How to Talk Sexuality with Trans and Non-Binary Teens

By TMPlanet

According to  Rachel Lynn Golden, Ph.D via Psychology Today, there are sex positive ways to approaching the topic of sexuality with your transgender or non-binary child:

1. EDUCATE YOURSELF.

There are a variety of resources you can access to better understand aspects of sexuality, sexual identity, and gender identity. Planned Parenthood , Scarleteen , both have comprehensive websites with information on sexuality and gender identity. Trans Bodies Trans Selves also serves as a textbook with helpful and informative chapters on many aspects of sexuality. It is written from a multitude of voices and perspectives and highlights a diversity of experiences.

2. Start with identities and build from there.

With any adolescent make sure to ask early and with genuine interest and authenticity about different facets of their identity. Create a space for them to tell you about how they understand their gender identity. As romantic and sexual attraction reflect the complexity of the experience of attraction, ask about sexual orientation/identity, and romantic orientation separately. Gender, sexual and romantic identities are distinct parts of the human experience, and there are myriad ways in which the three can converge in each of us. Consider yourself lucky to be trusted with a process of self-identity and discovery. Find ways to let your patients tell you about themselves and describe their experiences on a spectrum or continuum, rather than trying to fit their experience into rigid boxes.

3. Question your presumptions about sexuality.

Know that people from all experiences have their own relationship to sexuality. This means asking every patient about sexuality and not picking and choosing the individuals you have decided are more likely to want to have sex. Challenge your biases about gender, (dis)ability, body type, mental and physical health and their relationship to sexuality. Access resources challenging presumptions about sex and disability as well.

4. Be open in your discussion of pleasure and erogenous zones.

There are all sorts of ways to experience pleasure. Necks, arms, legs, ears and nipples, you name it, there is room for seeking out pleasurable experiences all over our bodies. In addition, conversations about pleasure open up conversations about the exploration of sexuality on one’s own. As with anyone discovering their sexuality, it can help to first figure out some basic aspects of pleasure on one’s own. It allows for individuals to take things at their own pace. This may be particularly important for adolescents who are beginning Hormone Replacement Therapy (HRT) that may be physically shifting their body.

5. Affirm asexuality.

Being sex positive does not imply that all sex is good, or that not having sex means that people will miss out on positive experiences. Rather, it means trusting your patients to know their identities and what experiences of sexuality will be most affirming, including desiring no sexual relationships at all. Affirming asexuality  also means affirming it as an identity, and not just as a route to risk reduction.

6. Talk about dysphoria.

The way in which dysphoria manifests can affect how people experience aspects of sexuality. For example, parts of the body that individuals are comfortable touching or having touched can vary by levels of specific dysphoria about those parts. Remember, individuals experience dysphoria differently. It can be diffuse or specific, and may not be there at all. In your conversations, be gentle. Talking about dysphoria can aggravate dysphoria. You can also ask your patients to let you know how their dysphoria interferes with desire for sexuality. Much like depression, dysphoria may lessen sexual desire altogether.

7. Refer to body parts in a way that makes your client feel affirmed.

Ask your patients how they refer to the parts of their body. Using their terminology provides another opportunity to affirm your patient. Do this both when you are talking together, and in situations where the patient has first consented to your use of that language with other providers. Another option your patient may prefer is that you use parts-first language such as: “People with penises…” and “People with vaginas…” You can also fill in your client’s terminology here. Note that, when you are talking about sexual behavior there are also a variety of ways you can refer to behaviors by just referring to parts.

8. Challenge heteronormative scripts around sexual identity, sexual behavior and gender roles in sexuality.

What truly constitutes sex is up to the person having it. Thus, sex is not only considered sex when it involves penetration. Broadening how you conceptualize sex will allow you the opportunity to talk with patients more authentically about their desires around pleasure, partnership, and sex roles.

9. Talk about consent.

Talk about enthusiastic consent. Talk about it being absolutely OK for your patients to start something intimate and change their mind. Talk about their right to say: “I used to like that, but I don’t anymore.” One way to practice saying yes and then no is to role play with your patients by practicing saying “yes” to talking about a neutral topic in your office, and then having them practice changing their minds and standing their ground. For example, you can practice with examples from the consent video here (link is external).

10. Practice communication.

Communication is essential with sexual partners, and it is critical in supporting affirming sexual relationships. Successful sexual communication allows people to talk about their desires, the areas of their body that provide pleasure, and do or do not provoke dysphoria. Practice asking and answering open-ended questions. To emphasize the importance of communication with sex partners, help your patients to practice how to start conversations about sex on their own. Talk about key points they want to make, and talk about how to ask partners about their desires as well. The goal is for the practiced communication to allow for your patient to flexibly express their experience of desire, consent to participate in sexual behaviors or decisions not to.

11. Be ready for things to change.

As adolescents grow and develop, their desires and motivation to engage in sexual behaviors may shift. Flexibility is especially important with pubertal and HRT-related changes. For example, dysphoria may intensify with puberty. If this happens, parts of the body that did not previously provoke dysphoria may now do so when they are talked about, or touched by self or others. In addition, when adolescents start hormones, changes that come with HRT may shift aspects of desire, pleasure, and dysphoria. Again, be gentle.

12. Make plans for disclosure and safety.

It is by no means a requirement for transgender and nonbinary adolescents to disclose anything about the gender they were assigned at birth or their body parts. Each individual likely has specific goals regarding sharing their gender identity. In addition, they may also face greater risk in intimate relationships and disclosures. This is incredibly important as this risk is well-documented, according to the Williams Institute, 30 to 50 percent of transgender people experience intimate partner violence as opposed to 28 to 33 percent of the general population. Therefore, talk openly about the risk posed to transgender and non-binary individuals without victim blaming. Talk about ways to mitigate risk, as well as is possible. There is excellent information in this  post about disclosing. Some possibilities are to disclose online first, to disclose in public places or with a trusted friend around.

13. CREATE access to care.

Make your office a place where patients don’t have to ask you for information, but where they can get information without even asking. Keep a jar of non-expired internal and external condoms, lube and dental dams in a visible and accessible place. Make sure your patients know they do not need to ask you to take one, two, or as many as they need. Create partnerships with gender and sexuality-affirming medical providers that are easier to access. Build relationship between your patients and these providers. One way is to make phone calls with your patients to help them schedule and connect to services. In addition, have resources at the ready like Vibrant , a company that makes sex toys for parts (not people). They have a section of their blog dedicated to gender-affirming toys. Scarleteen also provides information about sex toys. 

14. Help caregivers affirm their child’s sexuality. When caregivers are involved, work with them to facilitate an understanding of the variety of ways their child’s gender identity, romantic or sexual orientation/identity and desire for sexuality intersect. When caregivers are only beginning to understand their child’s identities or are invalidating about aspects of their child’s identity, it can be very dysphoria provoking for adolescents to answer questions about their gender and sexuality. Be prepared to provide education about the intersection of identities and the diversity of ways that identities present. Talk with the adolescent about having conversations with their caregivers without the adolescent having to be present. Have them let you know what they are comfortable with you answering on their behalf. Work with caregivers to understand that their participation in conversations about sexuality is a critical way to engage and affirm their adolescent and an opportunity to help reduce risk and encourage positive outcomes.

15. Mistakes happen. When you make a mistake, fail to be affirming, or your presumptions make themselves known, just apologize. You can also state that you will work to not make the same error in the future. Then move on. Be sure not to place the burden on the adolescent of working through your error with you. Later, work on addressing your error on your own. One way is to practice your affirming language no matter where you are, or what you are doing.

With gained confidence that a provider is truly acting from a place of affirmation and self-education, transgender and non-binary adolescents may feel free to be more open about their identities and behaviors. Greater openness in conversations can lead to greater accessing of sexuality-related medical care, and a reduction in other risks as well.

In addition, you too may be able to learn, grow and be even more affirming in your practice- and perhaps in your own life as well.

IF YOU WOULD LIKE TO DISCUSS THIS OR ANY OTHER TOPIC ON OUR SITE, PLEASE JOIN THE CONVERSATION ON  THE TMP FORUM

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Support Systems Can Be Important To Trans Mental Health

By Sabrina Samone

Before the internet and social media, support groups plaid a huge role in the lives of transgender people. Now many can connect online with others going through similar stories world-wide. There’s video chat, messengers, text and if you are close, a life long friendship can be formed. Yet, trans support groups are still very critical to the emotional and mental health of transgender people, no matter what stage of transition. Unlike a support group headed by a therapist, you are amongst peers without much fear of being analyzed. In fact you may not have to say a word at all and feel the benefits of socializing. Across the globe, no matter what country, nationality, religion; where there’s a large group of transgender people, there’s possibly a support group near you. The double-edged sword is that while we are fortunate with greater trans awareness to be able to reach others of shared interest, the traditional medium of support groups across the country are struggling to continue. That would be unfortunate for our community.

Looking back at how I became aware of being transgender, the support I received, the community spirit that was instilled in me at an early start: I feel very fortunate to have had the experiences I’ve had, unlike my partner who did it completely alone. That isn’t a unique story. There are many transgender people who become aware and make the necessary steps to live their authentic lives without any assistance, emotional support, no family or friends to relate too, and even some without much therapy at all. Though I haven’t seen an actual case study on the matter, and not a psychologist or sociologist myself, I have witness the long-term emotional distress, more intense dysphoria and shame associated with being trans with some that received no support through their entire transition.¹ Luckily for many today there is more acceptance than ten years ago, and more awareness. There are growing numbers of supportive parents of transgender youth, along with the beginnings of media representation that can make us feel just a little less alone. Yet, we hear of those happy stories of supportive families, communities, jobs etc., because they are still rare and unique stories to millions of trans people in medium, and small rural towns across the globe.

I have been humbled and moved by my transgender community.

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When I look back over the years of my transition, and living my truth; the moments that were the lowest for me were when there was no connection to anyone who understood. In a millennium long, long ago, in a small rural football loving, truck driving, tobacco chewing town in South Carolina, I began to live my truth. The initial thought of such a place to come out may cause immediate anxiety. While it was not a walk in the garden by no means, it wasn’t as bad as first thought. As I said I’ve always been fortunate, most of the time, to have a community. There were those that came before me even in that small town, a few transvestites, that were by my side from the first time I began presenting myself. I had that connection, along with being apart of my local lgbt community. It was in that community that my then best gay friend showed up and introduced me to my first trans sister. I remember that day, and remember not knowing it was even possible that I could ever transition to look like the woman I knew I was. I had no clue what transgender was. All I knew at the time was RuPaul. Yet, suddenly this woman who looked like Vanessa Williams, wearing Kenneth Cole thigh high boots, daisy dukes, a midriff shirt and showing ample cleavage, came prancing in my bedroom. I immediately jumped to attention. This was the first person I had ever seen that was transforming, and developing as themselves. It felt like someone was bringing me the answers to my dreams. Thankfully, she was very supportive and wanted to help, not all girls are and that’s unfortunate. I continue to be lucky, and over time we became close friends. She took me to my first doctors appointment and as I developed pass the boundaries of acceptance for the small town of Hartsville, South Carolina, I took off to trans city USA, Atlanta GA.

It was time to blossom

                         Support This Local Trans Support Group

Atlanta allowed me to blossom in the arms of a very united and supportive local trans community. For the first time I met hundreds like me, and learned about what it means to be trans. What I mean is being trans does not always mean you’re an expert on everything trans. I had a lot of education ahead of me and I still find myself remaining open to learning about my community, and myself to this day. At this point, I was in therapy and had the support of a community of trans sisters. Yet, I was still not part of a formal trans support group, exposing me to a wider diversity of our community. I’m ashamed to admit today, that when I met the first trans guy that wanted to get to know me better, I remember being so afraid and nearly homophobic. I would hide from him in public and complain to my friends, asking why does she think I’m a lesbian. This was ignorant I now know, but I make this point because that ignorance still persists in our community amongst ourselves when we are not exposed to the diversity that could easily be overcome through a local transgender support group.

After three years in Atlanta I unfortunately found myself back in that small rural town, where TS still meant a tropical storm. For the first time I didn’t have support, the transvestite girlfriends I did know there had sadly passed away. I performed as a gender illusionist along with gay men who dressed for performance only, and who would ask me why would I do such a horrible thing to my body. I had changed, developed, but the town was the same. My family would try to persuade me to hide my attributes, wear men clothing again in order to keep the towns folks appeased. At first I had a hard time getting a job, and when I did, they also would ask me to “tone it down”. I had no local support. My friends back in Atlanta could not relate and were little help. I resisted, stood my ground for my truth as long as I could, but several months later pressured by jobs, family, no friends that understood or support group, I gave in. I’m a male to female transgender woman, yet I found myself binding to hide my boobs so know one else would be offended and to please my family. Gone was the hair weave, and I began to grow my own hair which at first was a tiny pony tail. My insurance didn’t cover therapy or any transitional care. I was no longer in therapy. I paid out-of-pocket to get my hormones and could only find one pharmacist willing to fill my prescriptions within a thirty mile radius of me. In the gay community, I was the token trans who was only called upon when money was needed to be raised for local AIDS organizations. The spiral of depression was gradual but devastating. In 2002 it would nearly end my life after my first and last, near succesful suicide attempt that left me unconscious for hours. I had to receive blood to live due to a near fatal loss of blood, along with one month under psychiatric observation. At 25, had I had any wisdom to form a support group, been able to attend one, or have others that understood; things may not have happened as they had.

The meaning of community

DONATE TO HELP C.A.T.S.

When you’ve survived a near fatal suicide attempt, it’s then you decide to live. I had to find a way back to myself and love me for me. With the help of therapy I decided to move for my own sanity. I ended up not far, just three hours south in Charleston SC, but what a difference three hours had made.

In 1999, Olivia (read our story with Olivia)², had created C.A.T.S, Charleston Area Transgender Support Group. Though small at the time I first attended, it would be another learning curve as a transgender woman for me. The trans community of Atlanta I had come from placed the highest value on passability, and trans hierarchy. Many I had encountered did not validate the lives of those that transitioned later in life, or who only dressed on occasions due to non-supportive marriages or family. My time back in my hometown that lead to my depression had changed my views on those that could not always express who they are. I now knew from experience how that felt myself and could relate. Those first meetings, I was often the only trans person of color, but eventually that would change when William, a trans man of color who was married to a trans woman befriended me. Through William, I was educated on trans masculinity and had my first exposure to trans/trans relationships. I met two girls with one that remains a close friend to this day, Jenna, who was the first transgender lesbian I had ever met as well. Again, the circles I had known prior did not include transgender women that didn’t like men, and at first this was a delicate topic for us. I had to come to terms with my own internal homophobia, and be educated that my transness was my gender and not my sexuality. Jenna was the first to help me understand that sexuality varies among trans people, and adds to the beauty of our diversity.

After a year of attending the support group, I had made the close friends I was going to make, and kept in touch with Mrs. Olivia over the years. I would drop in and out over time. As the next few years passed,  the directors and members of the group would change. Mrs. Olivia had left due to illness, some good changes some bad. The most productive were during the time of Amy Garboti and the current director Lee Anne LeLand. During this time the support group would grow from just a dozen older transitioning, white trans women to be more welcoming to trans people color, trans men, non-binary and parents of transgender youth. That dozen grew over time to hundreds in the community, even creating new groups for trans men, non-binary persons and for those younger than 18. This community group that educated me on diversity, has itself become a beacon of diversity for Charleston’s trans community.

The effects on the trans community of South Carolina by this group and it’s network of groups, would be an understatement if I even attempted to try to explain. In the years I’ve been witness to their work, the group has gone from etiquette, make-up and hair classes to real issues that we face. It’s here you will get a list of health care providers, list of friendly businesses, help with name changes and legal documentation and join a network of trans people throughout the area and state. Even among those who no longer attend regularly, there remains a supportive network. They have helped many find work, therapist or simply a friend that understands. Saving countless from the tragic depths of loneliness and depression. I’ve witness people who for the first time presenting themselves, full of fear and anxiety,  become confident and beautiful. It has inspired some to get politically involved and now work in local politics, business and it was at the table of one of those C.A.T.S meetings, that the proposal of me blogging about trans issues was born. That inspiration is now leading to my dream of my own magazine for my community. They have grown, adapted and served the trans community along with other members of the Palmetto Transgender Alliance³, to serve the trans community of South Carolina. Now they need our help.

We should always pay it forward

Save a Support Group

If you follow TMPlanet, you’ve probably noticed that I’m not one to have many ‘about me’ type of blog post. I don’t speak that often of my story, or get too personal. I’m actually shy, and withdrawn despite what many think. This is not about just helping friends. I haven’t been to a meeting probably in a year. After a lot of tribulations personally over the past couple of years, and the development of my dream of this magazine; many have suggested a kickstarter or gofundme. I have shared fund me campaigns on our social media pages for anyone in our community who asked, and I was seriously considering one for TMP until I heard that this local support group that has done so much, needed some love back from the community. Now, this is bigger than TMP, or C.A.T.S or any individual trans person or entity. This is about the countless trans people who still feel alone. This is for those that heart drops to the pits of their stomach,  as they walk out that front door as themselves for the very first time. Those wanting a place where they are welcomed as their true self. This is about keeping a safe place for many in the years to come. This is about being able to meet people who knows what if feels like to be discriminated against, harassed, and also the joys of that first T or E shot.  It’s about the next Sabrina, who as a trans woman of color can come to a place of diversity and be welcomed, and where she herself can learn more about the diversity of her trans community.

This is about love. Love for my sisters and brothers of C.A.T.S and all the trans support groups on the ground that are making a difference in so many trans people’s lives. Will you please consider helping with their expenses, or share this blog post so someone who can will. Also, support your local trans support groups, or start one. Let’s make sure the next generation continues to have a place of love to come and feel safe.

IF YOU WOULD LIKE TO DISCUSS THIS OR ANY OTHER TOPIC ON OUR SITE, PLEASE JOIN THE CONVERSATION ON  THE TMP FORUM


  1. Trans Mental Health: There can be isolation, hiding and secrets, which can lead to depression and anxiety.  Transgender adults are much more likely to have suicidal thoughts, with 50% of adults reporting some suicidal ideation.  There seem to be two paths that people take early on: either one tries to hide their inner feeling of being the wrong sex and “passes” for what looks like a boy or girl, or one is incapable of hiding and presents as either a tom-boyish girl or a feminine boy.  Either path is fraught with problems for one’s emotional development.  The second scenario – of presenting as gender non-conforming is known to elicit harsh responses from society.  This is true for non-transgender people as well and many gay men and women experience this early on.
  2. Dear Trans Family…Will You Still Love Me When I’m No Longer Young and Beautiful?  Is the story and support of Olivia covered by TransMusePlanet, one of the founders of the first transgender support groups that is still in existence. Charleston Area Transgender Support Group, known as C.A.T.S. still operates today with several splinter groups for transgender men, non-binary and trans youth and most still attend the main meetings which can have an average of 50 attendees.
  3. Under Palmetto Transgender Alliance, the support groups are connected for greater awareness and reach for the states transgender community through their network of support.
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