Low-dose Sildenafil (Viagra) or Tadalafil (Cialis) are frequently prescribed to trans women to assist with blood flow when desired.
Hormone Replacement Therapy typically involves taking estrogen and anti-androgens (testosterone blockers). Because testosterone is the primary driver of spontaneous erections and libido in people assigned male at birth, lowering its levels usually leads to significant changes:
This is a common side effect of HRT. While some find this affirming, others may wish to maintain erectile function for sexual activity.
Understanding the biological and physiological aspects of erections for trans women and non-binary individuals on Hormone Replacement Therapy (HRT) involves navigating how estrogen and testosterone blockers affect the body. 1. The Role of Hormones