Young couple navigating transition together

What Is Sex Like After Transitioning? Therapists Weigh In

It’s OK to navigate the changes one step at a time.

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If you’re transitioning right now, you might be wondering what that means for your relationship (and your sex life). The transition process can come with emotional ups and downs, and relationship dynamics have a huge effect on weathering that roller coaster. It doesn’t have to mark the end of your relationship, but it does mean that some things will change — and having the tools to navigate those changes makes all the difference.

What exactly is a gender transition? According to the National Center for Transgender Equality, “Transitioning is the time period during which a person begins to live according to their gender identity, rather than the gender they were thought to be at birth.” Each person’s transition is unique and may include changing clothing, makeup, hairstyle, name, or pronouns. Some people also choose to undergo hormone therapy, surgery, or other medical procedures as part of their transition.

In order to navigate these changes, it’s helpful to know what to expect and to hear from other people who’ve been through something similar. Maybe you’re trans and aren’t sure how to bring up tricky topics with your sweetheart. Maybe you’re dating someone who’s trans and want to be a more supportive partner. Whatever your situation, here’s what you need to know about navigating sex and relationships during transition, according to experts.

First, Remember That *All* Bodies Change, & That’s OK

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According to Lucie Fielding, therapist, sex educator, and author of Trans Sex, all bodies are always in some type of transition. Events like childbirth, surgery, new medical diagnoses, and simply aging means that in the course of a lifetime, everyone will need to roll with changes in their own bodies. Accepting that a range of changes is natural can make it easier to accept physical evolutions and can lead to less shame, stigma, and anxiety.

While the mechanics of each transition may be unique, and everyone’s experience is different, the skills needed to manage physical and emotional changes — such as exploring our changing bodies and communicating with partners — are universal. So, remember that we all go through body changes in life, and you can learn to navigate them with confidence.

Hormones Can Change How You See Sex, Pleasure, & Intimacy

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Not every trans person chooses to take hormones or undergo surgery, but it’s important for these options to be readily available for those who want them. These tools can impact the way someone experiences sex, pleasure, and intimacy. “Hormonal transition, as well as surgical transitions, may provide a way to get from gender dysphoria to gender euphoria — which is when how you feel, look, and present align in harmonic, affirming ways,” explains Dr. Jenn Hutchinson, a nonbinary occupational therapist who specializes in sexuality and intimacy. “This could mean amazing things for your sex life, as your self-esteem is higher and your partners can feel you truly feeling yourself.”

Sid Napier, MS, a licensed professional counselor associate and post-graduate counselor, agrees that hormones can help you feel more comfortable and confident — and feeling more comfortable can lead to learning more about your identity and who you’re attracted to. “We're all fluid beings, and hormones will sometimes make you flow places you never were expecting. Once people saw me as a guy, or like I saw myself, I felt more comfortable being myself sexually — and this included being with men.”

But according to Fielding, sometimes the impact of hormones can be overstated or misunderstood. “I think too much emphasis is put on the impact of hormones on desire and arousal. Like, if you're on T[estosterone], that suddenly you'll become this over-sexed sex beast, and if you're on E[strogen], that you're going to lose any semblance of interest in sex. And that's just not the case,” Fielding says. “What I think of as the impact of hormones, for example, is really more about the pleasure map of the body. We do know that genitals will change shape, they will grow, or they will reduce in size. And with that will also come different ways that pleasure is experienced.”

These physical changes can impact how pleasure is experienced. According to articles by Dr. Maddie Deutsch, Medical Director for UCSF Transgender Care, “You may find that you get erotic pleasure from different sex acts and different parts of your body.” For people taking estrogen, the number and intensity of erections may decrease, and “your orgasms may feel like more of a ‘whole body’ experience and last longer, but with less peak intensity.” And for people taking testosterone, “Quite rapidly, your genitals, especially your clitoris, will begin to grow and become even larger when you are aroused.” This can also come with a different experience of orgasms, “with perhaps more peak intensity and a greater focus on your genitals rather than a whole body experience.”

Surgery May Change Sensations & Experiences During Sex

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Some trans folks may choose to undergo one or more gender-affirming surgeries. This can include a wide range of procedures, including facial surgery, top surgery (on the chest or breasts), and bottom surgery (on the genitals). Many of these surgeries come with major recovery time — plus, they can impact the body’s sensitivity to physical sensations. “When I had top surgery — breast augmentation — I lost sensitivity in my nipples,” Fielding says. “And it was only after a year that suddenly the sensitivity came back. It was like, ‘Ooh, ooh, this is fun. This is different.’ So, just expect the unexpected.”

Jack S., who is non-binary, transmasculine, and based in Portland, Oregon, shares how having top surgery led to feeling more comfortable in life in his skin — and in bed. “Top surgery was the most important thing in terms of my personal comfort with my body, my sexuality, with anything else,” he tells Elite Daily. “And after I got that done, I had a much better time with intimacy. I didn't have to worry about how I put my body to avoid contact with certain areas. And I didn't have to worry about having that conversation of like, ‘Please don't touch me there.’ And I didn't have to worry about accidentally seeing myself, seeing my chest as it was. So that was really helpful for me to avoid dysphoria or checking out when I was in an intimate situation with someone.”

You Can Define Sexual Pleasure On Your Own Terms

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No matter who you are or who you’re dating, navigating sex can sometimes feel intimidating. Remember, though: Sex looks different for everyone, and you get to define your sexual experiences on your own terms.

Fielding recommends avoiding making assumptions about sex — including any stereotypes or labels you may be trying to adhere to. “If I have a client who comes in and says ‘I want to have sex like a woman,’ I have no clue what any of the words in that sentence means, in and of themselves,” says Fielding. “It’s packed with assumptions. OK, what is a woman? What is sex?” She then suggests asking yourself and your partner follow-up questions to figure out each of your unique preferences for sex and intimacy. “What kinds of experiences are you wanting to have? What kind of emotional beats do you want to hit? How do you want to define sex and pleasure for yourself?” she says.

Fielding also points out that there’s no pre-defined way a body part needs to be used, whether or not surgery takes place. “Merely having, for example, a neo-vulva [a surgically-constructed vulva] has no bearing on how that part is to be used, or if it's to be used, even if it's present,” she says. You’re always in charge of your own body, and you get to write the narrative for when, how, or if your body engages in sex.

It’s Natural To Re-Learn Your Body & Pleasure

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If you’re going through transition, having to re-learn what your body enjoys might feel daunting at first. However, it can also be an incredible opportunity for exploration. “All of our bodies are capable of being erogenous zones. Once you approach play and pleasure from that perspective, so much opens up,” says Fielding. That means it can be a great time to take inventory of your desires; you can even create a “pleasure map” to illustrate them.

How does creating a pleasure map work? When re-discovering your body, lean on whatever kind of learning appeals to you. If you’re a writer, make lists of everything that feels pleasurable now. If you’re artistic, draw an outline of your body and color code the areas that enjoy touch. If you’re scientific or data-driven, you can even create a spreadsheet that tracks what kind of sensations your body enjoys. The idea is to find a tool that helps support your erotic exploration rather than stifle them. Next comes the fun part: Either alone or with a partner, experiment with different kinds of touch on different parts of your body, and take note of your responses.

In addition, you can try doing these exercises under different circumstances to help figure out how your desires change. For example, many folks notice their pain tolerance is lower when they’re tired or stressed, and higher when they’re aroused. This could affect if or when you enjoy things like spanking or hair-pulling.

Your Partner Can Help Support Your Transition

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A few years ago I met a cutie at a party and we exchanged numbers. On our first date, they told me they were trans. We went home together, and as clothes started to come off, I asked them what words they liked to use for their body parts. They stopped, in shock, and told me no one had ever asked them that before — and that’s a problem. Regardless of gender, sexuality, or body parts, we should all be communicating openly and clearly about our desires. Because more communication leads to better sex — for everybody.

When you cultivate skills like checking in about language, you become a better partner to trans and cis folks alike. Not only does additional communication make sex better for everyone, but having these conversations with all genders helps normalize them, and helps shift the culture to a place where these check-ins are standard practice.

When it comes to talking about where and how to touch, Jack says, “Having partners lead by example is very helpful.” And this is true of many vulnerable conversations. If you take the plunge and do the scary thing first, it can make it easier for your partner to take their turn. How could this look in the bedroom? Try adding a few “yeses” and “nos” to the conversation when you’re deciding to play together. For example, “I’m in the mood to have my hair pulled and I don’t want to have my feet touched — how about you?”

As a sex and relationship coach, I’ve seen firsthand how difficult it can be to navigate these conversations, but you’ve got this. For partners of folks who’ve had surgery: Be sure to avoid making assumptions about what your partner is going to want or how they’re going to feel. And even if you’re feeling excited about new possibilities, be careful that excitement doesn't come across as pressure for a particular timeline or outcome.

Partners, it can also be helpful to get a support system of your own. Think about it in terms of ring theory, which was developed to help people be mindful of where they’re placing emotional burdens. In ring theory, you don’t vent frustrations on the person who is most affected by whatever is going on (in this case, your trans partner). Instead, when interacting with your partner, it’s important to focus on supporting them and seeking outside resources for yourself. This could mean reading books (recommendations below), finding a trans-affirming therapist or coach, or even joining a support group.

These Expert-Approved Resources Can Help

The experts interviewed for this piece suggest the following websites, resources, and practitioners for everything from sex education to erotic inspiration:

Erotic tastes are highly personal, so if none of the above appeals to you, that’s OK! Simply figure out which elements are the biggest turn-ons and turn-offs, and use that information to keep searching for other options. Discovering what you don’t like is as valuable as discovering what you enjoy.

Jack points out that for some folks who are already in relationships, it doesn’t make sense to stay monogamous during or after transition. If you find yourself in that position, he recommends the book Polysecure by Jessica Fern, the Multiamory podcast, and the Relationship Anarchy Smorgasbord Tool.

Not all of these resources may resonate right now, so just remember that you can come back to this list the next time you could use some support. And even when things feel frustrating or tricky, try to explore sex with a beginner’s mind and embrace trial and error (and all its awkwardness). Not only will this help you find more pleasure now, but it will prepare you to embrace more changes in the future.


Lucie Fielding, Ph.D., MA, LMHCA, resident in counseling, sex educator, and author of Trans Sex: Clinical Approaches to Trans Sexualities & Erotic Embodiments. Find her on Instagram @sexbeyondbinaries.

Dr. Jenn Hutchinson, OTR/L, a nonbinary occupational therapist focused on sexuality and intimacy

Sid Napier, MS, LPC-associate

Jack S., a non-binary, transmasculine performer, coach, costume maker, stylist, and artist