I Can't Orgasm Anymore :(

[CatGirl69]

Hi everybody,

(content warning - brief mention of suicidal ideation)

(also, sorry, this is really long, but the context matters, and a lot of detail is included to fend off FAQs)

I'm a transgender woman, in my late 40s. I had my trans awakening about 3 years ago, and I've been on HRT for about 2.5 years, and had an orchiectomy 1.5 years ago. My current HRT regimen, which has remained pretty stable for 6-12 months, includes a moderate dose of estrogen and progesterone. My estrogen blood level is pretty normal for an adult woman.

My sexual history has been very active, but complicated. Well, for the first 40-something years of my life I thought I was a guy. I was pretty miserable and depressed most of the time, but sex was one thing that kept me going. No matter how confusing and frustrating the social world was, no matter how awkward I was with my "maleness," sex was one thing that worked for me, both single-player, and partnered sex.

I've been with my wife for almost 15 years, and our sex life has been pretty good. She has her own health challenges, and sometimes it's difficult for us to connect, but we manage. My transition has been a non-issue for her -- she realized some time ago that she's pansexual, and, well ... we've been able to confirm that as we've been intimate throughout my gender transition.

I've been on antidepressants for a good chunk of my adult life, usually an SSRI (fluoxetine/prozac for a while, then I switched to sertraline 10-15 years ago). The sexual side effects have been noticeable, but usually manageable. After an initial increase in dose, I'd have trouble "functioning" (eg, maintaining arousal, reaching orgasm), but then I'd more or less get used to it.

Since starting HRT, my body's sexual response has changed pretty significantly, as expected. My penis doesn't really care for being stroked or used to penetrate, but I've learned that it *does* like vibration. For the last couple years, that's the only way I've been able to orgasm is through vibration on the glans.

After my orchiectomy, my emotional state cratered. The working theory was that my hormones were going wacky from the sudden offlining of my natal T-producing gonads (it's a thing, apparently). Unfortunately, this led to a hospitalization for suicidal ideation (my mood was getting that low and unmanageable), and another increase in dose of sertraline.

Since then, my overall sexual response has become pretty muted, and orgasm has gotten harder and harder to achieve. I don't think I've had a decent orgasm in almost a year. I sometimes have little crappy pseudo-orgasms, where I feel the nice buildup, and maybe a little bit of typical ejaculate dribble, but no real "climax" or "release." Just, the "don't touch" sensitivity afterwards, and then .. I guess I'm done? Sometimes, I can't even get to the build-up portion ... it just ... doesn't respond.

This happens when I'm by myself or with my wife. When we have playtime, it feels amazing .. her touch, how she kisses me, how she makes me feel sexy and desired and loved and wanted . . my body delighting in her playing with my breasts, touching me gently, etc. I'm on fire with desire. Then I reach for my vibrator, and .... *crickets*. It doesn't matter if I try to have a "quickie" or if I take my time with a nice steady buildup. Once I / we get to the fun part .... *crickets*.

It's not that I *need* orgasm every time we have sex, but it's like ..,. can I get one at least once in a while? And I know there's more to life than orgasmic sex, but ... when I've been enjoying something regularly for most of my life, and then suddenly it's *gone* ... it's frustrating. It's sad. It's scary. I'm not ready to be done with my sex life. I wanna feel *good*, ya know?

I've sought out some resources, but they've been little help. A lot of it is generalities like "you gotta take it slow and communicate and learn what you like" (eg, "Girl Sex 101") or in the case of the "F---ing Trans Women" zine, a lot of "not for me" stuff (muffing? really?). How do I communicate what I like when *I* don't even know what I like, or if I even like *anything* anymore. I've tried different technical things -- vibrators, butt toys, prostate stimulation ... Nothing.

Dysphoria doesn't help any, either. I've come to realize that I *really don't want to have a penis anymore*. I don't like it, I never asked for it, and I *can't wait* for a month from now when I finally get vaginoplasty surgery. It's possible that a lot of this will resolve itself after I'm healed from that, and if/when I ever get to reduce my SSRI dose. But *geez*. It's really frustrating when I feel desire, when I want to feel good, I want to be a sexual person ... but I just can't.

[Heather]

Hey there, CatGirl. I can certainly understand how frustrated you're feeling around all this, and woof, it's clearly been a real journey on the whole, too. Kudos to you for keeping faithful and dedicated to what you want for yourself!

It's not likely the biggest comfort to know this, but just in case, it offers you something, the issues you're having with orgasm as a trans woman in transition are awfully common. From everything we know from personal and community anecdote, and then from what study there is, it does seem like it's most often a combo of, yep, the radical hormonal change (including changing from a more testosterone-rich body to a more estrogen-rich one and how the whole sexual response cycle can just feel so different for a lot of folks), the dysphoria, managing mental health and the impacts of some mental health meds, and thankfully, some things it doesn't sound like you are dealign with, like big changes inside sexual relationships.

I wonder how you might feel about two different possible options: 1) working with a trans-literate -- and even more ideally, a trans -- sexological bodyworker (for some basics on that, see here: https://sexologicalbodyworkers.org/whatis) and/or 2) kind of embarking on a journey to start as close to scratch as possible to effectively "learn" how to be orgasmic and experience sexual pleasure as if you were in your body and self completely anew? Per the latter, I'm thinking about things like dedicated time and space to all kinds of pleasure without the goal of orgasm, extending sexual pleasure of your whole body and self very intentionally, and a bunch of other things in this vein.

Do either of those things sound like good and accessible options for you?

Also, have you gotten your hands on a copy of Lucie Fielding's Trans Sex, yet? It's meant for clinicians, but it is written in an engaging way, and I think it might be helpful for you when it comes to exploring options with this and identifying some areas where you might be able to focus that could change how you're experiencing this for the better.

[CatGirl69]

Thank you so much for the quick and kind response. You're an angel! <3

To answer your questions:

1. I had never heard of that before, and even after reading up, I'm still not sure I get it? Either way, the only person near me charges way more than I can afford.
2. I feel like I've already done a lot of re-exploration? Unless I missed a spot?
3. I think I've seen that book in stores. I'll give it a look.

Thanks again! <3

[HannahP]

Hi CatGirl! I'll leave the first point to Heather when they come back, but I thought I'd pop in to talk about point number two, the re-exploration.

I wonder if it would be reassuring to you to know that one of the most frequent topics of discussion here on our boards are from young women who are struggling to figure out how to orgasm or how to experience sexual pleasure. The timeline you're talking about, of not being able to orgasm for the last year and feeling like your body has been responding differently for the last several years, is, I would say, completely in line with these other women's experiences (even though it's happening later in life for you.)

Of course, you are experiencing something different from an emotional perspective - we get questions from many young women who feel confused and frustrated and disheartened, just like you, but you are also experiencing a certain amount of grief, I think. You have the experience of your past orgasms to compare to, you know "what you're missing," so to speak. That's a tough emotional landscape to be exploring pleasure in, you know?

I think that's what Heather was getting at, not just the idea of doing lots of exploring, but also seeing if you can approach the exploration with a new perspective. It's disheartening to feel like you had something amazing and you lost it and now have so far to go to build yourself back up to where you were. Whereas thinking of yourself as "starting from scratch," as Heather suggested, like a woman who is new to her body and how it experiences pleasure, might give you some of the emotional space you need to effectively explore.

Does that make sense? How do you feel about it?

[CatGirl69]

Hi HannahP,

Thank you for the thoughtful and kind response.

Honestly, no, it's not really reassuring to me to know that young people are experiencing the same symptoms as me, because, at least in my mind and how I feel about things, the underlying problem is totally different. I'm not dealing with a body that is just awakening to this stuff, and I'm very well aware of the kinds of problems that come with that and how to solve them (or, at least how I would have if I were a young cisgender woman). I've consumed a *lot* of sex ed content over the decades, so I have a brain full of information.

I think another problem I'm having is ... not much really feels good anymore. Like, it might feel good in that a nice backrub or passionate kiss feels good, sometimes it feels good like a little tingle in my nipple. But it doesn't really "build" like it used to. You know, that "oh yeah that's the spot, keep going" kinda feeling.

If I was 18 years old, I could look forward to having my whole life to figure things out. But I'm not, and I don't have my whole life ahead of me anymore. Yeah, I'm grieving, I'm afraid, I'm sad, I'm frustrated. I'm starting to feel like, there's nothing left to "unlock" or "discover," and I'm hoping and praying that it'll just come back after I've recovered from surgery.

And again, I *have* done some of that "my body is new, let me just explore and touch and see what feels good." I dunno, maybe I haven't done it enough, or I haven't done it right, or thoroughly, or I'm not spending enough time on the right things? I have no clue. I'm sure I'm not alone in this, but since nobody seems to have any answers for me, and how I'm unable to draw useful connections between analogous situations and mine, I might as well be alone.

[CaitlinEve]

Hi CatGirl!

It's important to remember that even though this is frustrating, you and your body deserve grace! You are going through a second puberty; especially after your orchiectomy. Your body is still adjusting to the changes you're going through, even if you aren't 18 anymore. Have you noticed that your struggles with pleasure extend to non-sexual pleasure? It's not impossible that this could also be traced back to depression and your medication. Is it possible that you could talk to a doctor about changing your meds (either dosage or prescription) to see if this makes a difference after you feel more steady with your mental health?

I do think a lot of this may be connected to dysphoria and you may notice a change after your vaginoplasty (especially if it helps you connect your physical body and your ideal body!). I think the most important thing for you to understand and digest is that there is no way to 'do it wrong'. Some things may just not work for you, right now or in general, and that's okay. None of it is your fault! I'm sure it's isolating to try to explain your experiences and not be understood fully on the level you want to be understood; I think it may be beneficial to see if you can find communities of other transgender women/trans-femme people to see if you can talk one-on-one with someone else who is dealing with the same thing in the same context. I know that I personally am not trans-femme (though still trans) and so my experiences will not align exactly with yours!

[CatGirl69]

I would love to find communities of other trans women/femme folks to chat about this stuff, but I have had zero luck in finding any. I always end up having to leave because I'm uncomfortable with how people can be very inappropriate and unfiltered (eg, slurs, uncensored fetish content).

I don't really have much opportunity to experience physical pleasure of any kind lately, so I don't have much data there. It does feel nice when my wife touches me. But she's just as clueless as I am, and she's nervous about triggering dysphoria in me, and she's almost never in the mood for sexy times anyway -- various health issues, and she's as stressed as I am in a lot of ways.

Yeah, I have an appointment with my medication management doc (I *had* an appointment a month or two ago ago, but I'm a idiot and missed it and had to reschedule), and I'll bring it up. I suspect she'll just tell me to wait cuz I'm so close to surgery.

And that's probably the correct answer ... just wait, and hopefully I'll figure things out later. So, no fun sexy times for silly CatGirl.

[Heather]

Just in case this might be helpful to you, I wanted to post what I would do for myself in a similar situation (and have, though in my case it was about disability, immobility and chronic pain rather than embodiment around gender and hormonal changes).

For one, I would focus on pleasure by and for myself rather than with a partner, especially if my opportunities to be with a partner were both scarce and the partner I had also was having their own issues and uncertainty about how to be sexual with me.

I would start by making as long a list as I could muster of different sensory experiences or explorations I could give myself that I knew or expected would result in pleasure, more sensual stuff at first than sexual stuff, so things like:
• having a likely-great meal I could cook or go have at a restaurant somewhere and really lean into enjoying and savor
• spending an afternoon at a conservatory, letting myself take in all the different scents and visual delights and the humid warm air
• playing music (be it instruments or listening to music I love) or going to live music
• exploring movement or rhythm in my body
• getting a massage or some other kind of bodywork
• changing or doing things in my home environment to increase my pleasure in it, be that adding plants or flowers, home scent, new or clean sheets, new art, changing the lighting, etc.
• covering my body in fabrics that feel good to the touch as much as I could

With things like this, I'd be focusing on really leaning into the pleasure I am experiencing there, and paying attention to what makes me feel what way, and where most of my enjoyment and pleasure seems to live. I'd make a project of it over days, weeks or even months. Think eat-pray-love, but ideally less blond and boring.

From there, I'd take what I learned and next work towards incorporating that into my sexual life, bringing or translating as much of what I learned from that into, first, my masturbation practices. Like, were tasting or hearing things big sources of pleasure for me? If so, how can I bring those things to touching and exploring my body? How different might things feel if my environment is now more full of things that give me pleasure? I'd also be trying to approach masturbation in the same kind of mindset I approached all of that other pleasure exploration, and again, I'd be very observant of how I felt and would also make a point of devoting time, as a practice, to my own masturbation and related pleasure, whether that was an hour or so a day, or, if that felt like too much, a couple sessions of an hour each a week. Betty Dodson called that kind of dedication "erotic recess."

After THAT, I'd bring the things I knew and learned to partners, and then try and create a similar kind of practice with them as I had/have for my own masturbation, where we have some time each day or each week dedicated JUST to exploring pleasure together, sexual, sensual, or both, whichever felt right for us that day. So, maybe one of those days we would explore sex together, but maybe another we'd enjoy cooking and savoring a delicious meal.

Does this sound like something you've already tried? If not, how might you feel about giving it a shot?

[CatGirl69]

Thanks for the response.

I think I have tried some of those things, though maybe not as intentionally and mindfully as you're describing. I don't know what "eat-pray-love" means, but I think I get the gist.

I would love to be able to devote the time and energy to those things, but I don't. It sounds lovely, but ... I just can't. I'm tired and anxious all the time lately, and I have a hard time finding pleasure in anything. I love the idea of getting a massage, and treating myself in other ways, but again, that costs money that I just don't have.

I think I need to concede that sex/orgasm just isn't in the cards for me right now.

Thanks everyone. I'm sorry if I seem ungrateful or bitter or prickly or combative or contrarian. I'm not trying to be, I promise.

Peace and love.

[Heather]

It's so okay.

I do think this provides some really important information about your situation, though, which is that if anhedonia (finding it hard to take pleasure in *anything*) is in the mix, well... you're right. Not only is orgasm going to be pretty unlikely from that token alone, so is deeply enjoying yourself at all, sexually or otherwise. And that right there is likely the biggest impediment of all. I'm so sorry that you find yourself in that spot, it's a really hard one to be in.

Please know you get to feel however you feel about all of this, and we don't take it personally. If at any point you want to revisit this, or you just want some extra support in general, you know where to find us. <3