Does gender-affirming therapy help trans individuals with sexual development?

Although there are many societal changes still to go to provide trans individuals with a safe, supportive environment, there have been a number of positive moves in medicine that mean trans children are more likely to go through life as their identified gender, rather than the one given to them at birth, and experience life much like their cisgender peers. An investigation in Pediatrics looks into how early gender-affirmative treatment, which may include puberty suppression, using affirming hormones, and gender-affirmative surgeries, could have a positive impact on a trans person’s sexual and romantic development.¹

The researchers looked at 113 transgender teenagers who had been treated with affirmative hormones, affirmative surgery, and puberty suppression. They assessed the participants as young adults during and after their gender-affirmative therapy. Each participant was giving a questionnaire that asked about romantic experiences, sexual experiences, and subjective sexual experiences. The responses to this questionnaire were compare to a same-aged sample of the general population.

Investigators found that in the first year after surgery, young transgender adults said they had experienced a significant increase with all types of sexual activity. When comparing presurgery to post surgery responses, the investigators found that masturbation increased from 56.4% to 81.7%; petting when undressed increased from 57.1% to 78.7%; and sexual intercourse increased from 16.2% to 37.6%. Additionally, the researchers found that both transmen and transwomen in the study reported being roughly equally experienced. However, the young trans adults were still less experienced with all forms of sexual activity when compared to the general population.

In the discussion of the study’s results, the investigators mentioned that 2 of the big improvements seen through early gender-affirming therapy included psychological well-being, which can impact sexual health, as well as improving body image because trans people who have undergone early gender-affirming treatment are more likely to see who they truly are when they look in the mirror. However, they did note that many trans individuals begin engaging in sexual activity only after receiving gender-affirming therapy, which would put them behind their cisgender peers.

The researchers concluded that using early gender-affirming therapy could offer young transgender adults the chance to engage and increase their romantic and sexual experiences.

Reference

1. Bungener S, de Vries A, Popma A, Steensma T. Sexual experiences of young transgender persons during and after gender-affirmative treatment. Pediatrics. 146(6):e20191411. doi:10.1542/peds.2019-1411