Sexual self-esteem | Trans+ Sexual Wellbeing

Many people struggle with sexual self-esteem at different points in life, and you’re not alone in feeling this way. 

Self-esteem is the opinion we have of ourselves. It drives our positive and negative thoughts about our abilities, worth, and value. Our sexual self-esteem is how we feel about ourselves as desirable people, which is closely linked to this.  

For trans people, sexual self-esteem can be shaped by additional factors such as gender dysphoria, gender affirmation, stigma, misgendering, fetishisation, dating rejection, and access to gender-affirming care. These experiences can impact how confident and safe we feel in sexual situations.  

When sexual self-esteem is low, it can impact our sex lives and how well we look after our sexual health and overall wellbeing. If  we don’t feel desirable or feel uncomfortable with our bodies, it can impact us in different ways:  

Lack of sex drive 

If our sexual self-esteem is suffering, we may not feel sexy, sexual, horny or confident. Dysphoria or anxiety about our bodies can reduce our want for sex, intimacy, or touch. 

Hormones, surgery recovery, or changes during transition can also affect sex drive, and this can sometimes feel confusing or distressing. It’s important to remember that ups and downs in sex drive are normal. 

More sex than usual 

Sometimes, when our sexual self-esteem is low, we may seek out validation through sex. For trans people, this can include seeking gender affirmation, wanting to feel desired or recognised in our gender.   

This means we may have more sex than we normally would, and we may not look after our sexual health as well as we should,  in an effort to cope with feelings of low self-worth.    

Having sex we may not necessarily want 

If our sexual self-esteem is low, we might agree to types of sex, language, or dynamics that don’t feel affirming or enjoyable, in order to feel validated, please others, or accepted. 

Avoiding sexual contact 

We may try and avoid sexual contact, even if our sex drive is still high or active. Anxiety about our bodies, scars, chest, genitals, voice, or how a partner will react can lead us to avoid sexual situations. 

High anxiety around sex 

Low sexual self-esteem can cause anxiety about performance, desirability, or whether a partner truly sees us as our gender. We might worry about being rejected, misgendered, or fetishised. This anxiety can make it difficult to relax, enjoy intimacy, or communicate clearly about what we want. 

Avoiding sexually charged environments 

Low sexual self-esteem might mean we avoid places like bars, clubs, saunas, or dating apps. For some trans people, fear of harassment, discrimination, or body comparison can make these spaces feel unsafe or overwhelming. 

Physical symptoms 

When sexual self-esteem is low, it can also show up physically. This might include difficulty getting or maintaining an erection, difficulty orgasming, vaginal dryness, pain during sex, decreased sex drive, etc. 

For trans people on hormone therapy, some physical changes (such as changes to erections, lubrication, or orgasm) may be hormone-related. If symptoms are distressing, a GP or sexual health clinician can help. 

There are things you can do to manage or overcome sexual self-esteem issues: 

Take the pressure off 

It’s important to know that sex isn’t the most important thing. Friendships, connections and emotional intimacy are just as important. Forcing yourself to have sex to “fix” how you feel can make things harder in the long term. Take a step back and only have sex when you are ready. 

Find a trusted partner 

Find the right person to connect with sexually, someone who respects your pronouns, uses affirming language for your body, and understands your boundaries. This can improve sexual self-esteem. A supportive partner who can help you navigate your sex life and wellbeing could be an important move forward.  

Talk to your partner 

If you already have a partner, communication is key. If you aren’t feeling sexual at this time, communicate that to them. If you’re uncomfortable with your body, the talk to your partner and see how they can ease your anxiety. Talking through issues is often a great way of unpacking what you’re feeling and move moving forward as a couple. 

Look after your sexual health 

Test regularly. If you are having sex more often with multiple partners, test for HIV every six months and STIs every three months (depending on the type of sex you’re having). By looking after this important aspect of your health, it can allow you to feel better about other aspects of your wellbeing.   

Using condoms (internal or external), lube, and considering prevention methods such as PrEP and DoxyPEP, can help you feel more confident and in control of your sexual health. If you’ve had surgery or are on hormones, ask a clinician about any specific considerations for your body. 

Rebuild your relationship with your body 

If body confidence is low, your sexual self-esteem can suffer. Try to find one thing you love or appreciate about your body. Whether it’s your shoulders after starting testosterone, your skin on oestrogen, your smile, your hands... focusing on affirming parts of yourself can help rebuild confidence. 

Look at your relationship to media 

From Instagram to dating apps, to porn, media can strongly affect our sexual self-esteem. Trans bodies are often underrepresented, portrayed unrealistically, or the subject of abuse and scorn online. If certain media makes you feel less than or dysphoric, it’s okay to not use it. Try and build your feeds to include diverse, affirming trans people, messaging and bodies. 

Talk to people 

Talk to friends about how you feel about your sexual self-esteem. You may find a friend who has experienced similar feelings and can offer you advice, or you can work through it together. Talk anonymously in a safe place like the LGBT HERO forums, if you aren’t comfortable talking to friends, or safe spaces like LGBT HERO’s Trans+ HangOuts online groups. 

Talk to a therapist or GP 

If you find that your life is being seriously impacted, then consider talking to a professional about what you are going through. If you are having physical symptoms, .  such as erectile dysfunction (for example) then consider talking to your GP. A gender-affirming therapist can help you unpack dysphoria, shame, or anxiety around sex. If you’re experiencing physical symptoms speak to your GP or a sexual health clinic. 

You deserve intimacy that feels safe, affirming and right for you. 

Further help and support 

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