While it can be uncomfortable to discuss these topics, it’s important to be open about your needs and concerns ― with your partner or doctor.

Have you ever wondered if transgender men can ejaculate? Are you a trans man yourself and want to know how hormone replacement therapy (HRT) affects your sexual health?

Although these questions would be inappropriate to ask a trans person you’ve just met, it’s natural to feel curious and wonder. This article can answer just about all your burning questions and more.

The short answer is both yes and no.

No, trans men can’t produce sperm or semen. And they can’t ejaculate the way a person with a penis can. Even if a trans man (or any transmasculine person) were to receive bottom surgery, they’d still be unable to produce sperm.

Yes, trans men can ejaculate when their bodies release fluid during orgasm or climax. What people colloquially call “squirting” can happen to just about anybody with a vagina. A 2022 research review showed that this ejaculation could involve fluid secretion from the Skene’s glands, which have the same material as the prostate.

Yes, transgender men can orgasm the ways many people with a clitoris and vagina orgasm.

Not all trans men may want or be able to take HRT for their transitions, but for the transmasculine people who go on to take HRT, sexual health can resemble some menopause symptoms.

HRT can often affect the vagina by worsening conditions like endometriosis or polycystic ovary syndrome. It may also lead to dryness, atrophy, and pain. In a 2023 study, 351 out of 486 participants (72.2%) reported experiencing pelvic pain following testosterone therapy.

Sometimes, orgasms can be painful for people getting HRT, but these conditions are manageable with consistent and individualized treatments from your healthcare professional. Learn more about treatments for painful orgasms.

Sexual healthcare for trans men

As a trans person, having a doctor that understands all your healthcare needs, including your sexual health, is extremely important. Getting routine screenings, checkups, Pap smears, and ensuring your doctor can help address your needs are all vital to your health and well-being.

Ideally, you’ll have a primary care doctor who specializes in trans health, but if this isn’t the case, you’ll have to become your own advocate. Ways you can advocate for yourself in the doctor’s office can include the following:

  • List your questions ahead of time.
  • Keep a detailed journal of your health concern(s) and symptoms.
  • Let the staff know if their forms don’t have adequate options for your gender.
  • Bring a friend or family member with you if you need emotional support.
  • Stay up to date on the current standards of trans healthcare.
  • Be prepared to bring up topics like Pap smears and mammograms.

Know when to look for a second opinion or a new doctor. If you often feel rushed and that your doctor isn’t answering your questions to your satisfaction, you may need to access adequate healthcare.

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Yes, transgender men can pee standing up, even if they haven’t had gender-affirming surgery. They can do it in various ways, depending on their body type and whether they’ve had or haven’t had certain kinds of bottom surgery.

If a trans man or any transmasculine person has had bottom surgery during which a doctor lengthens the urethra, they can pee out of the phallus. This is often a part of phalloplasty, but not always.

They can also use stand-to-pee devices if they haven’t had surgery or HRT. Some are made of silicone and look like realistic penises, while others are made of plastic and are purely functional.

A trans man could be a father in many ways, including by:

Even with surgery, trans men can’t create sperm. But being a father is much more than just a genetic component.

All in all, there are many ways to exist as a man. Being a transgender man is just one of those ways.

While transgender men can’t produce sperm, there are still ways to achieve gender-affirming goals like ejaculation, peeing standing up, or fathering a child.

The health needs of a transgender man are specific and varied, and ideally, your primary doctor will be familiar with them. If you still have questions about your health as a trans person, we invite you to continue your education with more high quality, peer-reviewed articles like this one over on our LGBTQ+ Hub.