“Because your dysphoria gets in the way of you…it affects everything.” The mental, physical, and relational aspects of navigating body dysphoria and sex for trans masculine people

Abstract

Research suggests that many trans masculine people experience distress from body dysphoria. Social and medical transition through hormones and gender confirmation surgery offer some relief for body dysphoria; however, trans masculine people may continuously experience the impact of their body dysphoria on sexual experiences. This qualitative study explored the influence of body dysphoria on sexual experiences with 10 trans masculine people using Interpretive Phenomenological Analysis. The first emerging theme included mental negotiation of dysphoria in which participants described a process of having a mind-body connection, experiencing negative mental health outcomes, and continuous thoughts. The next theme was physical negotiation of body dysphoria in which participants described having body discomfort, using testosterone and surgeries to reduce body dysphoria, creating sex boundaries, using prosthetics, exploring masculinity, and self-pleasure. The last theme was relational negotiation of body dysphoria, participants discussed feeling burdened by sharing sexual needs, finding a stronger sexual connection with certain sexual identities, partner pleasing, communication, and receiving support. This study demonstrated that it is crucial for clinicians to understand the connection between body dysphoria and sexual experiences. Allowing a space for trans masculine people to be validated can reduce negative mental health outcomes, build community, and increase resiliency.

Keywords:

• Transgender
• body dysphoria
• sex
• LGBT

Acknowledgments

Special thanks to Sarah Stanton, Shaelise Tor, and Brandon Hollie for their time and genuine contribution to the data analysis process of this project.

Disclosure statement

The authors declare that there are no conflicts of interest.

Additional information

Notes on contributors

Tristan K. Martin

Tristan Martin is a doctoral candidate at Syracuse University in the Marriage and Family Therapy program. He has a master’s degree in Family Therapy from Mercer University School of Medicine. He is currently in private practice working with individuals, couples, and families of all identities. His clinical specialization includes providing support for LGBTQ people, specifically trans people and their families around transition. Tristan’s scholarly interests include relational issues among trans-identified couples and navigating sexuality. He has presented at multiple national conferences and contributed publications to the field of family therapy on trans issues.

Deb Coolhart

Deb Coolhart has a PhD in Marriage and Family Therapy and is an Associate Professor at Syracuse University in the Marriage and Family Therapy Department. She is also a Licensed Marriage and Family Therapist in private practice, specializing in work with trans people and their couple/family relationships for the past twenty years. Dr. Coolhart’s scholarly interests include clinical issues related to marginalized and queer experiences/relationships and intersectionality, with a particular focus on clinical issues of trans people and their families. Her research and publications have focused on trans youth and their families, trans family support, trans parents and their children, and trans sexuality. Dr. Coolhart created the Gender Expansive Support Team, housed in Syracuse University’s Couple and Family Therapy Center. This team provides free therapy services to the community and is comprised of students who gain specialized training working with trans and gender expansive people and their couple/family relationships, including working with clients on readiness for medical gender transition