(118) EVALUATION OF SEXUAL FUNCTION OF TRANSGENDER INDIVIDUALS DURING GENDER AFFIRMING THERAPY
Authors: Roncato TM , Franceschini SA , Homsi Jorge C , Oliveira Brito LG , Alves Silva Lara L 
Published: December 2024

Abstract

Introduction
Little is known about the sexual function (SF) of transgender (trans) people during gender affirming therapy (GAT). Most of the studies evaluates after gender affirming surgery (GAS).1

Objective
This study aimed to evaluate SF of trans people during GAT.

Methods
Trans individuals who were outpatients at our gender incongruence (GI) center for follow-up of GAT with age ranging 27 to 30 years old were invited to participate in this cross-sectional study. The FSFI was administered to all trans-females (n = 50) and all trans-males (n = 58). The score ≤ 26.55 is a risk for sexual dysfunction2. Also, each participant also responded to a semi-structured questionnaire that assessed feelings regarding being transgender in Brazil and satisfaction with sexual life. The Hospital Anxiety and Depression Scale (HAD) questionnaire was used to assess the individual’s mood3. A logistic regression model was constructed to estimate the relationships of different variables with FSFI scores, and the results were reported as odds ratios (ORs). The statistical analysis was performed using SAS version 9.4.

Results
There were 108 participants, 58 (53.70%) trans men, and 50 (46.30%) trans women. Analysis of the FSFI scores showed that 32 trans men (55.2%) and 41 trans women (82%) were at risk of sexual dysfunction (SDF). The semi-structured analysis of sexual satisfaction showed that 14 (23.72%) were satisfied, and 18 (30.50%) were very satisfied. Analysis of the trans women, showed that 14 (28%) were satisfied, and 5 (10%) were very satisfied. Analysis of body image indicated that 23 (33.9%) of the trans men and 17 (34%) of the trans women were satisfied. The Table 1 shows the results of the estimate of the logistic regression model with univariate analysis for being risk of SDF and evidences that age, BMI, years of study, ethnicity, marital status, sexual orientation, GAS, satisfaction with gender affirming hormone therapy, and feeling discriminated do not predispose SDF. While the gender, dissatisfaction with body appearance, having risk for anxiety and depression are factors of risk of sexual dysfunction. A multivariate analysis of these data showed that being a trans woman (OR: 0.242, 95% CI: 0.095, 0.615) and having score of risk for depression in the HADS (OR: 0.22, 95% CI: 0.055, 0.88) were significant risk factors for SDF (Table 2).

Conclusions
Our FSFI results indicated a high risk of SDF in trans women (82%), and that more than half of trans men also had a risk for SDF. However, these rates of SDF were lower in our semi-structured questionnaire. This discrepancy suggests the need for more specific validated questionnaires that more adequately assess the sexual function of trans individuals. It also demonstrates that validated questionnaires that were developed for cis-gender people are inappropriate for assessing sexual function of trans-gender people. Nonetheless, we found that status as a trans-female and depression increased the risk for SDF in our population.

Disclosure
No.