Sexual Experiences of Young Transgender Persons During and After Gender-Affirmative Treatment

Abstract

OBJECTIVES: Early gender-affirmative treatment (GAT) of adolescents may consist of puberty suppression, use of affirming hormones, and gender-affirmative surgeries. This treatment can potentially influence sexual development. In the current study, we describe sexual and romantic development during and after treatment. METHODS: The participants were 113 transgender adolescents treated with puberty suppression, affirmative hormones, and affirmative surgery who were assessed as young adults (38 transwomen and 75 transmen; mean age 20.79 years, SD 1.36) during and after their GAT. A questionnaire on sexual experiences, romantic experiences, and subjective sexual experiences was administered and compared to the experiences of a same-aged sample from a Dutch general population study (N = 4020). RESULTS: One year post surgery, young transgender adults reported a significant increase in experiences with all types of sexual activities: masturbation increased from 56.4% to 81.7%, petting while undressed increased from 57.1% to 78.7%, and sexual intercourse increased from 16.2% to 37.6% post surgery compared to presurgery. Young transmen and transwomen were almost equally experienced. In comparison with the general population, young transgender adults were less experienced with all types of sexual activities. CONCLUSIONS: Early GAT (including puberty suppression, affirmative hormones, and surgeries) may provide young transgender adults with the opportunity to increase their romantic and sexual experiences.

Normative and negative sexual experiences of transgender identifying adolescents in the community

“…This is in line with the findings of Veale et al (19) but differed from those of Bungener et al (18) and , who found that transgender identifying adolescents had fewer sexual experiences, and of Korchmaros et al (10), who reported that transgender adolescents had more sexual experiences than their cisgender counterparts. However, earlier research has focused on adolescents referred to mental health services due to symptoms of gender dysphoria (17,18), activist cohorts (19) or they have not focused specifically on transgender identifying youth but rather on LGBTQ youth as whole (10), for example. Our novel contribution is that we compared sexual development between transgender and cisgender youth in a general population sample.…”

“…However, this study focused on LGBTQ adolescents rather than specifically on transgender adolescents. Contrary to this, studies in the Netherlands and in Finland found that adolescents referred to evaluation due to gender dysphoric characteristics had fewer sexual experiences than their peers in the general population (17,18) whereas a Canadian study based on activist material found no difference in the numbers of sexual experiences (19).…”

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

“…Evidence supports the existence of surgical implications for transgender girls who proceed with pubertal suppression (van de Grift et al., 2020 ). Longitudinal data exists to demonstrate improvement in romantic and sexual satisfaction for adolescents receiving puberty suppression, hormone treatment and surgery (Bungener et al., 2020 ). A study on surgical outcomes of laparoscopic intestinal vaginoplasty (performed because of limited genital tissue after the use of puberty blockers) in transgender women revealed that the majority experienced orgasm after surgery (84%), although a specific correlation between sexual pleasure outcomes and the timing of pubertal suppression initiation was not discussed in the study (Bouman, van der Sluis et al., 2016 ), nor does the study apply to those who would prefer a different surgical procedure.…”

Gender-Affirming Treatment of Gender Dysphoria in Youth: A Perfect Storm Environment for the Placebo Effect—The Implications for Research and Clinical Practice

“…Coleman et al ( 2022 ) claimed that “longitudinal data exists to demonstrate improvement in romantic and sexual satisfaction for adolescents receiving puberty suppression, hormone treatment and surgery.” However, the supporting citation requires scrutiny. Bungener et al ( 2020 ) was a cross-sectional study of 113 young adults, 66% of whom were transmen (most who had undergone mastectomy and gonadectomy, not genital surgery). For its claims of post-surgery increases in sexual experience, it relied on recall of pre-surgical experiences.…”