Sex after gender confirmation surgery (commonly referred to as “sex change” surgery) is a significant topic of interest and concern for many individuals who undergo these procedures. The experience can be both physically and emotionally complex. Here’s what to expect based on the type of surgery:

  1. Vaginoplasty (Male-to-Female surgery):
    • Healing Time: Surgeons typically advise patients to wait 6-8 weeks post-surgery before engaging in sexual activity. This allows the neovagina and other surgical sites to heal.
    • Dilation: Regular dilation with medical dilators is crucial to maintain the depth and width of the neovagina. Over time, the frequency of dilation decreases, but some form of maintenance dilation might continue indefinitely.
    • Sensation: While the neovagina is constructed in a way that aims to preserve erogenous sensation, everyone’s experience varies. Some individuals report satisfying sexual sensations, while others might find sensitivity takes time to develop or is different than anticipated.
    • Lubrication: The neovagina typically doesn’t self-lubricate like a cisgender woman’s vagina. Lubricants will be necessary for vaginal intercourse.
  2. Phalloplasty (Female-to-Male surgery):
    • Healing Time: The recovery from phalloplasty is extensive. Surgeons generally advise waiting at least 3 months before attempting sexual activity, but this can vary based on individual healing and complications.
    • Sensation: Phalloplasty aims to achieve tactile and erogenous sensation through nerve hook-ups. Sensation can take time to develop and might start at the base of the phallus, gradually extending toward the tip over months or even years.
    • Erections: The neophallus won’t have spontaneous erections like a cisgender male penis. For penetrative intercourse, an erectile implant is required, which is usually a separate procedure done after the phallus has fully healed.
  3. Emotional and Psychological Aspects:
    • Adjustment: Engaging in sexual activity with new anatomy can be an emotional experience. There might be feelings of joy and affirmation, but also potential feelings of anxiety, dysphoria, or dissociation.
    • Communication: It’s vital to communicate with partners about feelings, boundaries, and any pain or discomfort. It can be a journey of exploration and discovery, and open dialogue is essential.
    • Support: Some individuals find it beneficial to seek therapy or join support groups to discuss their feelings and experiences related to sex after surgery.
  4. Safety and Health:
    • It’s essential to remember that, while pregnancy might no longer be a concern after gender confirmation surgery, protection against STIs remains crucial if engaging in sexual activity with partners of unknown STI status.
  5. Enhancing the Experience:
    • Exploring one’s body, perhaps through masturbation initially, can be a way to discover what feels good. Over time, individuals can find new ways to experience pleasure and intimacy.

Everyone’s experience with sex after gender confirmation surgery is unique. It’s essential to be patient, give oneself time to heal and adjust, and seek support when needed.