confidence and help you to form better relationships.
The great news is, that you’re never too late to make that first appointment!
What are the barriers to sexual health faced by the transgender community?
According to a recent study conducted by Ayden, Scheim and Travers, there are a number of reasons why members of the trans community have difficulty attending sexual health clinics. Whilst all these reasons are perfectly valid, organisations such as the Terence Higgins Trust, The Diversity Trust and Stonewall have been working tirelessly to promote better services and understanding of differing needs of the LGBT community.
It will take some time to get things absolutely right, so Tranz Health decided to examine some of the issues faced by the transgender community, discuss whether these issues are still ongoing and the examine possible solutions for service users.
Trans women are at low risk of contracting HIV and sexual infections so I don’t need to be tested.
Unfortunately, this is untrue. There are many different types of trans women but some trans women have had bottom surgery and others haven’t. If you haven’t had your genitals reconstructed, it is very important to carry on using condoms or a femidom to prevent STI’s and unwanted pregnancy. For trans women who have had surgery, the type of vagina that you have can make you more vulnerable to STI’s.
For example, those who have a vagina constructed from penile and testicular skin may find that they are deemed less vulnerable to STI’s because it isn’t made from a mucus membrane. However, during sex small tears in the skin can lead to an infection penetrating the body, so it is very important to continue practising safe sex. A vagina constructed using skin from the colon is more at risk of contracting STI’s during unprotected sex because mucus membranes are easily penetrated by infection.
The risk of passing on infection can be minimised by using condoms, femidons, dental dams and a generous helping of water-based lubricant to minimise tearing of the skin. Ensure that you make regular appointments with a sexual health clinic that you feel comfortable visiting and enjoy regular testing.
I don’t want to take my trousers off in front of a stranger.
Some clinics allow their users to swab themselves for infection. These kits can be sent off for analysis and you will be contacted with the results. However, you may require blood tests to check for other infections such as HIV, hepatitis and syphilis but these tests can be performed whilst you are fully clothed. You may also bring someone with you to the clinic for additional support and reassurance.
However, some trans men may still have a cervix and trans women may still have a prostate. As you get older, you will require regular screening of the prostate to check for serious but easily treated cancers, if caught early enough. These painless procedures may feel uncomfortable and embarrassing, but they may save your life.
I will have to disclose that I am transgender and discuss my genital status.
Although you won’t have to disclose your transgender status to the receptionist during your visit to a sexual health clinic, it is recommended that you disclose your trans status to the clinician who is treating you. By knowing whether you have had genital surgery, the stage of transition that you are at and the type of sex that you are having, they can collect the correct samples and give you the best care.
I have had a bad experience at a sexual health clinic before and I don’t want to go back.
Having a bad experience is always off putting, and unfortunately, discrimination against the trans community is nothing new. However, the Government have been working hard to ensure that the trans community benefit from extra training and increased understanding from all UK services. The Transgender Equality Report sets out several key points to combat the inadequacies faced by the trans community. These are:
- The creation of the Transgender and Non-Binary network. This network contains over 150 members, including members of the trans community who work together to improve the health service for transgender and non-binary people.
- In 2015 the Royal College of GP’s launched an online training module called Gender Variance. This module is designed to help GP’s and other practitioners better respond to the needs of the trans community.
- The General Medical Council is an independent statutory body that regulates the medical profession in the UK. They are incorporating awareness of transgender issues into the training of new medical staff and into the continuing profession studies of those already working. They also seek to offer better support to those who may encounter members of the trans community to ensure that they offer the best care.
Furthermore, Huxley in his recent blog post for NHS England detailed his desire to provide a better understanding of the needs of the trans and non binary community and addressed to need to focus regional events which offer more focus on the needs of local communities.
Although these are small steps, over time they will lead to a better standard of care for trans patients. If you really don’t want to go back to the same sexual health clinic, the NHS Choices website can help you to find another Sexual Health clinic in your local area.
I will have to attend gender-specific services and they will not have the right equipment or knowledge to provide the care that I need.
Some clinics do have gender specific services and this can cause some distress for those who are transgender, particularly if they don’t have the correct equipment needed for the necessary tests. Each sexual health services operates differently so when you call to make your appointment, discuss your needs with the receptionist to ensure that they have the correct equipment available. Not only will this help you to relax, but it ensures that your clinician gives you the best care.
My transgender status will be disclosed to others.
Confidentiality is a great concern for lots of young trans people, particularly if they haven’t ‘come out’ about their gender identity yet. However, trust is a very important part of your relationship with your sexual health clinician. The law surrounding confidentiality is very complex. But in short, patient information is given the utmost protection and your information will be held securely and protected against improper access. Furthermore, your personal information will never be disclosed unless it is necessary and you give explicit or implied consent, or you are at serious personal risk.
If you know someone who is employed by the sexual health clinic, they could lose their job if they discuss your personal information so it is highly unlikely that they would take that risk.
How can you make a change?
The best way to make a change to the way you feel about attending a sexual health clinic is by talking about your experience and giving feedback. A lot of clinics ask for anonymous feedback which gives a great opportunity for service users to make their voices heard. It doesn’t have to be poor feedback either if you’d enjoyed a relaxed and respectful service I’m sure your clinician would love to hear about that too.