Sex and masturbation with a changing body

[Spark]

Hi

Firstly, thank you so much for this site. First time I've posted but I've been reading it for years. Now I've got a few problems that I can't seem to find help for I thought this might be a useful place to turn.

I'm a trans guy who's been on testosterone for a couple of years and am pretty pleased with the effects that it's having. The one thing I'm struggling to cope with is how high my sex drive is. I've also recently been diagnosed with bipolar and while I'm in a hypo manic phase it can feel like I need sex, not just want it. To stay relatively safe I tend to stick to masturbation (not always) but even that has its issues. Not the first time I've been late for something because I've got to get relief first.

I know my testosterone levels are within the normal range so it's not that. I've also recently been tested for STIs and everything was clear. The nurse doing the test didn't notice anything. I was totally open about how high my sex drive can be when I first saw a psychiatrist, and know it can be a symptom of bipolar. He reassured me that it should settle down once I'm on the right medication. I've been on lamotragine six months, and while it's helping everything else it hasn't touched this.

I'll bring it up again when I go back to the psychiatrist next month, but is it better me saying it to someone else? Should I go back to my GP or the sexual health clinic again to try and explain just how much of an issue it is?

The other issue I'm having right now, kind of connected, is struggling to have safer oral sex. It's one thing that does usually give me relief bit I don't always know the status of the person doing the sucking so I want to be as protected as possible.

The problem is that since I've been on hormones my clit has grown significantly. I love the way it looks and feels now but if I use a dental dam like I used to it just feels like it gets stretched over it when I'm hard, and that's not comfortable. I don't want to feel like it's being pushed down. Obviously it's too small for even the tiniest condom, and I understand the wider area needs covered too. Is there something I'm missing? I'm usually the receptive partner but occasionally, when I'm big enough after oral, I've got enough to try penetrating someone anally. So the question applies to that too.

Thanks, and sorry about the long post.

[Heather]

I'm so glad what we do has been of value to you. Welcome to the boards!

Starting backwards, can I ask how tight you or a partner are holding the dam when you use it? You don't need to hold it so tightly it feels like it's pressing your clit down: you can hold it more loosely without losing any of the protection a dam can offer. Alternately, you might see if you have better luck using cling film instead of a dam, especially if and when you want to try the kind of anal sex you're suggesting. You have a much bigger amount of material to work with with cling film, in either case.

In terms of your desire for sex, the tricky thing is that either this isn't about the T and its effects at all (though it obviously probably is at least partly that, if not a whole lot of it), in which case there's really nothing to do about it -- though we can talk about other ways to either sublimate those desires or get similar expression from them from other things, if you want -- or it IS about the T, and the only way to change this may be to lower your T, which you probably don't want. I do think that talking about it to your whole healthcare team is a good idea though, just because you never know who might figure this out with you if there is a thing to figure out and it's good to at least know your options, you know? This is something where you really want to -- I think -- talk to in-person providers who have all your health information and who are experts who specialize in these kinds of care (trans medicine and mental healthcare).