Trans Women and Viagra
Q: I am a pre-op trans woman. I have been on hormones for a while now, but my partner would like us to try having sex where I can penetrate them. Can I take Viagra to help me get an erection, or will that mess with my HRT?
A common assumption about trans and non-binary women who were assigned male at birth (AMAB) is that we must automatically hate our penises and wish to be rid of them as quickly possible. While this might be true for some, it ignores the sizable portion of feminine-identified trans and non-binary folks who love their bodies, including their cocks. Not to mention that being able to penetrate our partners with our own equipment can be super sexy, empowering, and pleasurable. However, for those who have already begun an estrogen regimen, achieving and maintaining erections can be difficult. So, what’s a girl to do?
For lots of trans women, including adult performers, those doing sex work, or anyone simply looking to use their trans girl cock, erectile dysfunction medications such as Viagra, Cialis and Levitra can be essential. Prescription ED medications work by blocking phosphodiesterase type-5 (PDE-5), an enzyme that promotes the breakdown of cyclic guanosine monophosphate (cGMP), which regulates blood flow. This relaxes blood vessels in the body, including in the penis, which makes erections easier to achieve and maintain. These medications do not interact with or alter the effects of hormone replacement therapies (HRT) and work the same way in both trans women and cisgender men, but with some added considerations for trans ladies.
Trans women who are on HRT and have taken ED medications have reported that erections “feel different” than the erections they had prior to HRT. Erections may not be as firm as they were before hormone replacement therapy, but still firmer and longer-lasting than without ED medications. Estrogen also tends to make penile skin thinner and more sensitive, which may make erections feel more painful.
Lower testosterone levels typically decrease many trans women’s libidos. Since ED medications still require you be aroused in order to work, some may discover that Viagra, Cialis, or Levitra are not exactly the “magic pill” they were hoping for. ED medications won’t necessarily make sex “feel” more pleasurable, but if your aim is penetrating your partner, the confidence of knowing you can may improve your enjoyment.
There are of course other methods you can try to help achieve an erection. Some folks use injectables called prostaglandins such as Caverject or Trimix. These injections also increase blood flow to the genitals and are prescription-based, but unlike pills, they can provide erections whether or not the user is aroused. Cock rings are a great way to help maintain an erection by restricting the flow of blood out of the penis. There are also lubes or arousal gels, such as Max Arousal Gel, Intimate Earth Intense Clitoral Gel or others, that open the blood vessels to the genitals making erections easier. Another option to consider may be reducing or going off any androgen-blocking medications that you might be taking, unless doing so would be dysphoria-inducing. Be sure to consult with your medical provider before deciding to alter your hormones.
While penetrating your partner may be your goal, remember that penises don’t need to be hard in order to have sex. There are lots of ways to have and enjoy sex and orgasm with a flaccid or semi-erect penis. You might explore using a strap-on or an extender, that will allow you to still penetrate your partner without being erect. If you choose to take ED medications, follow the instructions, know the potential side effects, and see a doctor if you experience long-lasting erections. Ultimately, decide which erection method works best for you and your situation, be safe, and have fun!
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