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Please Help -- "Touched By A Tranny"...What Is The Risk?????

Oct 26, 2003

Hi Dr. Bob,

I love all of the information and comfort you provide on your site. You provide the facts, deliver them in a humorous way, and don't add any moral judgments. Thank you.

I'm writing to you again (I've written before without getting an answer, but also realize that you can't possible answer every question), because my anxiety has come back and I could use some reassurance.

I am a straight male, and several weeks ago I had a one time/only time experience with a transsexual prostitute. The only thing that occurred was that I performed oral sex on the prostitute. I'm trying to remember every detail, because it is when I remember some of the details that my anxiety comes back:

- I performed fellatio on the prostitute.

- For 99 of the time a condom was used.

- There were two times when the condom wasn't on:

1 - at the very beginning when I only licked the shaft and then had the entire penis in my mouth for about 10 seconds. I bring this up because this seems to be the most exposure I had. But, I also want to say that the penis was flaccid, so I'm wondering if that decreases my risk of exposure to precum (I don't know if there was any).

2 - The other time was when the condom slipped off in my mouth. I'm wondering if that poses any risk. After the condom came off, I licked the shaft again for a minute or two before putting on a new condom.

- The prostitute NEVER EJACULATED. I asked her if she could cum and she said it took her a long time.

I know this situation seems similar to many of the questions you have already answered regarding oral sex (I've read through the archives extensively), but the specifics I'm wondering about are:

- How risky do you think my encounter was, especially considering that it was with a transsexual prostitute, and I have read that they are a very high risk group? Assuming that the she was HIV + (I don't know the true status), how much risk did I put myself in?

- Does the fact that the penis was flaccid when it was in my mouth without protection have any impact on my risk?

- Does the fact that there was no ejaculation mitigate my risk?

- Does the fact that it was a transsexual impact the possible amount of precum that there could have been? In other words, since some transsexuals are on hormones, could this impact/limit the production of precum and therefore decrease my risk?

- Does the fact that the prostitute was uncircumcised increase my risk?

- When the condom came off in my mouth, does that pose a serious risk?

- Are there any probability statistics that you could cite that offer transmission risks for oral sex encounters?

I am waiting to get tested, but I have a high level of anxiety and I could really use your advice. It is very difficult for me to get through a normal day without being overwhelmed with worries about this. Thank you so much for everything you do.

-- Worried in the Big Apple

Response from Dr. Frascino

Dear Big Apple Worrier,

Yes, indeed, your questions are similar to many I've already answered that pertain to oral sex. My response to you is exactly the same. Nothing has changed. The risk of HIV transmission via oral sex is extremely low. Several recent epidemiological studies have suggested the risk is even lower than we initially thought. In fact, some studies failed to find a single episode of HIV transmission, despite the study participants having multiple HIV-positive partners, getting cum in their mouths, and even swallowing HIV-positive spunk. These studies cannot rule out the possibility that HIV transmission could occur, but they do offer reassurance that the degree of risk is remarkably (and fortuitously) low.

Certainly there could always be extenuating circumstances, and it should be noted that, unlike HIV, some other STD's are quite easily transmitted by oral sex. Nothing in your post suggests to me that you have placed yourself at any greater risk than any other person who tasted a bit of man candy. In fact, your exposure is quite minimal. Yes, get tested at 3 months. But, I think your degree of worry far exceeds your degree of risk. If the anxiety is overwhelming, seek some help with a compassionate counselor. I'll be waiting to hear your WOO-HOO soon. Good luck.

Dr. Bob

Risk factors
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