By Aedan Wolton | @aedan_james

Despite the wonderful diversity within our LGBTQ communities, it can sometimes feel like the ‘T’ is silent. Trans people are often left off the sexual health agenda, and even within community spaces, transphobia is rife.

On the often hyper-masculine, phallocentric gay scene, queer trans men (guys assigned female at birth) can experience unique forms of invisibility and discrimination, making even a simple hook-up feel really complex!

I spoke to Jamie, a 50-year-old trans man about his experience of navigating the cruising scene, and his strategies of maintaining good sexual health in a system that was not set up for trans people.

Jamie is currently not in a relationship. He spent 22 years in the military, and when not going to concerts or the football, he enjoys an active sex life with guys who he meets in cruise bars, darkrooms and saunas. He occasionally uses apps, but says they can be a bit time-consuming! For a lot of trans guys, another downside of apps is that they can provide an anonymous space for men who are not clued-up on trans issues to ask some pretty invasive or inappropriate questions.

Jamie spoke to me about his experience of cruising in saunas where “your body shape is more exposed, as are the scars.” In these steamy environments, he tends to opt for backless pants as he’s still undergoing lower surgery and avoiding lengthy discussions about his genital configuration makes life a little easier!

“Darkrooms are better, in that clothes can hide things more easily. You just need to stop wandering hands if you don’t want to be touched.” He tells me the downside of hooking up like this comes when someone wants to see him again, or spend the night together. “I can’t, because I didn’t explain who I was first.” For a lot of guys, knowing if or when it might be safe to tell a hook-up that you’re trans can be an incredibly difficult and anxiety-provoking experience.

On top of worries about disclosure or transphobia, sexual health can be a tough field to navigate for a lot of trans people too. There’s a lack of accurate information that’s relevant to trans bodies, and a lack of sexual health clinics able to offer trans-appropriate services. Despite this, Jamie is conscientious about his sexual health and is buying PrEP (medication to prevent HIV) online in order to stay HIV-negative.

“I was wary in case it wasn’t the genuine product. The turning point was accessing websites like iwantprepnow.co.uk.” Jamie had some concerns about whether PrEP is as effective for him as it is for other gay men, as no trans guys have been included in any of the PrEP studies so far, but he feels it’s a useful addition to his sexual health toolkit.

Jamie buys generic PrEP without prescription from AllDayChemist, and currently has all of his follow-up testing and care at 56 Dean Street in Soho, where I am a health advisor, helping to run cliniQ – the only weekly, trans-led sexual health clinic in the UK. “Although I don’t need them, I understand why some people would appreciate the dedicated trans clinics. Finding a place where having a non-standard body is expected and needs less of an explanation is important for lots of trans people. Anything that reduces barriers to accessing sexual health services and advice should be applauded.”

When Jamie first started to transition, he felt like all the other trans guys he met or read about were attracted to women, but after some exploration he found other gay and queer trans men who were also into the darkroom and sauna scenes. Jamie feels there are a number of places for people to find information on the medical aspects of transition, but that there is a very real lack of information to help navigate the sexual elements. “PrEP is really helping with that aspect. I don’t believe it has changed my outlook on HIV, but I feel free to embrace the sexually charged environments that I visit, and it’s great to think that someone else’s status is not an issue.”

There’s a need in the UK, and globally, for a more open discussion about trans people’s sexual wellbeing, not just limited to HIV prevention, but also sexuality, relationships, and sexual pleasure. “I can’t speak for others but I need to explore, and I need to know what I want in bed now. I have a different body, I have a different outlook, and I’m having sex in different environments from those I am used to. PrEP is important to me for that reason. I can relax and just enjoy this element of my life.”

With the advent of PrEP guys like myself, Jamie, and our patients in cliniQ can focus on finding the sex we want without fears for our sexual health. There’s still a huge amount of transphobia on the queer scene, but hopefully with education and increasing inclusion that sex can come without fears for our emotional health too.

Aedan Wolton is a social worker and specialist Trans Health Advisor at cliniQ and 56 Dean Street in Soho. He is also a campaigner, avid gardener and cat enthusiast.

For more information about trans sexual health, visit www.cliniq.org.uk.