Sexuality and gender affirmation in transgender men who have sex with cisgender men

ABSTRACT

Background: Transgender men who have sex with men (trans MSM) are underrepresented in the behavioral and social sciences literature, especially in research concerning sexual health. The available literature indicates that, in relation to gender affirmation (sometimes called “transition”), some trans men may experience shifts in their sexual attractions and the identity labels that they use to describe their sexual orientation. Most commonly, this shift entails increased attraction to cisgender men.

Aims: The purpose of this qualitative analysis was to investigate positive and negative aspects of sexuality and sexual behavior relevant for trans MSM who have affirmed their gender.

Methods: We conducted individual interviews with 16 trans MSM (M age = 32.5, SD = 11.1) who were recruited via venue-based recruitment and chain referral/snowball sampling methods. Interviews were transcribed verbatim and analyzed using a rigorous team-based approach to grounded theory.

Results: The four theoretical constructs that emerged included: (1) harmful social influences; (2) support and validation of a trans masculine identity; (3) sexual exploration and self-acceptance; and (4) internalized oppression. Overall, these themes described complex experiences of trans MSM managing oppression, both external and internalized, at the intersection of gender and sexuality.

Discussion: Affirming one's identity within a social context that marginalizes trans men and sexual minorities and promotes adherence to strict gender norms has important implications for the sexuality of trans men. In part, gender affirmation created an increased confidence and openness to exploring sexual interests for participants. Furthermore, trans MSM's identities and gender can be affirmed through sexual relationships with cisgender MSM. Greater understanding of gender affirmation and sexuality for trans MSM can inform healthcare recommendations for working with trans MSM, including healthcare policies and practices in sexual health.

KEYWORDS:

• Men who have sex with men
• sexual identity
• trans men
• transgender men

Acknowledgments

This publication was supported by a developmental grant awarded to PI Dr. Reisner (CFAR-FCHC-15-1) by: (1) the Harvard University Center for AIDS Research (CFAR), an NIH funded program (P30 AI060354), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, and OAR; (2) the Harvard Global Health Institute (HGHI). The findings and conclusions in this report are those of the authors and do not necessarily represent any official position of the funders. The completion of this manuscript was also aided by an award from the University of Massachusetts Boston's Committee on Undergraduate Research. A prior version of this paper was presented as an oral presentation at the 2014 Annual Philadelphia Trans-Health Conference.

Declaration of conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Funding

National Institutes of Health P30 AI060354