Testosterone, Sexual Health, and Pain During Sex among Transgender Men, Nonbinary, and Gender Diverse People

Testosterone, Sexual Health, and Pain During Sex among Transgender Men, Nonbinary, and Gender Diverse People | photo of a nonbinary person injection testosterone into their thigh (from gender spectrum)

The following is research that came out earlier this month (September, 2023) from the Pride Study:

What Did We Do?

We looked at sexual health experiences data from The PRIDE Study’s Annual Questionnaires from 2019-2021 provided by transgender men, nonbinary, and gender diverse people who were assigned female sex at birth (AFAB). We also looked at how these sexual health experiences were different or similar among people who were currently using testosterone and those who were not.

What Was New, Innovative, or Notable? 

Our study is one of the largest to look at the relationship between testosterone use, sexual health, and experiences of genital pain during sex among transgender men, nonbinary, and gender expansive people AFAB.

What Did We Learn? 

There were 1,219 participants in this study. 49% of participants were using testosterone and 42% had never used testosterone. Many (65%) reported having any genital pain during sex in the past 30 days (from when they completed the survey). Compared to people who never used testosterone, individuals who were using testosterone had a higher interest in sexual activity and a higher ability to orgasm. People who were using testosterone were also more likely to report genital pain during sex. We did not see a relationship between current testosterone use and satisfaction with sex life, ability for genitals to produce their own lubrication, or orgasm pleasure.

What Does This Mean for Our Communities? 

Testosterone usage for the purpose of affirming one’s gender can be associated with both positive and negative sexual health experiences. Testosterone likely impacts sexual health experiences in complex ways. For example, testosterone may play a role in genital pain during sex for some individuals. At the same time, testosterone may play a role in increased gender affirmation and improved mental health that may be related to more positive sexual experiences.

It is important that a high percentage of participants reported experiencing genital pain during sex because it can have an impact on their well-being and quality of life. However, there are not any treatments for genital pain during sex that have been evaluated specifically for transgender men or nonbinary and gender diverse people AFAB.

What’s Next? 

Our long-term goal is to identify effective and acceptable ways to treat or prevent genital pain during sex among transgender, nonbinary, and gender diverse people and to make treatments accessible. Future studies will focus on: learning more about people’s preferences for potential treatments, the ways that people using testosterone address genital pain symptoms, and what they find to be most effective. Lastly, we plan to look at how genital pain during sex impacts the overall quality of life, well-being, and relationships for transgender men, nonbinary, and gender diverse people AFAB.

Action Steps: 

See http://www.pridestudy.org/study for more information and to share this study with your friends and family.

If you are interested in conducting research related to LGBTQIA+ health, please learn more about collaborating with The PRIDE Study at http://pridestudy.org/collaborate.

Citation:

Tordoff DM, Lunn MR, Chen B, Flentje A, Dastur Z, Lubensky ME, Capriotti M, Obedin-Maliver J. Testosterone Use and Sexual Function among Transgender Men and Gender Diverse People Assigned Female at Birth. American Journal of Obstetrics & Gynecology. 2023 September 9; doi: https://doi.org/10.1016/j.ajog.2023.08.035 (article will be live in the near future)

View the full PDF at: https://escholarship.org/uc/item/6bz2x0j6