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Rose G, McCarron M, Reid M, Fayant-McLeod T, Gulka E, Young J, Clark M, Madill SJ. Using focus groups to inform a peer health navigator service for people who are transgender and gender diverse in Saskatchewan, Canada. Health Expect 2024; 27:e14022. [PMID: 38528661 DOI: 10.1111/hex.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND This study investigated healthcare access and quality for people who are transgender and gender-diverse (PTGD) in Saskatchewan (SK), Canada, to inform a larger project that was piloting two peer health navigators for PTGD. METHODS Two online focus groups were held. Nineteen participants were recruited to represent a broad range in age, gender and location in SK. Transcripts of the focus groups were analyzed using a thematic approach. RESULTS The core theme that was identified was participants' desire for culturally safe healthcare. This core theme had two component themes: (1) systemic healthcare factors and (2) individual healthcare provider (HCP) factors. The healthcare system primarily acted as a barrier to culturally safe healthcare. HCPs could be either barriers or facilitators of culturally safe care; however, negative experiences outweighed positive ones. CONCLUSIONS PTGD in SK face discrimination, with delays and barriers to care at all levels of the healthcare system. Peer health navigators can address some of these discrepancies; however, greater support is required for PTGD to be able to access culturally safe healthcare. PATIENT OR PUBLIC CONTRIBUTION People with lived experience/PTGD were involved in all stages of this project. They were included on the team as community researchers and co-developed the research project, conducted the focus groups, participated in the analyses and are co-authors. As well, both navigators and all the participants in the focus groups were also PTGD.
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Affiliation(s)
- Gwen Rose
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Mel Reid
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Emily Gulka
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Megan Clark
- Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Stéphanie J Madill
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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Lacombe-Duncan A, Persad Y, Shokoohi M, Underhill A, Cote P, Wheatley M, Gupta M, Kyne LT, Besharati AA, Chan LL, Hranilovic S, Nguyen Q, Loutfy M. HIV prevalence among a retrospective clinical cohort of transgender women in Canada: Results of the Montreal-Toronto Trans study, collected 2018-2019. Int J STD AIDS 2023; 34:1062-1071. [PMID: 37586721 DOI: 10.1177/09564624231185818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
BACKGROUND HIV prevalence data among transgender (trans) people are not routinely collected in national estimates, including Canada, contributing to gender-based inequities. We examined HIV prevalence and associated factors among trans women in clinical care in two large Canadian cities. METHODS Retrospective chart data of trans women aged 16+ were collected from six family medicine and/or HIV clinics in Montreal and Toronto, Canada, 2018-2019. Multinomial logistic regression was used to analyze factors associated with documented HIV positive or missing HIV status relative to documented HIV negative status. RESULTS Among 1,059 patients, 7.5% were HIV positive, 54.4% HIV negative, and 38.1% missing HIV data. Findings showed lower odds of being HIV positive for those <30 years or 30-50 years (vs. >50 years); higher odds were seen for those: of Black race/ethnicity (vs. white), landed immigrant or refugee (vs. Canadian citizen), receiving social assistance (vs. not), and whom ever having used recreational drugs. CONCLUSIONS Albeit high, the prevalence of HIV was lower than expected based on global estimates. Missing HIV status data suggest gaps in testing. Findings highlight socioeconomic and clinical realities among trans women in Canada and inform future HIV prevention and support.
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Affiliation(s)
- Ashley Lacombe-Duncan
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Women's College Hospital, Toronto, ON, Canada
| | | | - Mostafa Shokoohi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Angela Underhill
- Women's College Hospital, Toronto, ON, Canada
- Sexuality, Marriage, and Family Studies, St. Jerome's University, Waterloo, ON, Canada
| | - Pierre Cote
- Clinique de Médecine Urbaine du Quartier Latin, Montreal, QC, Canada
| | | | - Meenakshi Gupta
- Women's College Hospital, Toronto, ON, Canada
- Department of Medicine, Sunnybrook Hospital, Toronto, ON, Canada
| | - Luke T Kyne
- Women's College Hospital, Toronto, ON, Canada
| | - Amir A Besharati
- Clinique de Médecine Urbaine du Quartier Latin, Montreal, QC, Canada
| | - Ly Louie Chan
- Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Quang Nguyen
- Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada
- Sherbourne Health, Toronto, ON, Canada
| | - Mona Loutfy
- Women's College Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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Heatlie LC, Petterson LJ, Vasey PL. Heterosexual Men's Visual Attention to Nude Images Depicting Cisgender Males, Cisgender Females, and Gynandromorphs. ARCHIVES OF SEXUAL BEHAVIOR 2023:10.1007/s10508-023-02657-9. [PMID: 37495891 DOI: 10.1007/s10508-023-02657-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/28/2023]
Abstract
Gynandromorphophilia refers to sexual attraction and arousal to feminine males, who may or may not have breasts, and who retain their penises. Previous research has suggested that some capacity for gynandromorphophilia may characterize males who are gynephilic (i.e., sexually attracted and aroused to adult females). This study examined Canadian cisgender gynephilic men's (n = 65) visual attention and subjective ratings of sexual arousal when presented with nude images of feminine males with, and without breasts, masculine males, and feminine females. Visual attention was assessed using an infrared eye-tracker. Subjective arousal to feminine females was highest, followed by subjective arousal to feminine males with breasts, feminine males without breasts, and masculine males. However, subjective arousal to feminine males without breasts and to masculine males did not differ significantly. The patterning of visual attention to images of females was unique, in that participants were equally likely to attend first to the face, chest or genitals. These areas also elicited relatively greater fixation durations and counts. Although participants fixated onto the chests of feminine males with breasts for longer durations than those of masculine males, most of the differences between feminine males, with and without breasts, were non-significant. These results suggest that female sex-based traits play a more primary role in gynephilic men's sexual arousal than feminine gender-based traits.
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Affiliation(s)
- Lambert C Heatlie
- Department of Psychology, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada.
| | - Lanna J Petterson
- Department of Psychology, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - Paul L Vasey
- Department of Psychology, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
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Armstrong I, Lacombe-Duncan A, Shokoohi M, Persad Y, Tseng A, Fung R, Underhill A, Côté P, Machouf N, Saucier A, Varriano B, Brundage M, Jones R, Weisdorf T, Goodhew J, MacLeod J, Loutfy M. Feminizing hormone therapy in a Canadian cohort of transgender women with and without HIV. Antivir Ther 2023; 28:13596535231182505. [PMID: 37289725 DOI: 10.1177/13596535231182505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Potential bidirectional drug-drug interactions between feminizing hormone therapy (FHT) and antiretroviral therapy (ART) are of concern for trans women with HIV and their healthcare providers. This study aimed to characterize patterns of FHT and ART among trans women with HIV and to compare serum hormone levels to trans women without HIV. METHODS Charts of trans women were reviewed at seven HIV primary care or endocrinology clinics in Toronto and Montreal from 2018 to 2019. ART regimens, FHT use, serum estradiol, and serum testosterone levels were compared on the basis of HIV status (positive, negative, missing/unknown). RESULTS Of 1495 trans women, there were 86 trans women with HIV, of whom 79 (91.8%) were on ART. ART regimens were most commonly integrase inhibitor-based (67.4%), many boosted with ritonavir or cobicistat (45.3%). Fewer (71.8%) trans women with HIV were prescribed FHT, compared to those without HIV (88.4%) and those with missing/unknown status (90.2%, p < 0.001). Among trans women on FHT with recorded serum estradiol (n = 1153), there was no statistical difference in serum estradiol between those with HIV (median: 203 pmol/L, IQR: 95.5, 417.5) and those with negative (200 mol/L [113, 407]) or missing/unknown HIV status (227 pmol/L [127.5, 384.5) (p = 0.633). Serum testosterone concentrations were also similar between groups. CONCLUSIONS In this cohort, trans women with HIV were prescribed FHT less often than trans women with negative or unknown HIV status. There was no difference in serum estradiol or testosterone levels of trans women on FHT regardless of HIV status, providing reassurance regarding potential drug-drug interactions between FHT and ART.
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Affiliation(s)
| | - Ashley Lacombe-Duncan
- Women's College Research Institute, Toronto, ON, Canada
- University of Michigan School of Social Work, Ann Arbor, MI, USA
| | - Mostafa Shokoohi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Alice Tseng
- Toronto General Hospital, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Raymond Fung
- Endocrinology, Department of Medicine, Michael Garron Hospital, Toronto, Ontario, Canada
| | | | - Pierre Côté
- Clinique de Médecine Urbaine Du Quartier Latin, Montréal, QC, Canada
| | - Nimâ Machouf
- Clinique de Médecine Urbaine Du Quartier Latin, Montréal, QC, Canada
| | - Adrien Saucier
- Clinique de Médecine Urbaine Du Quartier Latin, Montréal, QC, Canada
| | | | | | - Reilly Jones
- Women's College Research Institute, Toronto, ON, Canada
| | - Thea Weisdorf
- Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada
- St Michael's Hospital, Toronto, ON, Canada
| | - John Goodhew
- Church Wellesley Health Centre, Toronto, ON, Canada
| | | | - Mona Loutfy
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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Heterosexual men's pupillary responses to stimuli depicting cisgender males, cisgender females, and gynandromorphs. Biol Psychol 2023; 178:108518. [PMID: 36801358 DOI: 10.1016/j.biopsycho.2023.108518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/25/2023] [Accepted: 02/12/2023] [Indexed: 02/18/2023]
Abstract
Gynandromorphophilia is the sexual attraction and arousal to feminine individuals assigned male at birth, who may or may not have breasts, and who retain their penises. Previous research has suggested that some capacity for gynandromorphophilia may characterize all males who are gynephilic (i.e., sexually attracted and aroused to adult cisgender females). This study examined Canadian cisgender gynephilic men's (n = 65) pupillary responses and subjective ratings of sexual arousal when presented with nude images of cisgender males, cisgender females, and gynandromorphs with, and without, breasts. Subjective arousal to cisgender females was highest, followed by subjective arousal to gynandromorphs with breasts, gynandromorphs without breasts and cisgender males. However, subjective arousal to gynandromorphs without breasts and to cisgender males did not differ significantly. Participants' pupils dilated more to images of cisgender females than to all other stimulus categories. Participants' pupils dilated more to gynandromorphs with breasts than to cisgender males, but pupillary response to gynandromorphs without breasts and cisgender males did not differ significantly. If the capacity for gynandromorphophilic attraction is a cross-culturally invariant aspect of male gynephilia, then these data suggest that this capacity may only extend to gynandromorphs with breasts and not gynandromorphs without breasts.
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Petterson LJ, Vasey PL. Men's Sexual Interest in Feminine Trans Individuals across Cultures. JOURNAL OF SEX RESEARCH 2022; 59:1015-1033. [PMID: 34985389 DOI: 10.1080/00224499.2021.2013429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Feminine trans individuals (i.e., individuals who were assigned male at birth but who have a feminine gender presentation and identity) are present in many cultures. In some cultures, these individuals identify as (trans) women. Many of these individuals undergo medical treatments to feminize their bodies (e.g., breast augmentation), but most do not undergo vaginoplasties and therefore have penises. In many non-Western cultures, feminine trans individuals identify as a non-binary gender (i.e., neither man, nor woman). Many of these individuals do not surgically augment their bodies. Across cultures, some men express sexual interest in feminine trans individuals. Are manifestations of sexual interest in feminine trans individuals consistent across Western and non-Western cultural settings? Our review suggests that, across cultures, most of these men are also sexually attracted to cisgender individuals. Many are sexually attracted to cisgender women or to cisgender members of both sexes. A small subset is sexually attracted to cisgender men. Men who are sexually interested in feminine trans individuals commonly report being primarily insertive during anal sex. Additionally, they tend to report that their sexual interest in these individuals is motivated by attraction to femininity or to the combination female- and male-typical characteristics.
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Affiliation(s)
- Lanna J Petterson
- Laboratory of Comparative Sexuality, Department of Psychology, University of Lethbridge
| | - Paul L Vasey
- Laboratory of Comparative Sexuality, Department of Psychology, University of Lethbridge
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Barcelos TMR, Ferreira CHJ, Lerri MR, Brito LGO, de Sá MFS, Silva de Sá AC, Lara LADS. Sexual Function of Transgender Women After Gender Affirming Surgery: A Mini Review. Clin Anat 2022; 35:560-570. [PMID: 35334140 DOI: 10.1002/ca.23863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/28/2022] [Accepted: 03/20/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND A transgender person has a gender identity opposite to the sex assigned at birth. Transgender individuals may have altered sexual function (SF) due to psychosocial factors related to body image distortion, shame, and dissatisfaction with genital appearance, and these conditions can increase the risk of sexual dysfunction. This study aimed to characterize the SF of trans-women after gender affirming surgery. METHODS We reviewed the Pubmed database for studies published between January 2008 to December 2021. RESULTS 17 studies were included, 4 were cross-sectional studies, 1 prospective study, 4 prospective cohort studies, five retrospective studies. The instruments used to evaluate the SF were Female Sexual Index (FSFI), semi-structured questionnaires, patients' opinion, Sexual Desire Inventory (SDI), Maudsley Marital Questionnaire-S, WHOQOL-100. The results of our review indicate there is weak evidence that gender affirming surgery improves the SF of trans-women. CONCLUSION We thus recommend that future studies use questionnaires that are validated for the assessment of the SF of trans-women to better determine the impact of genital surgery in this population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Thays Marina Roncato Barcelos
- Physiotherapist graduate at University of São Paulo. Master's Degree student at Departament of Gynecology and Obstetrics, University of São Paulo, Bandeirantes Avenue, 3900, 8th floor, Ribeirão Preto, Brazil
| | | | - Maria Rita Lerri
- Psychologist at Clinical Hospital of Ribeirão Preto, University of São Paulo, Departament of Gynecology and Obstetrics, Bandeirantes Avenue, 3900, 8th floor, Ribeirão Preto, Brazil
| | - Luiz Gustavo Oliveira Brito
- Profesor at University of Campinas, Department of Obstetrics and Gynecology, Tessália Vieira de Camargo Street, 126 - University City, Campinas, Brazil
| | - Marcos Felipe Silva de Sá
- Profesor at University of São Paulo, Departament of Gynecology and Obstetrics, Bandeirantes Avenue, 3900, 8th floor, Ribeirão Preto, Brazil
| | - Ana Carolina Silva de Sá
- Profesor at University of São Paulo, Departament of Gynecology and Obstetrics, Bandeirantes Avenue, 3900, 8th floor, Ribeirão Preto, Brazil
| | - Lucia Alves da Silva Lara
- Profesor at University of São Paulo, Departament of Gynecology and Obstetrics, Bandeirantes Avenue, 3900, 8th floor, Ribeirão Preto, Brazil
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Goldbach C, Lindley L, Anzani A, Galupo MP. Resisting Trans Medicalization: Body Satisfaction and Social Contextual Factors as Predictors of Sexual Experiences among Trans Feminine and Nonbinary Individuals. JOURNAL OF SEX RESEARCH 2022:1-12. [PMID: 35076336 DOI: 10.1080/00224499.2021.2004384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Past research has constructed a medicalized model of trans women's sexuality, where trans women are believed to be hyposexual and distressed by their bodies pre-transition, and are cured of their sexual dysfunction as a result of gender affirmative medical procedures. The current study engaged a community sample (N = 169) of trans feminine and nonbinary individuals assigned male at birth (TFNB) to investigate predictors of sexual experiences after addressing methodological biases of prior studies, including body satisfaction (using a modified Body Image Scale) and social contextual factors. Hierarchical regressions were conducted to test the hypothesis that after accounting for demographic variables and social contextual aspects (i.e., body satisfaction, social dysphoria, and fetishization), medical transition (i.e., hormone therapy) would not significantly predict five outcomes of sexual experience (i.e., receptive penetration, insertive penetration, importance of sex, sexual pleasure, and sexual intimacy). Across all models, medical transition was not a significant predictor of sexual experiences; however, sexual orientation, age, body satisfaction, and experiences of fetishization were frequent predictors. Results suggest that the sexual experiences of TFNB individuals do not align with the medicalized model and that demographic and contextual factors play an important role in the sexual outcomes for this population.
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Affiliation(s)
- Chloe Goldbach
- Department of Counseling Psychology, Southern Illinois University
| | - Louis Lindley
- Department of Counseling Psychology, University of Wisconsin-Madison
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Quinn GP, Tishelman AC, Chen D, Nahata L. Reproductive health risks and clinician practices with gender diverse adolescents and young adults. Andrology 2021; 9:1689-1697. [PMID: 33942552 PMCID: PMC8566321 DOI: 10.1111/andr.13026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Reproductive health counseling is essential for adolescents and young adults (AYAs). Transgender and gender diverse (TGD) AYAs would benefit from tailored counseling given concerns about iatrogenic infertility and sexual dysfunction, and high rates of interpersonal violence, unplanned pregnancies and sexually transmitted infections, yet there are multiple obstacles to providing this care at the patient/family and clinician levels. OBJECTIVES This narrative review summarizes the literature on reproductive health considerations for TGD AYAs, current practices, and clinician barriers and facilitators to providing culturally sensitive reproductive care for TGD AYAs. Specific areas of focus include reproductive health goals, risks, and access barriers; clinician knowledge practices and challenges; and strategies for improving counseling practices. MATERIALS AND METHODS PubMed, Google Scholar, Medline, Web of Science, and PsycInfo databases were searched using the following terms: transgender, non-binary, gender expansive, gender non-conforming, reproductive health, sexual health, fertility, family planning/building, contraception, sexual dysfunction; gender-affirming hormones/surgery, clinician, physician or provider knowledge and attitudes; counseling. RESULTS Many TGD AYAs desire biological children and improved sexual experiences. TGD AYAs may experience infertility and sexual dysfunction associated with transition; have disproportionate HIV/STI risk; experience high rates of interpersonal/sexual violence and trauma; and encounter barriers to accessing competent medical care. Clinicians lack knowledge about reproductive health needs of TGD AYAs; inconsistently discuss family building options; perceive counseling challenges; and desire more training in this area. DISCUSSION Enriched communication training for medical/mental health clinicians is necessary to provide a skilled workforce for TGD AYAs. Web-based reproductive health training with other populations (eg oncology) demonstrates efficacy for improving communication skills and confidence in counseling, CONCLUSION: This review highlights barriers to adequate reproductive care encountered by TGD AYAs, exacerbated in underserved minority youth. Dedicated training for providers, and programs increasing access are important goals for improving care. The need for additional research is also emphasized.
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Affiliation(s)
- Gwendolyn P. Quinn
- Grossman School of Medicine, Departments of OB-GYN and Population Health, NY, NY, USA
| | - Amy C. Tishelman
- Boston Children’s Hospital, Departments of Psychiatry and Endocrinology, Boston, MA, USA
- Harvard Medical School, Departments of Psychiatry and Endocrinology, Boston, MA, USA
| | - Diane Chen
- Potocsnak Family Division of Adolescent and Young Adult Medicine, and Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
- Departments of Psychiatry and Behavioral Sciences, and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Leena Nahata
- Department of Pediatrics, The Ohio State University College of Medicine; Section of Endocrinology, Nationwide Children’s Hospital, Columbus, OH, USA
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Columbus, OH, USA
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Schardein JN, Nikolavsky D. Sexual Functioning of Transgender Females Post-Vaginoplasty: Evaluation, Outcomes and Treatment Strategies for Sexual Dysfunction. Sex Med Rev 2021; 10:77-90. [PMID: 34219008 DOI: 10.1016/j.sxmr.2021.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Transfeminine genital reconstructive surgery is an important part of gender affirmation for many transgender women. Sexual health post-vaginoplasty is an important aspect of quality of life that can have a significant impact on overall well-being. OBJECTIVES The objective of this review is to provide a summary of the literature on the sexual outcomes of transgender females post-vaginoplasty and identify treatment strategies for those experiencing sexual dysfunction. METHODS A literature review was conducted with a focus on sexual health outcomes in transgender females post-vaginoplasty as well as treatment options for sexual dysfunction. RESULTS Penile inversion vaginoplasty with or without free skin grafts or local tissue flaps and intestinal vaginoplasty are the options available to patients interested in transfeminine genital reconstructive surgery with a neovagina. Sexual satisfaction post-vaginoplasty is high regardless of the vaginoplasty technique, however up to 29% of patients may be diagnosed with a sexual dysfunction due to associated distress with a sexual function disturbance. Hormone treatment, pelvic floor physical therapy, sex therapy, and sex surrogacy are treatment options for patients with sexual dysfunctions. CONCLUSION Patient reported outcome measures appropriately validated for this patient population are necessary to better understand sexual function outcomes, sexual dysfunction and treatment options for post-vaginoplasty patients. Schardein JN, Nikolavsky D. Sexual Functioning of Transgender Females Post-Vaginoplasty: Evaluation, Outcomes and Treatment Strategies for Sexual Dysfunction. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
| | - Dmitriy Nikolavsky
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY, USA
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Bigras N, Vaillancourt-Morel MP, Nolin MC, Bergeron S. Associations between Childhood Sexual Abuse and Sexual Well-being in Adulthood: A Systematic Literature Review. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:332-352. [PMID: 33017227 DOI: 10.1080/10538712.2020.1825148] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/29/2020] [Accepted: 08/08/2020] [Indexed: 05/27/2023]
Abstract
Child sexual abuse (CSA) tends to occur in close relationships and involves sexual acts and betrayal. Thus, it is thought to affect sexual well-being in adulthood more so than any other form of childhood trauma. Research conducted over the last decade resulted in an impressive diversity of evidence reporting that CSA may be related to greater sexual dysfunction and lower sexual satisfaction as an adult, but also to higher levels of sexual compulsivity and sexual risk behaviors. Some studies also found no significant association between CSA and adult sexual well-being. Faced with these mixed results, understanding how CSA may affect sexual well-being in adulthood remains challenging for clinicians and researchers. The aim of this comprehensive literature review was to synthesize the empirical studies published in the last five years documenting the associations between CSA and several indicators of sexual well-being in adults excluding risky sexual behaviors. The literature search yielded 18 eligible studies which mainly examined five domains of sexual outcomes of CSA: sexual function, sexual satisfaction, sex-related cognitions, sexual behaviors and affective components of sexuality. Findings suggest that CSA is not unanimously related to all domains of sexual well-being, but rather, that associations are largely a function of the presence of other comorbidities or nature of the sample. Moreover, men are still significantly underrepresented in reviewed studies. Implications of the findings will be discussed in light of their relevance for clinicians and for researchers about gaps in current literature need to be filled.
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Affiliation(s)
- Noémie Bigras
- Department of Psychology, Université De Montréal, Montréal, Canada
| | | | - Marie-Chloé Nolin
- Department of Psychology, Université Du Québec À Trois-Rivières, Trois-Rivières, Canada
| | - Sophie Bergeron
- Department of Psychology, Université De Montréal, Montréal, Canada
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Lindley L, Anzani A, Prunas A, Galupo MP. Sexual Satisfaction in Trans Masculine and Nonbinary Individuals: A Qualitative Investigation. JOURNAL OF SEX RESEARCH 2021; 58:222-234. [PMID: 32787679 DOI: 10.1080/00224499.2020.1799317] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The present study investigated the ways trans masculine and nonbinary individuals describe aspects of their sexual satisfaction. Sexual satisfaction refers to an individual's subjective evaluation of their sexual experiences, and is influenced by relational, contextual, and personal experiences. Prior research with sexual satisfaction among trans individuals utilized quantitative measures, restricting the ability for respondents to describe trans-related aspects. Further, the pervasive focus on the effects of medical transition on binary trans individuals' experiences in prior research limits our understanding of those who do not desire a medical transition or live outside of the gender binary. Participants represented a community sample of 358 trans masculine and nonbinary individuals who responded to the question: "In what ways are you satisfied with your sex life?" Thematic analysis revealed eight overarching themes that represented two categories: universal and trans-related. Discussion focuses on the ways in which clinicians and researchers can utilize the current findings to improve the sexual satisfaction of trans masculine and nonbinary individuals.
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Affiliation(s)
- Louis Lindley
- Department of Counseling Psychology, University of Wisconsin-Madison , Madison, MI, USA
| | - Annalisa Anzani
- Department of Psychology, University of Milano , Bicocca, Italy
| | - Antonio Prunas
- Department of Psychology, University of Milano , Bicocca, Italy
| | - M Paz Galupo
- Department of Psychology, Towson University , Towson, MD, USA
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13
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Canadian undergraduate men's visual attention to cisgender women, cisgender men, and feminine trans individuals. Sci Rep 2021; 11:388. [PMID: 33432074 PMCID: PMC7801675 DOI: 10.1038/s41598-020-79870-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 12/10/2020] [Indexed: 11/27/2022] Open
Abstract
Some heterosexual men express sexual interest in feminine trans individuals with penises. It is possible that this interest arises from a tendency for heterosexual men to be sexually responsive to gender in addition to sex. We compared the self-reported sexual attraction and visual attention patterns of Canadian undergraduate heterosexual men (N = 51) and gay men (N = 20) to nude images of feminine trans individuals with penises, cisgender men, and cisgender women. Heterosexual men were most attracted to cisgender women and fixated on them the longest. However, they were more attracted to feminine trans individuals with penises than to cisgender men. They also biased their attention to feminine trans individuals with penises over cisgender men. This pattern was unique to heterosexual men. Gay men were most attracted to cisgender men and allocated the most visual attention to them. They responded to feminine trans individuals and cisgender women in a relatively similar manner. As such, heterosexual men appear to be responsive to sex and gender, which may account for sexual interest in feminine trans individuals among some heterosexual men.
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