Sexual Desire and Gender Affirming Hormone Therapy in Transgender Individuals with Gender Dysphoria

Background: Sexual desire is an important and yet still poorly explored dimension of sexual health in transgender individuals. Longitudinal studies on sexual desire before and after gender-affirming hormone therapy (GAHT) remain relatively scarce. Here, we examine sexual desire in transgender individuals, both assigned male (AMAB) and female at birth (AFAB).

Methods: A total of 124 participants were recruited before starting GAHT, and 57 of them  completed follow-up questionnaires after being exposed to GAHT. Longitudinal mixed models explored associations between exposure to GAHT and sexual desire, considering GAHT exposure both dichotomously (before vs after) and continuously (number of months under treatment).

Results: AMAB and AFAB individuals reported significant differences in sexual desire at baseline. After GAHT, AMAB individuals experienced a decrease of dyadic and total sexual desire (beta = -10.52, p = 0.026), while AFAB individuals experienced an increase across solitary, dyadic and total sexual desire (beta = 13.68, p = 0.039). Assessing sexual desire through time, no significant effects emerged for solitary sexual desire. However, dyadic and total sexual desire continued to be sustained for AFAB individuals (beta = 1.26, p = 0.020)

Conclusion: Although solitary sexual desire may increase in AFAB individuals after GAHT, this effect seems to be temporary and GAHT effects mainly seem to affect dyadic components of sexual health - at least for a longer period of time. Future research may better elucidate the long-term temporal dynamics of sexual desire in transgender individuals after GAHT, exploring the relevance of interpersonal factors in promoting sexual health.