Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study

Mauro E Kerckhof, Baudewijntje P C Kreukels, Timo O Nieder, Inga Becker-Hébly, Tim C van de Grift, Annemieke S Staphorsius, Andreas Köhler, Gunter Heylens, Els Elaut

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: Studies about sexual functioning in trans persons have mainly focused on sexual functioning after genital gender-affirming surgery, have had small sample sizes, and have not explored the broad range of possible sexual dysfunctions. Measuring sexual functioning in trans persons during transitioning is important to determine the kind of care trans persons may need in order to regain their sexual health. Aim: The first aim of the present study was to explore the prevalence of sexual function disturbances and dysfunctions (with distress) in trans women and trans men 4 to 6 years after initial clinical entry. The second aim was to compare the prevalence of sexual dysfunctions among the various treatment trajectories and between trans persons with or without further genital treatment intentions. Methods: An online follow-up questionnaire was filled out by 518 trans persons (307 identifying predominantly feminine, 211 identifying predominantly masculine) as a part of the European Network for the Investigation of Gender Incongruence initiative. All participants had their initial clinical appointments in gender clinics in Ghent, Amsterdam, or Hamburg. Main Outcome Measure: The main outcome measures were the prevalence of sexual dysfunctions and medical treatment data, measured via self-report items. Results: The most frequent sexual dysfunctions experienced by trans women and trans men were difficulties initiating and seeking sexual contact (26% and 32%, respectively) and difficulties achieving an orgasm (29% and 15%, respectively). Compared with trans women after hormone treatment and non-genital surgery, trans women after vaginoplasty less often experienced arousal difficulties, sexual aversion, and low sexual desire. Compared with trans men without medical treatment, trans men after a phalloplasty experienced sexual aversion and low sexual desire less often. No significant differences were found between participants with or without further genital treatment intentions. Clinical implications: Clinicians should consider sexual counseling after medical treatments, paying particular attention to potential social and psychological barriers to the sexual health of their patients. Strengths & Limitations: This study included all trans persons irrespective of treatment decisions, and focused on a broad range of potential sexual difficulties taking the distress criteria into account. Limitations include the cross-sectional design, the limited power for the comparison of treatment groups and the absence of validated questionnaires about sexual functioning for transgender persons. Conclusion: Sexual dysfunctions among trans men and women were very common among the various treatment groups and were unrelated to intentions to have further genital treatment. Although medical treatment may be helpful or even essential to developing good sexual health, a significant group of trans persons experienced sexual dysfunctions after genital surgery. Kerckhof ME, Kreukels BPC, Nieder TO, et al. Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study. J Sex Med 2019; 16:2018–2019.

Original languageEnglish
Pages (from-to)2018-2029
Number of pages12
JournalJournal of Sexual Medicine
Volume16
Issue number12
DOIs
Publication statusPublished - 1 Dec 2019

Cite this

Kerckhof, Mauro E ; Kreukels, Baudewijntje P C ; Nieder, Timo O ; Becker-Hébly, Inga ; van de Grift, Tim C ; Staphorsius, Annemieke S ; Köhler, Andreas ; Heylens, Gunter ; Elaut, Els. / Prevalence of Sexual Dysfunctions in Transgender Persons : Results from the ENIGI Follow-Up Study. In: Journal of Sexual Medicine. 2019 ; Vol. 16, No. 12. pp. 2018-2029.
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title = "Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study",
abstract = "Introduction: Studies about sexual functioning in trans persons have mainly focused on sexual functioning after genital gender-affirming surgery, have had small sample sizes, and have not explored the broad range of possible sexual dysfunctions. Measuring sexual functioning in trans persons during transitioning is important to determine the kind of care trans persons may need in order to regain their sexual health. Aim: The first aim of the present study was to explore the prevalence of sexual function disturbances and dysfunctions (with distress) in trans women and trans men 4 to 6 years after initial clinical entry. The second aim was to compare the prevalence of sexual dysfunctions among the various treatment trajectories and between trans persons with or without further genital treatment intentions. Methods: An online follow-up questionnaire was filled out by 518 trans persons (307 identifying predominantly feminine, 211 identifying predominantly masculine) as a part of the European Network for the Investigation of Gender Incongruence initiative. All participants had their initial clinical appointments in gender clinics in Ghent, Amsterdam, or Hamburg. Main Outcome Measure: The main outcome measures were the prevalence of sexual dysfunctions and medical treatment data, measured via self-report items. Results: The most frequent sexual dysfunctions experienced by trans women and trans men were difficulties initiating and seeking sexual contact (26{\%} and 32{\%}, respectively) and difficulties achieving an orgasm (29{\%} and 15{\%}, respectively). Compared with trans women after hormone treatment and non-genital surgery, trans women after vaginoplasty less often experienced arousal difficulties, sexual aversion, and low sexual desire. Compared with trans men without medical treatment, trans men after a phalloplasty experienced sexual aversion and low sexual desire less often. No significant differences were found between participants with or without further genital treatment intentions. Clinical implications: Clinicians should consider sexual counseling after medical treatments, paying particular attention to potential social and psychological barriers to the sexual health of their patients. Strengths & Limitations: This study included all trans persons irrespective of treatment decisions, and focused on a broad range of potential sexual difficulties taking the distress criteria into account. Limitations include the cross-sectional design, the limited power for the comparison of treatment groups and the absence of validated questionnaires about sexual functioning for transgender persons. Conclusion: Sexual dysfunctions among trans men and women were very common among the various treatment groups and were unrelated to intentions to have further genital treatment. Although medical treatment may be helpful or even essential to developing good sexual health, a significant group of trans persons experienced sexual dysfunctions after genital surgery. Kerckhof ME, Kreukels BPC, Nieder TO, et al. Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study. J Sex Med 2019; 16:2018–2019.",
keywords = "Gender Dysphoria, Gender-Affirming Surgery, Hormone Replacement Therapy, Prevalence, Sexual Dysfunction, Sexual Health, Sexuality, Transgender Persons",
author = "Kerckhof, {Mauro E} and Kreukels, {Baudewijntje P C} and Nieder, {Timo O} and Inga Becker-H{\'e}bly and {van de Grift}, {Tim C} and Staphorsius, {Annemieke S} and Andreas K{\"o}hler and Gunter Heylens and Els Elaut",
note = "Copyright {\circledC} 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.",
year = "2019",
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Kerckhof, ME, Kreukels, BPC, Nieder, TO, Becker-Hébly, I, van de Grift, TC, Staphorsius, AS, Köhler, A, Heylens, G & Elaut, E 2019, 'Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study' Journal of Sexual Medicine, vol. 16, no. 12, pp. 2018-2029. https://doi.org/10.1016/j.jsxm.2019.09.003

Prevalence of Sexual Dysfunctions in Transgender Persons : Results from the ENIGI Follow-Up Study. / Kerckhof, Mauro E; Kreukels, Baudewijntje P C; Nieder, Timo O; Becker-Hébly, Inga; van de Grift, Tim C; Staphorsius, Annemieke S; Köhler, Andreas; Heylens, Gunter; Elaut, Els.

In: Journal of Sexual Medicine, Vol. 16, No. 12, 01.12.2019, p. 2018-2029.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Prevalence of Sexual Dysfunctions in Transgender Persons

T2 - Results from the ENIGI Follow-Up Study

AU - Kerckhof, Mauro E

AU - Kreukels, Baudewijntje P C

AU - Nieder, Timo O

AU - Becker-Hébly, Inga

AU - van de Grift, Tim C

AU - Staphorsius, Annemieke S

AU - Köhler, Andreas

AU - Heylens, Gunter

AU - Elaut, Els

N1 - Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Introduction: Studies about sexual functioning in trans persons have mainly focused on sexual functioning after genital gender-affirming surgery, have had small sample sizes, and have not explored the broad range of possible sexual dysfunctions. Measuring sexual functioning in trans persons during transitioning is important to determine the kind of care trans persons may need in order to regain their sexual health. Aim: The first aim of the present study was to explore the prevalence of sexual function disturbances and dysfunctions (with distress) in trans women and trans men 4 to 6 years after initial clinical entry. The second aim was to compare the prevalence of sexual dysfunctions among the various treatment trajectories and between trans persons with or without further genital treatment intentions. Methods: An online follow-up questionnaire was filled out by 518 trans persons (307 identifying predominantly feminine, 211 identifying predominantly masculine) as a part of the European Network for the Investigation of Gender Incongruence initiative. All participants had their initial clinical appointments in gender clinics in Ghent, Amsterdam, or Hamburg. Main Outcome Measure: The main outcome measures were the prevalence of sexual dysfunctions and medical treatment data, measured via self-report items. Results: The most frequent sexual dysfunctions experienced by trans women and trans men were difficulties initiating and seeking sexual contact (26% and 32%, respectively) and difficulties achieving an orgasm (29% and 15%, respectively). Compared with trans women after hormone treatment and non-genital surgery, trans women after vaginoplasty less often experienced arousal difficulties, sexual aversion, and low sexual desire. Compared with trans men without medical treatment, trans men after a phalloplasty experienced sexual aversion and low sexual desire less often. No significant differences were found between participants with or without further genital treatment intentions. Clinical implications: Clinicians should consider sexual counseling after medical treatments, paying particular attention to potential social and psychological barriers to the sexual health of their patients. Strengths & Limitations: This study included all trans persons irrespective of treatment decisions, and focused on a broad range of potential sexual difficulties taking the distress criteria into account. Limitations include the cross-sectional design, the limited power for the comparison of treatment groups and the absence of validated questionnaires about sexual functioning for transgender persons. Conclusion: Sexual dysfunctions among trans men and women were very common among the various treatment groups and were unrelated to intentions to have further genital treatment. Although medical treatment may be helpful or even essential to developing good sexual health, a significant group of trans persons experienced sexual dysfunctions after genital surgery. Kerckhof ME, Kreukels BPC, Nieder TO, et al. Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study. J Sex Med 2019; 16:2018–2019.

AB - Introduction: Studies about sexual functioning in trans persons have mainly focused on sexual functioning after genital gender-affirming surgery, have had small sample sizes, and have not explored the broad range of possible sexual dysfunctions. Measuring sexual functioning in trans persons during transitioning is important to determine the kind of care trans persons may need in order to regain their sexual health. Aim: The first aim of the present study was to explore the prevalence of sexual function disturbances and dysfunctions (with distress) in trans women and trans men 4 to 6 years after initial clinical entry. The second aim was to compare the prevalence of sexual dysfunctions among the various treatment trajectories and between trans persons with or without further genital treatment intentions. Methods: An online follow-up questionnaire was filled out by 518 trans persons (307 identifying predominantly feminine, 211 identifying predominantly masculine) as a part of the European Network for the Investigation of Gender Incongruence initiative. All participants had their initial clinical appointments in gender clinics in Ghent, Amsterdam, or Hamburg. Main Outcome Measure: The main outcome measures were the prevalence of sexual dysfunctions and medical treatment data, measured via self-report items. Results: The most frequent sexual dysfunctions experienced by trans women and trans men were difficulties initiating and seeking sexual contact (26% and 32%, respectively) and difficulties achieving an orgasm (29% and 15%, respectively). Compared with trans women after hormone treatment and non-genital surgery, trans women after vaginoplasty less often experienced arousal difficulties, sexual aversion, and low sexual desire. Compared with trans men without medical treatment, trans men after a phalloplasty experienced sexual aversion and low sexual desire less often. No significant differences were found between participants with or without further genital treatment intentions. Clinical implications: Clinicians should consider sexual counseling after medical treatments, paying particular attention to potential social and psychological barriers to the sexual health of their patients. Strengths & Limitations: This study included all trans persons irrespective of treatment decisions, and focused on a broad range of potential sexual difficulties taking the distress criteria into account. Limitations include the cross-sectional design, the limited power for the comparison of treatment groups and the absence of validated questionnaires about sexual functioning for transgender persons. Conclusion: Sexual dysfunctions among trans men and women were very common among the various treatment groups and were unrelated to intentions to have further genital treatment. Although medical treatment may be helpful or even essential to developing good sexual health, a significant group of trans persons experienced sexual dysfunctions after genital surgery. Kerckhof ME, Kreukels BPC, Nieder TO, et al. Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study. J Sex Med 2019; 16:2018–2019.

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KW - Gender-Affirming Surgery

KW - Hormone Replacement Therapy

KW - Prevalence

KW - Sexual Dysfunction

KW - Sexual Health

KW - Sexuality

KW - Transgender Persons

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