Sexual experience, relationships, and factors associated with sexual and romantic satisfaction in the first Australian Trans & Gender Diverse Sexual Health Survey

Abstract

Background: Sexual and romantic satisfaction are important aspects of sexual health and wellbeing, but they have not been thoroughly investigated among transgender and gender diverse (‘trans’) people in Australia. Aims: To address this gap and improve sexual health and wellbeing, we assessed the sexual behavior and relationships of a national sample of trans people in Australia, and factors associated with sexual and romantic satisfaction. Methods: We conducted a national survey of trans people from Australia in October-November 2018. Results: The sample included 1,613 trans participants, of whom 353 (21.9%) were men, 397 (24.6%) were women and 863 (53.5%) were non-binary. Over 70% of the sample had been sexually active in the previous year, and 56.9% were in a relationship, but only 32.4% were satisfied with the sexual aspects and 47.1% with the romantic aspects of their lives. Sexual satisfaction was associated with younger age, being asexual, having more trans friends, more frequent sex, and using illicit drugs in the context of sexual activity. Anxiety or fear about sex was associated with less sexual satisfaction, as was being in an open relationship. Romantic satisfaction was associated with younger age, having non-binary partners, and being in a current relationship (particularly a monogamous one). Recent distress, anxiety, or fear about sex were associated with less romantic satisfaction. Conclusion: Participants reported a broad range of sexual relationships, but low levels of satisfaction with the sexual and romantic aspects of their lives. The findings underscore the importance of supportive partners, access to social support and peer networks of trans people, as well as access to mental health support and sex-positive, trans affirming counseling in sexual health services.

Keywords:

• relationships
• romantic satisfaction
• sexual behavior
• sexual satisfaction
• transgender persons

Acknowledgments

We thank all the trans people who participated in the study and former members of the study investigator group (Vincent Cornelisse, Emanuel Vlahakis and Jeremy Wiggins).

Disclosure statement

No potential conflict of interest was reported by the authors.

Authors’ contributions

Study conception, design, data collection, analysis and interpretation: MH, DC, MP, LDC, TC, SR. Statistical analysis for this article: TB. MH wrote the article with input from TB, DC and SR. All authors reviewed the article, provided commentary for revisions, agreed with the final version and agreed to the accuracy and integrity of the work.

Data availability statement

Data cannot be shared publicly because of their sensitive nature, the potential for individual identification, and ongoing stigma and discrimination enacted against transgender and gender diverse people. Due to these considerations, approval for this research granted by the human research ethics committee of UNSW Sydney (reference: HC180613) and ACON’s population-specific human research ethics panel (reference: 2018/21) was provided under the condition that data would not be shared publicly. Data may be provided at request to researchers who agree to the privacy and security provisions of this approval. Such requests can be sent to [email protected]

Additional information

Funding

Department of Health, Australian Government. The Australian Trans and Gender Diverse Sexual Health Survey was supported with funding from a National Health and Medical Research Council Program Grant (GNT1071269). The Centre for Social Research in Health and the Kirby Institute receive funding from the Australian Government Department of Health.