Scarleteen

I'm a trans guy, 19, on testosterone for 18 months. For about a week I've been seeing an excessive amount of vaginal discharge. It's enough that it's almost like a light period, but without any blood. None of the cramping or other symptoms I get when I menstruate. Now today I'm feeling some pain in my external genitalia. No internal pain. My first instinct was that I might have an STI, but my last STI screening was negative and I haven't had sex since then. I also really don't want to see a gynecologist unless I really have to for dysphoria reasons. I've never seen one before and I don't know who I would go to. Any suggestions about what might be going on? Do I need to see someone?

Just to check in first: is a doctor prescribing your T for you? If so, and they are not just a mental healthcare provider, are they someone you could/can see for a genital exam if and when needed?

Also: how severe is this pain? And can you get any more specific about where exactly it is?

(Edited to add: hey! You made it that two-year wait, since we last saw you! Mazel tov!)

Yeah, I get my testosterone through a doctor, but he's at a clinic that primarily does hormone therapy. He's the one who does my STI screenings, because he has to order lab tests to monitor my testosterone levels anyway, but I don't think he could do an exam.

Sounds like he probably could, but even if he couldn't, he is who I would ask for a referral to a trans-friendly healthcare provider who could. That way, you can make sure you get someone who understands the extra challenges this kind of healthcare can pose for you and who knows how to make it emotionally easier.

Without hearing how severe this pain is, it's hard for me to say if you need care or not. The discharge alone does make me a bit concerned, and that can be a symptom of a bacterial infection (and we don't have to have sex with others to get those) you'd want treated, if so. So, ideally, I'd say to see a sexual healthcare provider, but I also understand your reservations, especially if you don't have anyone you already have established for that care. You will need at least some of it eventually, though, so this might be one of those no-time-like-the-present situations.

That makes sense. Darn. I was really hoping you would say it doesnt sound like a big deal so don't worry about it. Yeah. I'll get in touch with the clinic and see if I can get an appointment. Thanks, Heather.

I've no doubt. But honestly, while maybe this is coming at you sooner than you'd like -- which is totally understandable -- this is care you'll need soon enough, anyway. Like, pap smears are still advised for trans men. So, I personally would vote for just going ahead and starting with someone now. It will be nice to know you have a sexual healthcare provider you can see and expect competent, sensitive care from.

In the odd event that other doctor can't give you a referral (unlikely), feel free to holler back. We'd be happy to help you find someone, too.