detrans.ai 

Back to studies

연구 속 대부분의 트랜스 남성과 논바이너리 사람이 성관계 중 성기 통증, 테스토스테론은 질 통증 증가와 연관

출생 시 여성으로 지정된 트랜스젠더 남성과 성별 다양 사람들의 테스토스테론 사용과 성기능

설문 조사교차성호르몬
Authors
Diana M. Tordoff, Mitchell R. Lunn, Bertha Chen, Annesa Flentje, Zubin Dastur, Micah E. Lubensky, Matthew Capriotti, Juno Obedin-Maliver
Journal
American Journal of Obstetrics and Gynecology
Year
2023
Source
https://doi.org/10.1016/j.ajog.2023.08.035

Summary

Testosterone thins vaginal tissue, which can make sex painful. This study used the US PRIDE online study to compare sex lives in 602 people born female who were currently on testosterone and 516 who had never taken it. Pain during sex was strikingly common in both groups: 65% of sexually active people had genital pain or discomfort in the past month, 67% of testosterone users and 63% of non-users. Testosterone users reported more interest in sex and easier orgasm, and slightly more vaginal pain, but no greater satisfaction with their sex lives. The group also reported very high rates of past sexual abuse (78%), depression (81%) and PTSD (40%). Because it is a one-time survey of volunteers, it shows links only, not causes. But it records a large and little-noticed problem of painful sex.

Key findings

  • 연구는 PRIDE 연구의 출생 시 여성인 트랜스 남성과 논바이너리 사람 1,219명을 살폈습니다. 현재 테스토스테론 사용 602명, 한 번도 쓰지 않은 516명, 중단한 76명이었습니다.
  • 성적으로 활동적인 1,091명 중 65%가 지난 한 달 동안 성관계 중 생식기 통증이나 불편함이 있었고, 가장 흔한 곳은 질(52%), 그다음이 음핵 주변(29%)과 소음순(25%)이었습니다.
  • 성관계 중 생식기 통증은 테스토스테론 사용 여부와 상관없이 흔했습니다. 현재 사용자의 약 67%, 한 번도 쓰지 않은 사람의 63%였습니다.
  • 현재 테스토스테론 사용은 성에 대한 분명히 더 많은 관심, 약간 더 쉬운 오르가슴, 성관계 중 약간 더 많은 질 통증과 관련이 있었습니다.
  • 테스토스테론 사용은 성생활에 대한 더 큰 만족, 윤활, 소음순 주변 통증, 오르가슴의 쾌감과는 관련이 없었습니다.
  • 사람들은 평생 성적 학대(78%), 성폭행(50%), 우울 진단(81%), PTSD 진단(40%)의 매우 높은 비율을 보고했습니다.
  • 저자들은 트랜스 남성의 5% 미만이 사용한 적이 있다고 보고하는 질 에스트로겐 같은 치료에 대한 더 나은 접근을 요구합니다.

Abstract

BACKGROUND: Testosterone use among transgender people likely impacts their experience of sexual function and vulvovaginal pain via several complex pathways. Testosterone use is associated with decreased estrogen in the vagina and atrophic vaginal tissue, which may be associated with decreased vaginal lubrication and/or discomfort during sexual activity. At the same time, increased gender affirmation through testosterone use may be associated with improved sexual function. However, data on pelvic and vulvovaginal pain among transgender men and nonbinary people assigned female at birth are scarce.

OBJECTIVE: This study aimed to assess the association between testosterone and sexual function with a focus on symptoms that are commonly associated with vaginal atrophy.

STUDY DESIGN: We conducted a cross-sectional analysis of 1219 participants aged 18 to 72 years using data collected from 2019 to 2021 from an online, prospective, longitudinal cohort study of sexual and/or gender minority people in the United States (The Population Research in Identity and Disparities for Equality Study). Our analysis included adult transgender men and gender diverse participants assigned female at birth who were categorized as never, current, and former testosterone users. Sexual function was measured across 8 Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction domains.

RESULTS: Overall, 516 (42.3%) participants had never used testosterone, and 602 (49.4%) currently used testosterone. The median duration of use was 37.7 months (range, 7 days to >27 years). Most participants (64.6%) reported genital pain or discomfort during sexual activity in the past 30 days, most commonly in the vagina or frontal genital opening (52.2%), followed by around the clitoris (29.1%) and labia (24.5%). Current testosterone use was associated with a greater interest in sexual activity (β=6.32; 95% confidence interval, 4.91-7.74), higher ability to orgasm (β=1.50; 95% confidence interval, 0.19-2.81), and more vaginal pain or discomfort during sexual activity (β=1.80; 95% confidence interval, 0.61-3.00). No associations were observed between current testosterone use and satisfaction with sex life, lubrication, labial pain or discomfort, or orgasm pleasure.

CONCLUSION: Testosterone use among transgender men and gender diverse people was associated with an increased interest in sexual activity and the ability to orgasm, as well as with vaginal pain or discomfort during sexual activity. Notably, the available evidence demonstrates that >60% of transgender men experience vulvovaginal pain during sexual activity. The causes of pelvic and vulvovaginal pain are poorly understood but are likely multifactorial and include physiological (eg, testosterone-associated vaginal atrophy) and psychological factors (eg, gender affirmation). Given this high burden, there is an urgent need to identify effective and acceptable interventions for this population.

Conclusion

Testosterone use among transgender men and gender diverse people was associated with an increased interest in sexual activity and the ability to orgasm, as well as with vaginal pain or discomfort during sexual activity. Notably, the available evidence demonstrates that >60% of transgender men experience vulvovaginal pain during sexual activity. The causes of pelvic and vulvovaginal pain are poorly understood but are likely multifactorial and include physiological (eg, testosterone-associated vaginal atrophy) and psychological factors (eg, gender affirmation). Given this high burden, there is an urgent need to identify effective and acceptable interventions for this population.