Last week I shared some of my favorite puberty resources which were geared towards younger patients. Many older adolescent patients have questions about navigating dating and sex in a gender diverse body. 

Before we dive into resources together, I want to share some of how I talk with adolescents about sexual health. 

• I always ask for consent. “Is it okay if we talk about your genitals (or insert patient’s terminology of choice)?” 
• If they say, “no.” I thank them for sharing their boundaries with me. I let them know I would like to communicate about it in the future as the medicines we use to support their gender will affect their genitals. I ask them to think about how they would like to learn about that- talking with me, reading, watching a video, researching on the internet/talking to friends and sharing a summary of what they learn (verbally, video, or writing). And I plan a time to check in with them for an update. 
• I usually start by asking about sex with the question, "Are you kissing anyone?" Advancing the question often looks like, "Are you kissing anyone below the neck?" or "Are you more then kissing anyone?" I ask them if they are having sex with anyone and I describe sex as anything more than kissing. 
• From a disease transmission perspective touching with clothes on is obviously a non-issue, but for trans folx touch over clothes can lead to physical safety issues if the other participant(s) is transphobic. 
• I ask if they are interested in having sex with anyone.
• I ask if they have questions about having sex with anyone. 
• I ask when/if they disclose to people they are sexually or romantically interested in their gender diversity. 
• I share that I am a place where they can ask any questions they have about their body and about sex with themselves or with others. I tell them I know most school based sexual health education programs do a poor job of covering queer and trans sexual health. I can answer questions about how to talk to others about being trans, how to masterbate, different ways to have sex, and safer sex practices. 
• I remind them that I will not share any of our conversation with others without their consent.

Many providers who are not queer or gender diverse themselves (allies) may not be able to help trans and queer youth navigate how to have sex. Allied providers may never have had to think about their physical safety while disclosing their identity to a sexual partner. Allied providers may not have experience with how queer and trans bodies have sex- the actual mechanics. Allied providers may not know how to prepare for anal receptive sexual practices. Educating ourselves is important- QueerCME’s content series after we finish our pediatric block in December will be trans sexual health starting in January! Other great resources to review yourself and to share with patients include:

• Scarleteen
• Sex Etc
• Amaze
• Sex Positive Families
• Navigating the World More Safely as a Gender Diverse Youth (webinar)
• Queer Sex Ed Podcast
• TikTokers to follow
• Instagram to follow

Your organization could also host an event with a queer sex educator:

• Erika Hart
• Pidgeon
• Jimanekia Eborn
• Aida Manduely

Or share Trans Families’ recurring trans youth sex ed course with your patients. It happens twice a year, Healthy Relationships: Bodies, Dating, and Sex.

Remember consent and education are essential!