: GAHT typically involves estrogen and anti-androgens (testosterone blockers) like spironolactone or cyproterone acetate. Testosterone is the primary driver of spontaneous and maintained erections; when it is lowered to the female range, the physical ability to achieve an erection often decreases or stops entirely.
Research indicates that sexual dysfunction is common but varies significantly between individuals. Estrogen HRT and Sexual Function - FOLX HEALTH
The primary cause of ED in trans women is the during gender-affirming hormone therapy (GAHT).
: Estrogen can change genital sensations, sometimes making the experience of an erection feel uncomfortable or different than before. Frequency and Impact
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