The Sexual Health of Transgender Men: A Scoping Review

Abstract

There is a general paucity of research concerning the sexual health of transgender individuals, and most existing research focuses on transgender women. A scoping review concerning the sexual health of transgender men was conducted to identify gaps in the literature and to highlight opportunities for future research and intervention. A comprehensive search of seven databases was conducted. The Joanna Briggs Institute Reviewers' Manual was used as a framework. Some 7,485 articles were initially identified using a search strategy applied to seven online databases: 54 articles were identified as relevant to the research questions and reviewed in detail; of those, 33 were included in the final analysis. Studies were conceptualized into four broad themes: sexual behaviors, sexual identity, sexual pleasure and sexual function, and transactional sex. Besides an overall lack of research, existing studies were often characterized by small convenience samples that do not allow for generalization to the larger population of transgender men. Significant gaps in the literature regarding sexual coercion, sexual and intimate partner violence, and relationship quality and functioning among transgender men exist. There is a need to improve the scope and depth of research examining the sexual health of this population, especially concerning sexual risk behaviors and structural barriers to sexual health care access.

High risk and low uptake of pre‐exposure prophylaxis to prevent HIV acquisition in a national online sample of transgender men who have sex with men in the United States

“…This was a convenience sample of trans MSM that is most likely not representative of the trans MSM population in its entirety. However, findings are generally consistent with existing HIV‐related studies in other high income settings . Respondents were recruited from a variety of sources, including social media, peer networks, and dating apps.…”

“…Higher perceived HIV risk was found to be associated with increased odds of PrEP indication among trans MSM. Prior research on perceived versus actual risk in trans MSM have been mixed, with some studies finding concordance and other others not . The congruency of high perceived risk and PrEP indications in this sample may be related to study eligibility criteria which was limited to trans MSM who had sex with cis man in the last six months.…”

“…Studies demonstrate that trans women are disproportionately affected by HIV infection relative to (“cis”) people and have been a focus of HIV prevention interventions, including pre‐exposure prophylaxis (PrEP) to prevent HIV. Only recently, have researchers begun to evaluate HIV risk among trans masculine people, those assigned a female sex a birth who identify as men, transgender men, or another gender identity on the trans masculine spectrum . Trans masculine individuals have often been erroneously thought to identify exclusively as heterosexual or to engage in sex with only cis women .…”

Sexual Experiences in Transgender People: The Role of Desire for Gender-Confirming Interventions, Psychological Well-Being, and Body Satisfaction

“…An important strength of this study is that most research thus far has only included transgender people with a diagnosis who are clinically referred or have already been treated (Klein & Gorzalka, 2009;Stephenson et al, 2017). In this way these studies focus on transgender people who seek genderaffirmation therapy.…”

Prevalence of Sexually Transmitted Infections and Human Immunodeficiency Virus in Transgender Persons: A Systematic Review

“…13,14 Similar to transgender women, transgender men are emotionally and sexually attracted to people of all gender identities and can identify as straight, gay, bisexual, queer, or with another sexual orientation, resulting in a range of sexual risk behaviors among this group. 15,16 One review found that a common goal of sexual behaviors among transgender men was affirmation of their post-transition masculinity, leading many to have receptive anal sex with cisgender men and avoidance of vaginal sex. 16 Infrequent condom use is also described among transgender men; in one study that included 62 transgender men, 71% reported not using a condom during their last sexual encounter.…”