A reader writes: “I am a woman who recently started dating a man who was assigned female at birth and transitioned several years ago, a fact that he shared when we began talking about having sex.
“As part of my usual pre-sex discussion, I asked him about getting tested for HIV and other STIs, and he said that he has had very negative experiences with health care providers and was not willing to get tested.
“He said that since he has not engaged in risky behavior since he was tested several years ago, he could not possibly have HIV, and that he can’t transmit any fluid-based STIs to me anyway since he can’t ejaculate. (There are of course skin-to-skin STIs, but those are more difficult to test for).
“I know the likelihood of getting a fluid-based STI from him performing oral sex on me is very low, but I would still like him to get tested. From his vantage point, because of the very low risk factor, I am making an unreasonable request. From my vantage point, getting tested is something that responsible adults do to take care of themselves and their partners.
“However, I know that it is difficult for me to fully understand his resistance to medical settings, and the last thing I want to do is traumatize him or pressure him to do something that has a negative impact and have him end up resenting me. He appears to identify very strongly as male and not as trans, and I don’t think he would be open to going to an LGBT clinic, as he has felt marginalized by the queer community in the past.”
I completely understand his discomfort with medical providers. Many trans people feel this way, and many do not get regular health care, even if they can afford it, because of their concern about how they might be treated or their trauma because of how they have been treated in the past.
And not all STIs can be diagnosed with a simple blood test. Some require examination, a urine test, or cells taken from the genital area, which can be very unpleasant for anyone, but particularly for trans people. So I do not fault him for this at all.
However, you are not making an unreasonable request, and his argument that not producing semen has anything to do with spreading STIs is off base. As you have said, STIs can be spread through skin-to-skin contact, and they can be present in other body fluids as well.
It would be nice if your boyfriend would agree to get tested and put your mind at ease. But he is refusing to do so. This doesn’t mean that he doesn’t love you or care about you. He might care about you very much, but the thought of going to a doctor is so overwhelming that it outweighs any other considerations, including your feelings.
The bottom line is that we are each responsible for our own sexual health. A person can receive a clean bill of health on Monday, contract an STI on Tuesday, and show a potential sexual partner his or her medical report on Wednesday. That doesn’t even mean that the person is trying to deceive his or her partner. It’s just something that can happen.
And because you and you alone are responsible for your own sexual health, you have to decide how you will proceed in this relationship. You have to decide what types of protection you require and what sexual acts you are and are not willing to engage in, based on what you know and don’t know.
You don’t want to do this out of spite or as punishment – “You refuse to get tested, so here’s what you’re not going to get!” As a responsible adult, you have to decide what level of risk you are comfortable with and act accordingly. Your partner then has to decide how he wants to proceed. Those are just the negotiations that happen in a sexual relationship.
(Editor's Note: Despite the fact that Matt Kailey, one of my closest friends, passed away earlier this year I will continue to republish his writing on MileHighGayGuy.com - as I did when he was alive - as a resource for the gay community to know more about trans people. This post originally appeared on Matt Kailey's award-winning website Tranifesto.com)
