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Many people ask themselves how transgender people actually have sex. There is a lot of ignorance here and a lot of gossip. Not for nothing was the first question of people, before whom I outed myself as a trans, whether I am now also gay. The type of erotic life of a transgender person depends on many factors. But whether someone is trans does not say anything about sexual orientation. There are Transmen, i.e. woman-to-man Transgender, who love men, but also those who prefer women. And vice versa. If the finding of identity is an important factor in puberty for everyone, and sometimes even beyond it, it is much more difficult for transgender people to find out who or what they are, and usually it takes longer. And what you like. Although I knew early on that I was primarily attracted to women, I couldnt really find my way in my male role. Which is why my behaviour when conquering women or girls was characterized by passivity. Which was not well received by the opposite sex. Thats why I was rather late for the legendary first time. At some point I admitted to myself that I also find a trained male body quite attractive. After trying it out, I knew that enthusiasm is one thing, but fantasy and reality are two different pairs of shoes. (I still find David Beckham in the underwear commercial damn sexy as long as he keeps his underpants on...). Once the identification process is complete, an important factor is whether a hormone treatment is carried out or how far it has progressed. If a hormone treatment is aimed at and approved, a man-to-woman transgender is first given a testosterone blocker. Subsequently, artificial female hormones are administered. Woman-to-man transgenders are clearly given testosterone. This hormone administration, by the way, must last a lifetime. And it has extremely intensive effects on the person. Apart from the fact that the external appearance changes, it also usually causes strong changes in the libido. Transmen suddenly have the need for constant sexual activity, while transfemales have the opposite effect. In the latter case, the administration of estrogen also leads to the fact that the erectile capacity of the male genitals diminishes more and more, and at some point becomes virtually impossible. Transfemales must always be aware of this when seeking hormone therapy. Another factor, of course, is the possibility of an operation to correct the gender. Transfemales are treated according to the so-called invagination method. And the newly designed vagina must first be bougiert regularly with a dildo, thus stretched, to prevent shrinkage. If this lengthy procedure of adjustment has been carried out without too many complications, a satisfying sex life can be achieved. Feelings and even sexual highlights are possible with the neo-vagina. The penoid structure of a woman-to-man transgender is much more complex. However, an erection of the new genital on its own is not possible. Therefore, an artificial erectile tissue is incorporated into the limb, and a hydraulic pump mechanism can be used in one of the two testicular prostheses. And the penis is simply pumped up when needed. Well, there are probably some men in their mid 50s who would like to have such a pump. In any case, as long as there are no major complications, it should also be possible to have penetrating sexual intercourse with this inflated penis. The strength of the sexual feeling varies from person to person. So you can see that the sexual life of transgender persons can offer many possibilities. What you choose and how you live it out clearly depends on the individual person. But at some point everyone will find the right one.

How does gender matching work?

Dr. Black carries out 300 gender adjustments per year. For him, the surgeries are routine, for his patients they are life-changing. But how does such an operation actually work? Felicitas is a tall, blond, slim woman. With a penis. Still. Because today, the 18-year-old has her sex-adapting operation in a special clinic in Munich. Feli is a transfer woman, which means she was born with male genitals. And they are supposed to be gone today. Instead of a penis and testicles, Feli will then have a so-called neovagina, i.e. a new vagina. Thats the job of Dr. Bernhard Liedl. For patients like Feli, these operations are life-changing. For him they are routine. He performs 300 gender adjustments a year. But how does an operation like this actually work?

Transgender: Man-to-woman surgery

Dr. Blacks surgical method is called the invagination method. The most difficult and longest part of the operation, however, is the formation of the new clitoris from the glans, explains Dr. Black. The glans is completely preserved at its vascular nerve bundle in order to form the neoclitoris. It is prepared in such a way that only the upper part visibly looks out of the skin. There is a risk that a vascular nerve bundle will be injured and the clitoris will die, says Dr. Black. The official name of this surgery is man-to-woman surgery. After the operation, the patients remain in hospital for about a week. Afterwards, they must regularly keep their new vagina open with the help of a vibrator-like set so that the neovagina does not contract again. In the second operation, which usually takes place a few months later, the excess skin that remains before the vaginal entrance after the first operation is removed. The vaginal entrance is straightened and widened. In addition, the mons pubis is built up. The woman-to-man operation The counterpart to the man-to-woman surgery is the woman-to-man surgery, in which patients who were born with a vagina receive a penis. This operation is much more complex. At the surgical clinic in Munich-Bogenhausen, where Dr. Black works, these patients can be recognized by the fact that they walk through the corridors with a thick bandage around their forearms. The dressing comes from the fact that a skin flap is removed from their arm, from which the doctors then form a penis. The so-called woman-to-man operation is very time-consuming due to the many individual steps and operation appointments. In the first step, the uterus, ovaries and vagina are removed and the vagina is closed. In addition, the clitoris is formed into the so-called clit, i.e. a clitorispenoid. Only in the next step is the penoid formed, later the glans reproduced, the silicone-testicle prostheses inserted and the scrotum formed from the labia majora. The patient has to spend about seven weeks together in hospital. Since the operation is so incredibly time-consuming, some patients decide not to perform all the individual steps. Anyway, gender adaptations are controversial, not only because they are risky. There are very many people who are trans and speak out against physical intervention. Some do not fit into the binary sex system, they are neither male nor female. Others say, Im a woman with a penis too or I dont need a penis to be a man and perceive gender adjustment as something that is forced upon you by society to be accepted as a real man or a real woman. In addition, you lose fertility as a result of the procedure.

Transsexuality Life after sex adjustment

The clinic in which Dr. Black works, for example, requires at least one and a half years of psychotherapy and two independent expert opinions from the patients, and the diagnosis transsexuality must also be made by a doctor. Some of those affected also feel that this is a problem, they have to have a disorder certified, even if they actually have no illness. But, says Dr. Black, if you understood them to be healthy, the health insurance companies would not pay anything. And the health insurance funds have been obliged to do so since the 1980s, as the Supreme Social Court decided at the time. In the past, surgery like this was called gender reassignment. The more recent term sex reassignment emphasizes that the body is reassimilated and not sex reassimilated. In 1991, Dr. Black began to perform gender-adapting surgeries. In the 70s and 80s, such operations were performed only occasionally, and the results were sometimes very poor. So I thought to myself, I could do better. According to Dr. Black, there are now several good surgeons in Germany who sometimes use different methods.


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