The need for affirmation in transgender women can sometimes drive risky behaviors; here’s what to do to stay safe (Brian King/HES interview part 4)

In part 3 of our interview with Brian King of HES/Prism/NETA in Beverly, MA  we learned about compartmentalizing behavior and how to help oneself be more integrated.  Here in part 4, our final post, we’re talking with Brian King about how the deep need for affirmation by transgender women can sometimes drive them to take risks they might not otherwise engage in.   We’ll also talk a bit about how transgender women can stay safe and conclude our interview with Brian.

Beck’s Café: Brian, we’ve talked about risk behaviors and some of what motivates those behaviors that harm people’s health. And we’ve also talked about peer groups and how those help people to make wise choices and to stay healthy.  Does affirmation (or lack of affirmation) of who we are also play a role in a trans-persons behavior and potentially be a cause of risky sexual behavior?

HES: Well, it’s important for your readers to know that sexual activity is not risky in and of itself. However, affirmation is indeed an important issue and particularly for those who have had some sort of history or abuse for whom they are.  Let’s take a look at something simple like using a condom.

Becki, on the surface of it, using a condom should be a no brainer. But for some, stopping the physical romantic moment is something they won’t do.  Not because they don’t understand the potential risk, but because it would ruin the chance for being affirmed for whom they are as a trans-woman.  The trans-woman doesn’t bring it up so that the opportunity for being accepted is not ruined.  When you are in the moment what is more important? The affirmation or taking care of one’s own health.  For many, the affirmation comes first, not the health.  Sex addiction may also play a part in this, but that addiction is really a symptom of something deeper driving that person.  If you are having multiple partners it’s helpful to examine your behavior in your context: Are you someone who is single, having fun exploring sex; protecting yourself in the midst of that, having conversations with your partners; having fun?  Or is your context more about: sleeping with multiple partners; not using a condom; the physical interactions are emotionless; sex feels meaningless and you keep wondering why are you doing this over and over again?

Beck’s Café: I can see how affirmation is pretty important now.  Brian, what steps should a transgender person take to protect themselves should they decide to be sexually active?

HES: I try not to use the word “should” because contexts are always different and that’s your best determiner of behavior.  So, is a trans-person in a long term relationship and they have trust over 6 months that you are monogamous?  A barrier like a condom might not make sense, if you truly don’t have a risk.  You are both in a safe monogamous relationship then.

Another example; someone is in a relationship that they thought was going to be forever but, did it last a week or a month?  Did the other person betray or hurt you?  How long should you wait till you build trust with the new person your are with?  You need communicate together about yourselves and about your sexual health.  One out of two people who have HIV don’t know their status.

Some people choose to use oral condoms for oral sex.  Oral sex is very low risk for HIV it’s more likely for STD’s and they are alot easier to get than HIV. Gonorrhea of the throat and syphilis of in the mouth are risks with unprotected oral sex.  Many times you don’t have symptoms but you can still pass along these other STD’s!

HES recommends getting your STD screenings once or twice a year.  Just make it a normal activity, around your birthday.  When you don’t know that you have an STD and you are not displaying any symptoms, that’s when very serious damage to your personal health and to others can happen.  But many STD’s can be cured with simple anti-biotics if is caught early.

Normalize this, it doesn’t make you dirty because it is not, you are just taking care of your own health.  80% of women over 35 have HPV, human papillomavirus, for example!!! It’s that common.  I get my STD tests on a normal basis; don’t fear being stigmatized.   At least get tested for the most common STDs: gonorrhea, chlamydia, syphilis, and HIV. A general STD test should include testing every place on your body where your sex happens.  If you give oral sex make sure your throat is swabbed.  If you have anal sex, make sure your behind is swabbed.   A urine test for genitals.   A blood test for syphilis.  And we offer a simple rapid HIV test with a finer prick that gives you your result 10 minutes.

And it’s really easy; even I got tested when the HES Van came to a Friends of Randolph Country Club Party (FoRCC) at RCC in Randolph one night and I was completely healthy!

HES: Terrific Becki!

Beck’s Café: Brian, any last thoughts here as we finish up this wonderful conversation and pot of coffee here at Beck’s Care?

HES: Yes, NETA and HES would love to hear from the transgender community!  We want to offer our services and be a resource.  It’s important for the transgender community to tell us how to help them, what their needs are, and how they are being met or not being met.  What is working and what is not working? We really want to fill in the gap on health care for transgender people, and complement and collaborate with the services that already exist.

Beck’s Café: Thanks so much Brian for visiting with us.

HES: My pleasure Becki and thanks for the coffee!

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