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Evaluation of Sexual Function of Transgender Individuals

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Abstract

Purpose

The current study sought to evaluate the sexual function of transgender men and women and to identify associated factors.

Methods

Trans individuals who were outpatients at our gender incongruence (GI) center for follow-up of gender-affirming hormone therapy with age ranging 27 to 50 years were invited to participate in this cross-sectional study. Clinical data were collected from the medical records. Two scales, the Female Sexual Function Index (FSFI) and the Male Sexual Function Index (MSFI), were administered to all females (n = 50) and all males (n = 58). Each participant also responded to a semi-structured questionnaire that assessed feelings regarding being transgender and satisfaction with sexual life.

Results

Relative to trans women, trans men had a higher total FSFI score, and higher scores in the FSFI domains of arousal, lubrication, orgasm, and satisfaction (all p < 0.01), and in the total MSFI score, and higher scores in the MFSI domains of arousal, erection, orgasm, and satisfaction (all p < 0.01). A separate semi-structured evaluation indicated that more than half of the trans men and almost half of the trans women were satisfied or very satisfied with their sexual life.

Conclusions

The total scores from the FSFI and MSFI indicated a high risk of sexual dysfunction in trans men and especially, in trans women. However, the semi-structured evaluation showed that more than half of the trans men and almost half of the trans women were satisfied with their sexual life.

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Data Availability

Each time the data is requested, the corresponding author will send it via email.

References

  1. Edwards-Leeper L, Spack NP. Psychological evaluation and medical treatment of transgender youth in an interdisciplinary “Gender Management Service” (GeMS) in a major pediatric center. J Homosex. 2012;59(3):321–36.

    Article  PubMed  Google Scholar 

  2. Gorton RN, Erickson-Schroth L. Hormonal and surgical treatment options for transgender men (Female-to-Male). Psychiatr Clin North Am. 2017;40(1):79–97.

    Article  PubMed  Google Scholar 

  3. Reed GM, Drescher J, Krueger RB, et al. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry. 2016;15(3):205–21.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Elaut E, Bogaert V, De Cuypere G, et al. Contribution of androgen receptor sensitivity to the relation between testosterone and sexual desire: an exploration in male-to-female transsexuals. J Endocrinol Invest. 2010;33(1):37–41.

    Article  CAS  PubMed  Google Scholar 

  5. Bockting W, Coleman E, Deutsch MB, et al. Adult development and quality of life of transgender and gender nonconforming people. Curr Opin Endocrinol Diabetes Obes. 2016;23(2):188–97.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kerckhof ME, Kreukels BPC, Nieder TO, Becker-Hébly I, van de Grift TC, Staphorsius AS, Köhler A, Heylens G, Elaut E. Prevalence of sexual dysfunctions in transgender persons: results from the ENIGI follow-up study. J Sex Med. 2019;16(12):2018–29. https://doi.org/10.1016/j.jsxm.2019.09.003. Erratum in: J Sex Med. 2020 Apr;17(4):830. https://doi.org/10.1016/j.jsxm.2020.02.003

    Article  PubMed  Google Scholar 

  7. Roncato TMR, Ferreira CHJ, Lerri MR, Brito LGO, Sá MFS, Sá ACS, Silva Lara LA (2022) Sexual function of transgender women after gender affirming surgery: A mini review. Abstract Clin Anat 35(5) 560–70. https://doi.org/10.1002/ca.23863

  8. Ferenidou F, Kirana PS, Fokas K, Hatzichristou D, Athanasiadis L. Sexual response models: toward a more flexible pattern of women's sexuality. J Sex Med. 2016;13(9):1369–76. https://doi.org/10.1016/j.jsxm.2016.07.008.

    Article  PubMed  Google Scholar 

  9. Sánchez-Díaz M, Salazar-Nievas MC, Molina-Leyva A, Arias-Santiago S. Risk factors of quality-of-life and sexual function impairment in chronic spontaneous urticaria patients: cross-sectional study. Dermatology. 2023;239(4):601–8. https://doi.org/10.1159/000530518.

    Article  PubMed  Google Scholar 

  10. Wierckx K, Elaut E, Van Caenegem E, Van De Peer F, Dedecker D, Van Houdenhove E, T'Sjoen G. Sexual desire in female-to-male transsexual persons: exploration of the role of testosterone administration. Eur J Endocrinol. 2011;165(2):331–7. https://doi.org/10.1530/EJE-11-0250.

    Article  CAS  PubMed  Google Scholar 

  11. Pacagnella Rde C, Martinez EZ, Vieira EM. Validade de construto de uma versão em português do female sexual function index [construct validity of a Portuguese version of the female sexual function index]. Cad Saude Publica. 2009;25(11):2333–44. Portuguese. https://doi.org/10.1590/s0102-311x2009001100004.

    Article  PubMed  Google Scholar 

  12. Kalmbach DA, Ciesla JA, Janata JW, Kingsberg SA. the validation of the female sexual function index, male sexual function index, and profile of female sexual function for use in healthy young adults. Arch Sex Behav. 2015;44(6):1651–62.

    Article  PubMed  Google Scholar 

  13. Rosen C, Brown J, Heiman S, Leib R. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191–208.

    Article  CAS  PubMed  Google Scholar 

  14. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.

    Article  CAS  PubMed  Google Scholar 

  15. van der Sluis WB, Bouman MB, de Boer NKH, Buncamper ME, van Bodegraven AA, Neefjes-Borst EA, et al. Long-term follow-up of transgender women after secondary intestinal vaginoplasty. J Sex Med. 2016;13(4):702–10.

    Article  PubMed  Google Scholar 

  16. Klemmer CL, Arayasirikul S, Raymond HF. Transphobia-based violence, depression, and anxiety in transgender women: the role of body satisfaction. J Interpers Violence. 2021;36(5-6):2633–55. https://doi.org/10.1177/0886260518760015.

    Article  PubMed  Google Scholar 

  17. Basson R. The female sexual response: a different model. J Sex Marital Ther. 2000;26(1):51–65.

    Article  CAS  PubMed  Google Scholar 

  18. Lerri MR, Romão APMS, Santos MAD, Giami A, Ferriani RA, Lara LADS. Características clínicas de uma amostra de pessoas transexuais. Rev Bras Ginecol Obstet. 2017;39(10):545–51. https://doi.org/10.1055/s-0037-1604134.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Cocchetti C, Ristori J, Mazzoli F, Vignozzi L, Maggi M, Fisher AD. Management of hypoactive sexual desire disorder in transgender women: a guide for clinicians. Int J Impot Res. 2020;33(7):703–9. https://doi.org/10.1038/s41443-021-00409-8.

    Article  PubMed  Google Scholar 

  20. Garz M, Schröder J, Nieder T, Becker I, Biedermann S, Hildebrandt T, et al. Body image and sexual desire in the context of gender affirming therapy: results of a cross-sectional multi-centered transgender study. J Sex Marital Ther. 2021;47(5):435–45.

    Article  PubMed  Google Scholar 

  21. Reisner SL, Pletta DR, Potter J, Deutsch MB. Initial psychometric evaluation of a brief sexual functioning screening tool for transmasculine adults: transmasculine sexual functioning index. Sex Med. 2020;8(3):350–60.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Vedovo F, Di Blas L, Perin C, Pavan N, Zatta M, Bucci S, et al. Operated male-to-female sexual function index: validity of the first questionnaire developed to assess sexual function after male-to-female gender affirming surgery. J Urol. 2020;204(1):115–20.

    Article  PubMed  Google Scholar 

  23. Defreyne J, Elaut E, Kreukels B, Fisher AD, Castellini G, Staphorsius A, et al. Sexual desire changes in transgender individuals upon initiation of hormone treatment: results from the longitudinal European network for the investigation of gender incongruence. J Sex Med. 2020;17(4):812–25.

    Article  CAS  PubMed  Google Scholar 

  24. Spector IP, Carey MP, Steinberg L. The sexual desire inventory: development, factor structure, and evidence of reliability. J Sex Marital Ther. 1996;22(3):175–90. https://doi.org/10.1080/00926239608414655.

    Article  CAS  PubMed  Google Scholar 

  25. Huang G, Basaria S, Travison TG, Ho MH, Davda M, Mazer NA, et al. Testosterone dose-response relationships in hysterectomized women with or without oophorectomy: effects on sexual function, body composition, muscle performance and physical function in a randomized trial. Menopause. 2014;21(6):612–23.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Hajimirzaie SS, Tehranian N, Razavinia F, Khosravi A, Keramat A, Haseli A, et al. Evaluation of couple’s sexual function after childbirth with the biopsychosocial model: a systematic review of systematic reviews and meta-analysis. Iran J Nurs Midwifery Res. 2021;26(6):469–78.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kronawitter D, Gooren LJ, Zollver H, Oppelt PG, Beckmann MW, Dittrich R, et al. Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study. Eur J Endocrinol. 2009;161(2):363–8.

    Article  CAS  PubMed  Google Scholar 

  28. Laube JS, Auer MK, Biedermann SV, Schröder J, Hildebrandt T, Nieder TO, et al. Sexual behavior, desire, and psychosexual experience in gynephilic and androphilic trans women: a cross-sectional multicenter study. J Sex Med. 2020;17(6):1182–94.

    Article  PubMed  Google Scholar 

  29. Basson R, Gilks T. Women’s sexual dysfunction associated with psychiatric disorders and their treatment. Women's Health (Lond Engl). 2018;14:174550651876266.

    Article  Google Scholar 

  30. Qaderi K, Yazdkhasti M, Zangeneh S, Behbahani BM, Kalhor M, Shamsabadi A, Jesmani Y, Norouzi S, Kajbafvala M, Khodavirdilou R, Rahmani N, Namadian M, Ezabadi SG, Alkatout I, Mehraeen E, Rasoal D. Changes in sexual activities, function, and satisfaction during the COVID-19 pandemic era: a systematic review and meta-analysis. Sex Med. 2023;11(2):qfad005. https://doi.org/10.1093/sexmed/qfad005. Erratum in: Sex Med. 2023 May 08;11(2):qfad027. 10.1093/sexmed/qfad027

  31. Hessami K, Sayegh N, Abdolmaleki AS, Bakht S, Qaderi S, Darabi M, Shamsi T, Bagheri F. Women's sexual function before and during COVID-19 pandemic: a systematic review and meta-analysis. J Obstet Gynaecol Res. 2022;48(9):2285–95. https://doi.org/10.1111/jog.15337.

    Article  CAS  PubMed  Google Scholar 

  32. Masoudi M, Maasoumi R, Bragazzi NL. Effects of the COVID-19 pandemic on sexual functioning and activity: a systematic review and meta-analysis. BMC Public Health. 2022;22(1):189. https://doi.org/10.1186/s12889-021-12390-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Dashti S, Bolghanabadi N, Ghavami V, Elyassirad D, Bahri N, Kermani F, Fathi NT. The impact of COVID-19 on female sexual function: a systematic review and meta-analysis. J Sex Marital Ther. 2022;48(5):520–31. https://doi.org/10.1080/0092623X.2021.2006842.

    Article  PubMed  Google Scholar 

  34. Nowaskie DZ, Roesler AC. The impact of COVID-19 on the LGBTQ+ community: comparisons between cisgender, heterosexual people, cisgender sexual minority people, and gender minority people. Psychiatry Res. 2022;309:114391. https://doi.org/10.1016/j.psychres.2022.114391.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The study was approved by the ethics committee of Ribeirao Preto Medical School/University of Sao Paulo, under the number CAAE of 29969419.8.0000.5440.

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Authors and Affiliations

Authors

Contributions

T.M.R.B.: conceived and designed the analysis, collected the data, wrote the paper, performed the analysis; L.G.O.B.: contributed to analysis of the data and reviewed the paper; C.H.J.: contributed to analysis of the data and reviewed the paper. S.A.F.: contributed to collecting the data and reviewed the paper; J.K.T.: contributed to collecting the data and reviewed the paper; R.A.F.: reviewed the paper; L.A.S.L.: advisor, conceived and designed the analysis, collected the data, wrote the paper, and performed the analysis.

Corresponding author

Correspondence to Thays Marina Roncato Barcelos.

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Handling Editor: Rufus Cartwright

Editor in Chief: Maria A. Bortolini

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All the participants attended the Gender Incongruence Outpatient Clinic of Ribeirão Preto Medical School (FMRP), University of São Paulo (USP) from 15 February 2020 to 15 February 2022. This study was approved by the Research Ethics Committee of the Clinical Hospital of Ribeirão Preto Medical School (RPMS) of the University of São Paulo (USP), CAAE 29969419.8.0000.5440

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Barcelos, T.M.R., de Oliveira Brito, L.G., Jorge, C.H. et al. Evaluation of Sexual Function of Transgender Individuals. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05857-6

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