Yuvan’s Experience as an Asexual Trans Man in Gender-Affirming Healthcare

Interviewee: Yuvan
Location: West Bengal, India
Identity: Trans man, asexual
Topic: Asexuality, Gender Transition, And Experiences Within Healthcare Systems

The Ongoing Medical Misunderstanding of Asexuality and Its Impact on Asexual Trans Men

Interviewer: Could you begin by telling us a little about yourself and how you came to understand your gender identity and asexuality?

Yuvan: I am a trans man from West Bengal, India. Looking back, I realized that my understanding of my asexuality actually came before many aspects of my medical transition. For a long time, I knew that I did not experience sexual attraction in the way people around me described it. Even before I had the language for being transgender, I had already noticed that sexual attraction was largely absent from my life.

When I eventually learned about asexuality, many of my experiences suddenly made sense. It provided a framework that helped me understand myself. My realization that I was asexual was separate from my understanding of being trans. One explained my experience of gender, while the other explained my experience of attraction.

Interviewer: When you began your medical transition, did you discuss your asexuality with your healthcare provider?

Yuvan: Yes, I did. I believed it was important to be honest about all aspects of my identity and experiences. During consultations related to my transition, I informed my doctor that I identified as asexual and that I did not experience sexual attraction.

At the time, I assumed that this information would simply become part of my medical history. I did not expect it to become a point of concern. Unfortunately, my doctor interpreted my asexuality very differently.

Interviewer: How did your doctor respond when you disclosed that you were asexual?

Yuvan: The doctor appeared to assume that my lack of sexual attraction was evidence that something was wrong. Rather than understanding asexuality as a valid sexual orientation, he seemed to believe that my experience reflected a problem with my transition process or with my hormone levels.

There was an underlying assumption that a “successful” transition should result in a particular level of sexual desire. Because I did not report experiencing that desire, my asexuality was viewed as a symptom rather than an identity.

I remember feeling frustrated because it seemed that my own understanding of myself was being dismissed. Instead of listening to what I was telling him, the doctor was trying to fit my experiences into a medical framework that did not accurately describe me.

Interviewer: What happened as a result of that misunderstanding?

Yuvan: The doctor decided to increase my testosterone dosage. The rationale appeared to be that a higher level of testosterone would increase my libido and therefore “correct” what he perceived as a deficiency.

At the time, I trusted that my doctor knew what he was doing. However, I was uncomfortable with the assumption that my asexuality needed to be fixed. I repeatedly explained that I had identified as asexual before beginning hormone therapy and that my lack of sexual attraction was not a new development. Nevertheless, the increased prescription went ahead.

Interviewer: Did you experience any effects from the increased dosage?

Yuvan: Yes. After the dosage was increased, I began experiencing severe itching and various forms of physical discomfort. The symptoms were significant enough that I became concerned something was wrong.

At first, I was uncertain whether these experiences were normal. Medical transition can involve many changes, so I did not immediately know whether what I was experiencing was expected or not.

As the symptoms continued, I started seeking information elsewhere.

Interviewer: How did you determine whether your experience was unusual?

Yuvan: I reached out to other trans men who had undergone similar transition processes. Community networks are often incredibly important because people share practical experiences that are not always discussed in clinical settings.

When I described what was happening, many of them were surprised. They told me they had not experienced the same symptoms and that their hormone regimens appeared different from mine.

Those conversations made me question whether the issue was really my body failing to respond appropriately, or whether the treatment itself was the problem.

Interviewer: What did you do after speaking with other trans men?

Yuvan: I returned to my doctor and raised my concerns directly. I pointed out that I appeared to be receiving significantly higher levels of testosterone than other trans men I knew. I also explained that the physical symptoms had begun after the dosage increase.

Most importantly, I tried to explain again that my asexuality was not a medical problem. I emphasized that I had identified as asexual before beginning transition and that there was no reason to assume hormones should change that aspect of who I am.

It was a difficult conversation because doctors are often viewed as unquestionable authorities. Challenging a medical decision can feel intimidating, especially when you are also dependent on that provider for gender-affirming care.

Interviewer: How was the situation ultimately resolved?

Yuvan: After further discussion, the additional testosterone treatment was discontinued. Eventually, the doctor accepted that my asexuality was not something that required correction.

Once the dosage was adjusted, the issue was resolved. The physical symptoms subsided, and I no longer felt that I was being subjected to unnecessary treatment.

While I was relieved by the outcome, the experience left a lasting impression on me. It demonstrated how easily asexuality can be misunderstood, even within healthcare settings that are supposed to support gender diversity.

Interviewer: Looking back, what do you think this experience reveals about healthcare systems and asexuality?

Yuvan: I think it reveals a broader problem. Many healthcare professionals still operate from the assumption that everyone experiences sexual attraction and that everyone should desire sex in similar ways. When someone does not fit that expectation, their experience is often viewed as a symptom rather than a legitimate identity.

For trans people, this can become even more complicated. Medical providers may have preconceived ideas about what transition is supposed to look like, including assumptions about sexuality and libido. If an asexual trans person does not match those expectations, there is a risk that their identity will be pathologized.

My experience was not simply about one doctor’s misunderstanding. It reflected a larger lack of awareness about asexuality within healthcare systems.

Interviewer: What would you like to advise to the medical professional, researchers, advocates, and policymakers?

Yuvan: I would encourage people to recognize that asexual individuals can be harmed when their identities are treated as medical problems requiring correction.

When discussions focus on conversion practices, coercive interventions, or medical pathologization, asexual experiences are often overlooked. Yet these experiences can occur in subtle ways, including assumptions that a person must be made more sexual in order to be healthy or complete.

I also suspect that I am not the only asexual trans man who has encountered this issue. Others may have had similar experiences but lacked the confidence, information, or community support needed to challenge medical decisions.

That is why awareness matters. Healthcare providers need education about asexuality, and researchers need to pay greater attention to how asexual people experience medical systems. Recognition is an important first step toward preventing similar experiences from happening to others.