Societal barriers have been credited with making it more difficult for non-CIS and non-heterosexual citizens to take medical action, from scheduling an appointment to screening for cancer or STIs, to undergoing the actual process of getting a gender affirmation surgery.

Overcoming Gender Affirmation Surgery and Sexual Health as Stigma

Though transgender concerns are less invisible than they have been in the past, even talking about gender affirmation surgery publicly has been a type of social stigma.

Celebrity Laverne Cox took Katie Couric to task in January 2014, when Cox was asked a very invasive question about her body, sharing that the heavy focus on surgery objectifies transgender individuals and draws attention away from the very real health issues that should be the center of the conversation.

For example, below are just a handful of the procedures or tests those who have undergone gender affirmation surgery should prioritize:

• Transgender people need regular screenings for preventative health, as breast, cervical and prostrate screenings affect everyone, and health is important for every gender identity.
• Transgender men have avoided or delayed STI and pelvic screenings at 48 percent due to discrimination fears.
• Transgender men should still be screened for unintended pregnancy after gender affirmation surgery.
• Transgender individuals experience higher STI infections than the national population at three to four times the risk, especially for Latinos and African-Americans.
• Continued hormone therapy needs must be monitored with prescriptions for recovery and preexisting conditions, as adverse interactions may occur.

According to a 2016 report in the journal of Medical Care, many transgender individuals fail to get evaluated because they don’t want to risk being sent to the wrong room or being misgendered by a doctor or nurse who has limited experience with transgender healthcare. The same report showed about 30 percent of transgender patients reporting delaying or not seeking care due to discrimination, and one in four saying they were denied equal treatment in healthcare settings.

Nearly 70 percent of transgender people have experienced discrimination when receiving or seeking out healthcare. The National Institute of Minority Health Disparity has classified gender and sexual minorities as a “health disparity population,” which makes funded studies from the National Institute of Health possible for long-term transsexual healthcare research.

Recovery and Making Love: Not a One-Step Process

Whether one’s transitioning from male to female or transitioning from female to male, age is less of a determining factor when it comes to the timing of the trasition. For instance, there are individuals who decide to transition in their twenties or those who wait until later in their lives, like Caitlyn Jenner.

One long-term studied followed up on 32 male-to-female and 23 female-to-male patients after gender affirmation surgery, evaluating their general and sexual health after surgery. The study showed a trend toward higher general health problems in male-to-females; however, the study also recognized that this could be the result of smoking habits and older age. Overall, emotional and social expectations were met for patients, and 80 percent shared that their sexuality had improved, with the majority reporting change in orgasmic perceptions.

Female-to-males with erection prosthesis realized sexual expectations but experienced some pain during intercourse. Two thirds of male-to-females reported a vaginal secretion from the Cowper’s glands. While those who have undergone surgery can attest that when positive sexual activity matches one’s gender identity after gender affirmation surgery, it’s can be an amazing feeling — pain within those experiences still warrants being addressed by a physician.

In an interview with Vogue, Nomi Ruiz describes being hesitant to jump into sexual activity at first. She also warns that when she did have sex, it was understandably a little weird at first: “I was really self-conscious… I was like, Maybe it’s not working. It’s not like other girls’ vaginas. It’s not right. I’m not getting pleasure.” However, Nomi emphasizes the importance of not giving up hope during that critical time period, because for her it just took “meeting the right guy” to discover what she liked.

As Nomi emphasizes, partner support and exploring at your own pace are important parts of transition. According to WebMD author Matt McMillen, regular contact with your doctor after surgery is vital, and a doctor should offer clearance before engaging in any sexual activity.

Dealing With the Mental Aspect of Gender Affirmation Surgery

Partners of transgender individuals may have their own issues processing this big change and what that means for their relationship. According to Therapy Tribe, it’s normal for partners to have many questions, like: Who are we? How will we work as a couple? How do I best support my partner and ease their recovery? In these instances, Therapy Tribe suggests that couples counseling and individual counseling could be integral to staying balanced and mutually supportive.

Additionally, coming to terms with a new body may take some time. In a personal narrative published on The Guardian, Juliet Jacques describes a temporary disconnect with one’s own body: “Mentally, it’s a strange time. At first, the discomfort and discharge stopped me from forming a positive relationship with my altered body.” Jacques and others with similar experiences stress how helpful it can be to reach out to your local LGBT and transgender communities during this time period for additional support and people who will truly understand what’s being experienced.

It’s time to extend transgender topics to sexual and reproductive health. It’s time to educate medical professionals about transgender healthcare and put effective treatments plans based on real research into action.

Cover image courtesy of Getty Images.

By Kate Harveston on June 28, 2017