Scarleteen

I'm a pre-op trans woman and have gotten a UTI a couple of times. I don't know how best to prevent them, as most advice seems to assume that people who get UTI's have vulvas. Some risk factors might be that I tuck (so the tip of my genitals sits around my perineum most of the time), I often have to hold my pee (if there isn't a safe bathroom nearby), I take spironolactone for hormone therapy (a diuretic), and I have oral sex without barrier protection sometimes. Given this, is there anything I can do to reduce my UTI risk?

So sorry you've had such a hard time with this!

Ultimately, the prevention need here is effectively that same: keep bacteria out of the urinary opening and tract in the first place.

So, it's pretty for sure that tucking very well could contribute to this. I don't know of any specific studies about this, but anything that can bring bacteria to that tract -- be it other body parts, something like a thong, some kinds of sex, all of the above -- is going to increase changes of infection.

You already know holding it isn't ideal, so you want to do what you can to limit/decrease that ("Go first even if you don't have to!" I say, sounding like everyone's mother.) Same goes for going without barriers: you'll want to use those more for more prevention. In terms of the bacteria that might be getting a shorter path because of tucking, my best suggestion would just be to put extra effort into keeping the your anus and perineum really clean, maybe by keeping some of those wet wipes meant expressly for toileting/genitals handy on the regular. That way, you can still tuck and probably be at less risk of UTIs. There are also cranberry supplements that work for some people (real cranberry juice is virtually undrinkable, so).

If you continue to get them even after you make adjustments like this, you can also talk to your doctor about it. Sometimes it's that you just keep not fully getting the infection cleared by the treatment and need something else. Some people with chronic UTIs also take a low-dose antibiotic regimen.

Does that clear you up and translate things for you in the way you needed?