I Feel No Pleasure With Orgasm, But I Don't Really Want to Masturbate In the First Place

Anonymous
asks:
I'm a transgender man. I wasn't able to orgasm until a few months after I started testosterone about 6 months ago. Though I've had increased arousal and can now orgasm, I feel no pleasure with it at all. I'm too embarrassed to bring it up to my doctor. The thing is, I don't particularly WANT to feel pleasure with it. I'd rather it go back to how it was before testosterone, where I rarely got aroused and could just enjoy reading erotic stories or looking at pornography without any sexual aspect. To be honest, I hate the feeling of arousal, it's super uncomfortable, and the only reason I masturbate at all is to stop the arousal, because it typically is faster than waiting for it to go away. I'm asexual, so it's not like I ever anticipate having sex and thus need to be able to experience this stuff. But I certainly can't stop taking my testosterone, nor do I want to. I can't find any resources on this issue online. All I can find is info about ways people have attempted to start experiencing pleasure – and even that is rarely successful. This is very frustrating to me: I feel like there must be something seriously wrong with me for not wanting this. I've been teased before for not enjoying masturbation and not wanting sex, but I was content before. Now I feel like I'm conflicted all the time. It seems like my only hope is to wait until I'm further into taking testosterone and hope this mellows out. Any advice I could be offered would be greatly appreciated. Thanks!
Mo Ranyart replies:

This sounds like a frustrating situation, and I'm sorry this side effect of your testosterone has made things so much trickier in this one respect, but in case it helps to have a reminder: your lack of interest in masturbation or sex doesn't mean there's something wrong with you, and I'm sorry to hear people have made fun of you for it. This isn't necessarily a sign of a physical problem; it sounds like an unfortunate conflict between the increased arousal you're feeling and your lack of real desire for and interest in partnered or solo sexual activity.

What sticks out to me here is that it sounds like masturbation isn't something you really want to be doing. If that's the case, there isn't much I can recommend to make it more pleasurable. The reason for this is that sexual pleasure is about so much more than just what you're doing with your body; if your mind isn't engaged in the process, and it feels more like a burden or chore you're taking on only to reduce arousal, then it isn't likely to feel very good no matter what you're doing physically.

I think this excerpt from our article about sexual response and orgasm sums it up nicely:

Desire for sexual activity is like being hungry in order to eat: if you aren't hungry, eating doesn't tend to feel good. It's a matter of having a sexual appetite at a given time. If you don't have a feeling of sexual desire, sex of any kind, either with our self or a partner, isn't going to feel very good.

It doesn't sound like you're feeling a real desire for masturbation; what I'm hearing is that it feels more like a means to an end, so it doesn't surprise me that it wouldn't feel great. To extend the hunger metaphor, masturbation might currently feel like forcing yourself to eat something when you haven't eaten in a while, even if there isn't any food that sounds appealing to you. It can be hard to make that into something enjoyable.

You do have the option of choosing not to masturbate. I know you said it was the quickest way to get rid of your feelings of arousal when they come up, but because it seems pretty clear that you don't want to masturbate, I think finding ways to distract or redirect yourself from arousal until it dissipates will feel more comfortable and be better for you in the long run.

It isn't enjoyable or emotionally healthy to keep doing a thing we don't want or enjoy and don't need to do, and I suspect you'll feel better if you take a break from masturbating.

Some people find that physical activity helps arousal fade more quickly, so if that's something you're up for, that could be worth a try. It doesn't have to be intense exercise; a walk around the block or some quiet yoga could be a good place to start, although if you like higher-intensity activities those could be helpful as well.

Other than these more physical distractions, the sort of mental work you could do with mindfulness exercises or cognitive-behavioral therapy tools might be helpful. These may help you acknowledge feelings of arousal as they come up and be able to set them aside without feeling like they need to be acted on. Your local library is likely to have some basic materials you could check out, if you want to investigate these methods but if you have a mental healthcare provider as part of your healthcare team, this is something I encourage you to ask them about, even if you aren't comfortable giving the full details of why you're looking for help in dealing with the discomfort of arousal without masturbating. We have a couple suggestions for books on mindfulness on this page of anxiety and other mental health resources here.

If, after trying other ways of handling arousal, you still feel like masturbation is the easiest or most efficient method despite the discomfort you feel around it, I wonder if it would help to reframe how you think about the process.

To go back to the idea of hunger above, sometimes we might not feel hungry, but know we should eat something anyway, since bodies need food on a regular schedule to function well. It might not be the most enjoyable meal in the moment, but we can still choose to eat something that doesn't taste bad and does the job. You might try approaching masturbation from a similarly practical standpoint. It might feel more like washing your hair or brushing your teeth, that way: like something you do that helps keep your body running smoothly, even if it doesn't necessarily feel any more thrilling than flossing. In our hunger metaphor, perhaps it's equivalent to an energy bar; it may not be exciting, but it allows you to curb your hunger and move on with your day.

Having said this, though, I really do think it's going to be better, in the long run, to find other ways to handle your arousal so you can skip masturbation entirely, unless your feelings about it change dramatically. Doing something you don't enjoy and ultimately don't want to do just isn't going to be the best or healthiest thing for you, in the long run.

I want to specifically mention that there are some medications that can have sexual side effects that include diminished sexual pleasure or unsatisfying orgasms. If you're taking medications other than testosterone, you may want to see if any of them are known to have sexual side effects; antidepressants are a common example, but there are others that may have a similar impact.

I know you're hesitant to talk to your doctor about this, but questions about sexual side effects of medication, and sexual response in general, are ones a doctor should be ready to handle without making you feel even more awkward in the moment. Even letting them know that it's a difficult subject for you to discuss might help cue them to be extra patient with you during that conversation. Since it doesn't sound like sexual response is important to you, I realize you may not want to investigate the medical side of things at all, but I do want to mention it in case you want to check in with your doctor at your next appointment. This would be appropriate to bring up with your general physician or the person who's prescribing your testosterone, if those are two different people; if you feel more comfortable with one than the other, you could discuss it with them.

I can sympathize with feeling uncomfortable or awkward when it comes to discussing sexual topics with doctors; a lot of people struggle with this. If you feel so uncomfortable with a particular healthcare provider that you don't feel like you can bring this up at all, though, that's something I'd worry about a bit; it's important that doctors are able to put you at ease enough for you to bring up difficult questions, especially when you're starting a new treatment that can have significant impacts on your health and body. If you're feeling uncomfortable talking about this with a doctor because it feels embarrassing, or too personal, that's one thing, but if there's a lack of trust there, or your doctor's said or done things that are dismissive or disrespectful, I'd encourage you to either talk to your doctor directly about those issues or see if there's another provider you can see instead. Being able to talk openly and honestly with your healthcare providers is important in any situation, but when you're getting gender-affirming care from someone and navigating those early months and years of taking testosterone, it's even more so; the number of awkward-yet-important conversations you'll need to have is likely to be significant.

Do you know other people who are in their first months or years of starting testosterone, who you'd feel comfortable talking to about this? Connecting with others who are dealing with the big ups and downs of starting T could help you get some additional perspective and comfort from folks who've also had to manage big changes in their arousal levels or other aspects of their sexualities as they adjust. Depending on where you live, you may have in-person support groups available to you; those are often run through queer community centers but community centers, healthcare clinics, schools, or sometimes just groups of like-minded people can host them as well. A general web search for "trans support group + your town name" is a good place to start, if you want to see if one exists near you. You could also start a thread on our message boards and see what other Scarleteen users have experienced.

Finally, it may help to know that while it's very common for sexual desire or arousal to increase when people start taking testosterone, it's also common for those feelings to diminish or even out again over time. It's very possible that this increase in arousal will fade in the coming months and give you some relief. While I do hope that you can find a workable solution to the situation you're in right now, there's also hope that it will be less of a problem before long. I wish you the best of luck in finding a good way to handle the frustration you're experiencing now until things hopefully calm down a bit.