Sexual Activity and Attraction, Relationship Status, and Mental Well-Being in Transgender and Gender Diverse People Pubblico
McLean, Jason (Spring 2023)
Abstract
Background: Transgender and gender diverse (TGD) individuals bear a higher risk for mental health problems. Little is known about the sexual activity patterns, attraction, and relationships in transfeminine (TF) and transmasculine (TM) persons, and even less is known about the influence of these factors on mental health in this population.
Methods: This study used survey data administered to members of the Study of Transition, Outcomes, and Gender (STRONG) cohort, nested within Kaiser Permanente integrated health systems in Georgia, Northern California, and Southern California. The survey data included self-reported information regarding sexual contacts in the previous 12 months, relationship status, level of gender affirming therapy (GAT) (none, hormone only, top surgery, or bottom surgery), and socio-demographic characteristics (age, education, race/ethnicity). Additionally, participants were asked to report their sexual attraction to others based on gender identity and expression. Mental health status was assessed by administering two validated instruments: the Center for Epidemiologic Studies Depression Scale (CES-D) and the Beck Anxiety Inventory (BAI). All associations were expressed as multivariable adjusted prevalence ratios (aPR) and the corresponding 95% confidence intervals (CI)
Results: Of 697 people with survey data, 651 (328 TF and 323 TM) provided required information for the study. GAT was associated with having a life partner, but only in TF. No significant association was found between GAT and reporting a life partner in TM, and no association was found in either group between GAT and sexual activity. Sexual activity was significantly related to lower prevalence of depression in TF only (aPR = 0.73, 95% CI: 0.58, 0.92). Life partnership was associated with lower prevalence of depression in both groups (aPR = 0.74, 95% CI: 0.58, 0.95 for TF; aPR = 0.72, 95% CI: 0.56, 0.91 for TM). Neither variable was significantly associated with anxiety. Bottom surgery in TF and top and bottom surgery in TM were associated with lower prevalence of anxiety and depression.
Conclusions: Although GAT was unrelated to sexual activity in this study, having a sexual and especially a life partner was associated with lower prevalence of depression in both TM and TF groups. Longitudinal studies and large clinical datasets are required to further evaluate these associations.
Table of Contents
Introduction 1
Methods 3
-Study Population 3
-Study Measures 3
-Data Analysis 4
Results 6
-Overview of the study population 6
-Factors associated with having sexual relationship or a life partner 7
-Associations of having a sexual relationship or a life partner with depression and anxiety 7
Discussion 9
Conclusions and Future Directions 11
Public Health Implications 12
References 13
Tables and Figures 16
About this Master's Thesis
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