Sex Counselling for Gender-Variant Individuals

Introduction and rationale: Since medical interventions for transgender individuals were made available, guidelines were proposed to identify candidates who could benefit the most from such interventions. These guidelines set the stage for a “pathologization” of the sexual life of transgender people in the eyes of mental health professionals. The fear of being excluded from medical treatments may still play a role for trans clients, and they might show a guarded attitude whenever questions around their sexual life are raised in consultation. Population and settings: Trans people of all sexualities can benefit from sex counselling at any stage of their transition or beyond any need for it. Outcome: For gender-variant individuals, receiving validation of their own gender identity from a partner who accepts and shows interest in them is an experience of paramount importance, which may act as a protective factor for their psychological as well as sexual well-being. The aim of the consultation with the trans and gender-variant client should, therefore, be enhancing such experiences, helping the client feel comfortable with and enjoy their sexual bodies and removing the hurdles that hinder sexual satisfaction and well-being. Discussion and recommendations: Sex counselling should help the client challenging trans-normative assumptions, find personal ways to cope with body dysphoria (if present) while sharing intimacy (i.e., setting restrictions to intimacy with a partner, re-gendering genitals), dealing with the effects of hormonal therapy on the client, explore sexuality after surgery, and addressing other mental health issues that hinder sexual well-being.