Hi Jamie –

Thank you for your question. I’m going to start this out with a couple of definitions. Infertility is the inability of a person to conceive, i.e. to reproduce. Erectile dysfunction, or impotence, is the incapacity for a person with a penis to have or to maintain an erection that is hard enough to have sexual intercourse. I clarify these terms for two reasons.

First of all, there is sometimes confusion between these two terms and, secondly, it is much more common for young men to ask about erectile dysfunction rather than infertility. The following paragraphs will address the question of infertility. If you have further/other questions about erectile dysfunction, please feel free to email them to us.

Generally, people become aware of their inability to conceive when they attempt to have a child. There are particular syndromes and illnesses, however, where people may become aware of the potential for infertility at a much younger age. This could be the case, for example, in someone who developed cancer of the reproductive organs and had to have them surgically removed. In addition, if there is a hormonal or genetic problem then some common signs are, for example, being short for one’s age and as compared to one’s parents or developing breast tissue. Other signs may be late onset of hair growth in the pubic area or the underarms.

However it is important to know that many people who mature later than their counterparts are completely normal.

The medical definition of infertility is when a couple attempts to conceive for 1 year and they are unable to do so. In about 1/3 of cases, there is a problem in the cis man’s reproductive system and in about 1/3 of cases, there is a problem in the cis woman’s reproductive system. The remaining couples generally are experiencing a mixture of problems from both or the reasons for their infertility remain unknown. There are multiple reasons a person with a penis may be infertile. They may make too few sperm or not make any at all. There may be a problem with the motility of the sperm or with the route the sperm takes to leave the body. This may happen when sperm are abnormally shaped or when the person is missing their vas deferens, which are part of the “highway” which the sperm travel.

There are many factors in ones’ environment that adversely can affect sperm, these factors include: alcohol, cigarettes, drugs, radiation, and environmental toxins, like pesticides.

Some people with penises are able to have orgasms without ejaculating. As ejaculation is required for fertilization, if a person can never ejaculate during orgasm he needs to see a doctor as there may be a problem with sperm or semen production or its transport along the urethra, i.e. the common conduit for both urine and sperm. Then again, a failure to ejaculate during orgasm can also be normal in adolescents who have started to have erections and orgasms recently.

There are also many reasons–some psychological and some anatomical– that may make people with penises unable to have erections or orgasms. For example, if a person can regularly achieve erection and orgasm, for example by masturbating (which is completely normal), but is sometimes unable to, for example with a partner–their trouble may be transient and/or related to their emotions when they are with their partner and would not usually be related to their fertility. However, each case is individual and merits discussion with the person’s doctor.

In general, a person born with a penis will not know whether they are infertile unless they (a) go through the process of trying to conceive and/or (b) have the appropriate testing done by a doctor. The material that is produced when a person with a penis ejaculates has several components, including sperm and seminal fluid. The testing for infertility looks at the composition of the fluid to determine how much sperm there is and whether the sperm appears healthy.

I think that an important question for you to ask yourself is why you are worried about this. Unless you are trying to have a child at this time, if you are sexually active, it is really important to use contraception for the protection of both yourself and your partner. Only condoms will give you protection against sexually transmitted infections and HIV. However, there are many other options for birth control that you and a partner could look into.

Since you do not provide more details about your own situation I cannot guide you more but I would suggest that you see a doctor regarding any concerns that you may have. He or she is obligated to keep anything you discuss confidential, unless there is a clear and imminent or significant danger to your health, in which case the doctor may need to discuss the situation with your parents. You may find this website helpful.

Take care and please feel free to email further questions.

Sincerely –

Lorin and Rimma, for AlterHeroes