Sexual health and gender-affirming care – Harvard Health Blog

LGBTQ+ people are often considered a cohesive group, but sexual orientation and gender identity are different. Sexual orientation describes who a person prefers to be sexually intimate with. Gender identity, on the other hand, describes their sense of themselves as male, female, or another gender. Transgender and other gender diverse (TGD) people, whose gender identity is not aligned with their recorded sex at birth, can have any sexual orientation. (The same is true, of course, with cisgender people, whose gender identity aligns with their recorded sex at birth.)

What is sexual health?

Sexual health is a concept that goes beyond pregnancy and sexually transmitted infection prevention. The World Health Organization describes it as “the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence.” This is not assured for many people, particularly TGD people, who face higher risks for discrimination and interpersonal violence, including within their intimate relationships.

This blog post discusses two aspects of sexual health: how certain types of gender-affirming care may affect sexuality and fertility.

Can gender affirmation through medical or surgical means affect your sexuality?

The lived experience of every TGD person is unique, as are their approaches to gender affirmation. While some people may choose to affirm their gender only socially, or not at all, others use a variety of medical and surgical procedures to do so. Some research shows that gender-affirming care, when accessible and desired, may reduce distress and can make it easier to live in a sometimes hostile world.

People are more likely to enjoy intimacy with others when they are happier and feel comfortable in their own skin. Those who choose to pursue gender-affirming care may find it affects their sexuality in both positive and negative ways. The examples below speak to both possibilities, although

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