Hi Yana,

I’m a transgender male, no bottom surgery yet (there’s a good chance it’s not even in the cards for me, anyway) and I’ll be starting HRT (hormone replacement therapy) soon.

I’ve always been very frank with partners that I’m not comfortable with being touched, and they’ve respected that. But, the few times I’ve allowed a girlfriend to go down on me, I didn’t orgasm. I can’t orgasm by myself, either. I’ve never even had one.

I’ve tried, I’ve done all the homework, come to find out I’ve been prone masturbating since I was a really little kid and didn’t even know it. Will going on T [short for “testosterone”] fix whatever the hell is wrong with my junk?

When I say that I’ve really tried to figure out the whole orgasm thing, I mean I’ve REALLY tried. Dysphoria aside, will I ever be able to receive my own satisfaction during sex? (With women, to be specific. Penetrative sex is an extremely uncomfortable, dysphoria-inducing thought for me.) I tried not masturbating for a month or so, and not only was that super difficult, it also didn’t fix the problem.

Please help!

—Working on Jerking Off


Dear Working on Jerking,

When I teach pleasure workshops at various colleges, I like to ask the group to please raise their hands if they learned about penile ejaculation and orgasms in their sex education classes (provided they had these classes at all). Every single time, every single person raises their hand. When I then ask how many people learned about vaginal ejaculation and/or clitoral orgasm, I’m lucky if I get two hands up in the room. Usually, I see zero.

Dang. I mean, we all get it, right? Without penile ejaculation, we’ve got no reproduction (the little darling of traditional sex ed). Without vaginal ejaculation and/or clitoral orgasm, the only thing we’re missing out on is this little thing called sexual pleasure (and don’t worry, I see you uncircumsized people who are also rarely provided info about how to navigate your anatomy).

What’s this have to do with you? Well, unfortunately, you and many others have been simply screwed out of having social permission, examples, and representation about how to access sexual pleasure and/or orgasm in your body. Orgasm for an entire category of anatomy is barely represented and that’s not even considering the intersection of genitalia with gender and sexuality!

A GLSEN National School Climate Survey found that fewer than five percent of LGBT students had health classes that included positive representations of LGBT-related topics. Among self-identified “millennials” surveyed in 2015, only 12 percent said their sex education classes covered same-sex relationships at all. So I’m going to go ahead and assume that “How to Orgasm Alongside Your Gender Dysphoria” isn’t a standard sex ed section.

There is so much that goes into our experiences of our own bodies, sexualities, and orgasm. The aforementioned sex education and representation of your body/sexuality/gender/anatomy is certainly one. Others include your view of yourself, your experience of your body, the health of your relationships, and yes, your hormones!

The effects testosterone has on the body include a spike in libido (helloooo, sex drive!), increased blood-flow to your junk (hellooooo, increased sensation!), and longer-term changes in the genitalia such as the clitoris getting larger in size (I call it the clitoris here, but always name your sweet bits whatever you see fit).

So, will T “fix” you? I hesitate to label you or your junk as broken. Rather, it seems to me that you’re a perfectly intact person who has the challenging task of moving the few puzzle pieces you’ve been offered here (within a rather broken sex- and gender-education system) in order to create a full sexual picture of yourself, for yourself.

No, I don’t think it’s wise to conceptualize of T as the magic fix. But, I do think that T will adjust a lot of these variable puzzle pieces — the possible reduction of dysphoria, the way you see your body, the way you’re able to experience and express your gender, and the biological way hormones interact with your body. The way this affects the full picture could be the game changer, here. But broken you are not.

Yana Tallon-Hicks is a relationship therapist, sex educator, and writer living in the Pioneer Valley. You can find her work and her professional contact information on her website, yanatallonhicks.com.