Gender and Sex

Issues of identity are often at play in our sex lives. Discovering yourself through your sexuality can be joyful and exciting, but you may also avoid sex if it raises identity questions that you don’t have answers to. Gender identity may be a cause of your difficulty with sex.

Gender Issues

Sometimes people avoid sex because their gender is not straightforward, and they don’t feel comfortable in their body. This can be because you don’t identify with/as your assigned gender, which can make using some body parts confusing or unpleasant. Even if you chose surgery to change your anatomy, you may have a complicated relationship with your new body, needing to learn to accept it and how to find and give pleasure in this new form.

Other people struggle with gender because they are not clearly male or female. There are almost two dozen different medical or genetic conditions that fall in the spectrum of “intersex” that mean someone does not clearly fit into a binary view of gender. For some of you, this was discovered at birth, and you may have been assigned a gender or surgically altered as an infant or child. For others of you, the condition was only discovered later, as a teen or adult. Without fitting into a clear category of male or female, and perhaps without having the genitalia you might expect, you may experience confusion, embarrassment, shame, or self-doubt when you have sex. You may have to expand what it means to have sex. Find a way to be open with your partner about how you feel and what’s going on, so you can work together to make sex enjoyable.

Consider Medical and Surgical Changes

If you’ve had surgery to change your body, especially your sexual parts, you will likely have to adapt to the new you. Whether that surgery has been to change or adapt your gender, or the result of medical treatment (like mastectomy or prostate surgery), your body is different, and your sexual functioning may be affected. Your core sense of yourself as a sexual being may have changed. If these changes are positive, if they bring you into alignment with who you are, you may have an easier transition, but it’s still going to take time to feel at home in your new skin and adapt to your body in sex.

If those changes are negative or unwanted, the result of an accident or medical treatment, you likely have loss and grief to deal with on top of learning to have sex in your new body. These are complex changes and can easily lead to avoiding sex. Talking openly with your partner is crucial. They are likely timid about bringing this up and may struggle to know how to talk about it. If you can open the topic and share what’s on your mind, it makes space to hear how the changes have affected them, as well.

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