A Conversation: The Impact a Diagnosis of Type 1 Diabetes Has on a Young Man’s Sexual Health and Well-Being

Yes, like any exercise, it helps to check your glucose before sex and keep your testing supplies and a fast-acting carb within reach so you can treat a low glucose during or after sex, if necessary.

This discussion leads to a question of when and how to tell a new partner or new love interest that you have T1D. I like how Alan Uphold, in a diaTribe blog, shared how he discloses his T1D diagnosis: “I know we don’t know each other that well yet. But I like you, and I feel like I should tell something. I have diabetes.”

That is a tricky timing question. I mean—who knows when it is the “right” time to say, “I love you”? You must go with your gut. But unlike a too-fast “I love you,” sharing “I have type 1 diabetes” carries far less risk and usually sets the tone for an honest getting-to-know-you phase.

So yes—I agree with Alan: the sooner, the better.

An article published in diaTribe stated, “while everyone experiences some form of sexual anxiety at some point in their lives, PWD have an added level of stress.” Would you agree, Jan?

Absolutely. The first time having sex as a person with T1D was strange from several perspectives. Like the first time exercising, I was nervous and didn’t know exactly what to expect. I didn’t know exactly how my glucose levels would respond. Usually, I have no problem with someone seeing my sensor on my arm. But somehow it is weird: being intimate and naked with a woman while still wearing a sensor? I can’t shake the feeling that I’m naked in 2 ways. My chronic condition becomes visible. In everyday life, it’s mostly invisible. It’s counterproductive and somehow out of place, but the thoughts are still there: Can I even perform properly? And of course, “perform” isn’t a nice word. But the thought comes anyway. And the fear of not being good enough is also present.

Jan, thank you for courageously sharing your personal experience, your vulnerability.

I am opening to the world so others can heal.

Jan, what you shared reflects how the diagnosis of a chronic disease like T1D can impact a man’s identity and sense of masculinity:

Living with a chronic disease threatens men’s sense of masculinity and self-image, as well as their perceived ability to fulfill expected social roles. Social images of men’s bodies influence how men express their emotions, attributes, and attitudes, or acknowledge the need for and seek social affirmation. ¹

Changes caused by chronic illness are devastating in and of themselves. However, for men, there can be an additional layer of pain in that these changes implicate what they see as their male identity. . . . Chronic illness evokes feelings of vulnerability, fear, and sadness. Many men struggle with allowing and expressing those normal feelings, believing that real men should be stoic. ²

In my experience, the first dates were the hardest. I felt weak. I was stressed and anxious about how my date would see my disease.

Amber Clour, diagnosed with T1D in 1984, wrote about how diabetes impacts romantic relationships: “being diagnosed with diabetes is a traumatic event. . . . Self-compassion is key to healing trauma and building positive relationships. We have to learn to love ourselves first, diabetes and all.”

That hits home. In the first months, I was trying my best, but it felt like I was fighting my own body. I couldn’t accept bad days, and it messed with me mentally. I just wanted life to be normal again. But once you’re diagnosed with T1D, life changes fast. One of the first steps toward really living again is accepting that some days, T1D is limiting. That acceptance hurts, but it also opens a door and is an important first step. We Type 1s live closer to the edge than most people do. Every day.