Last Updated on March 15, 2020 by Dr. Philip Schein MD

Equal rights of people and the development of human rights of the last generation (the so-called gender rights) in many countries have led to an increase in the number of medical services for transgender people. For a substantial sum of money, everyone can change their gender and make a male genital organ. However, since this is not a full-fledged penis, the risk of developing erectile dysfunction in them is extremely high compared with ordinary men (given the fact that the prevalence of ED is high a priori). What caused this situation and how to deal with it?

Transgender People in the USA and their Problems

About 1.5 million adults in the United States are transgender people. About half of them are transr men, that is, persons who have a female gender from birth, but have a male identity. Many of them have done or want to do a sex change procedure, the so-called gender affirmation surgery. The result of this operation is the formation of neophallus from the skin of the forearm and urethra. Sometimes a scar on the forearm is extremely visible and may be treated as sign of phalloplasty in the past and for many men who want to hide this fact, this can be a problem.

problems of transgenders

But there is another critical problem. Formed neophallus can be used for constant urination, but it is not suitable for sexual intercourse because it does not have cavernous structures for filling with blood and hardening.

According to a study by Mauro E. Kerckhof et al. (The Journal of Sexual Medicine, 2019), trans women / men most frequently experienced the following sexual difficulties:

  • problems with initiating sexual intercourse (approx. 30%)
  • difficulties with reaching orgasm (about 15%)

Besides this, trans women who had vaginoplasty less often suffered from low sexual desire (decreased libido) and aversion to sex.

This information was obtained by filling an online questionnaire by more than 500 trans persons (307 identifying predominantly as females and 211 as males). A large percentage of the persons experienced dysfunctions after a surgery on genitalia. 

Treatment of Erectile Failure in Transgender Men

According to studies, one of the factors that reduce interest in phalloplasty is the lack of reliable and safe devices that would allow one to have a full erectile function.

For pronounced virilization of people (their physiological transformation from woman to man), hormonal drugs are used. However, it is not known for certain whether Viagra can help treat erectile dysfunction in transgender men. There are no relevant studies, but it can be assumed that this medication will have low efficiency due to the artificial structure of the new organ (neophallus). It has a similar shape, but excellent structure, it does not have full cavernous bodies, in which the action of Viagra is directed to increase blood flow. However, it is known that sildenafil can enhance arousal in women, that is, theoretically, it can have a positive effect on the genital area in transgenders. In any case, if you are a transgender man and want to try Viagra, you should definitely consult a doctor.

External Devices

Internal penile prostheses are one of the most popular ways to get penetrative sex. However, their implementation is fraught with various complications and is associated with a host of risks. Therefore, many individuals try to resort to non-invasive methods.

device for transgenders

For example, in the USA, the Elator device is being tested. The new development consists of two silicone rings connected by a rod. One ring is worn at the base of the organ, while the other ring supports the head (glans), providing the necessary extension of the penis. If the device successfully passes the test, hundreds of thousands of American trans men will receive an additional tool to ensure proper erectile function.

Read our article about Porn-Induced ED.


Sexual dysfunctions in transgender people are very common, but you can find means to deal with them in the market. If you make informed decisions and choose proven medicines / devices, the problem is solvable in many cases. However, the study of problems leaves much to be desired at the moment.

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I’m an Oncologist and Hematology Specialist primary located in Bryn Mawr, Pennsylvania. I have over 55 years of experience in the medical field and more than 20 years of practice. I’m skilled at the treatment & diagnosis of a large array of ailments & diseases in adults.

Board certifications

  • American Board of Internal Medicine Certification in Internal Medicine
  • American Board of Hematology Certification in Hematology
  • American Board of Medical Oncology Certification in Medical Oncology