Physical, Mental and Sexual Health among Transgender Women: A Comparative Study among Operated Transgender and Cisgender Women in a National Tertiary Referral Network
The Journal of Sexual Medicine(2021)
摘要
Background: Few studies have investigated how physical, mental and sexual function are associated with each other in operated transgender women (oTW). Aim: To provide information on the physical, mental and sexual health of oTW in comparison with a group of cisgender women (cisW). Methods: An age-matched control study was carried out, recruiting 125 oTW in 7 national referral centers and 80 volunteer women. Beck Depression Inventory Primary Care (BDI-PC), General Health Survey (SF-36), Female Sexual Function Index (FSFI) and operated Male to Female Sexual Function Index (oMtFSI) question-naires were web-based administered. Data included: age, area of origin, educational level, sexual orientation, years since surgery and hormone therapy. Outcomes: T-test was applied to inspect mean score differences between oTW and cisW, in mental, sexual and physical health; simple correlations and multiple regression analysis revealed how mental, sexual and physical health were concurrently associated in the two groups Results: Response rate 60% (52% oTW, 71% cisW). oTW mean age 38.5 years (SD = 9.3), cisW 37.7 years (SD = 11.5). Both cisW and oTW reported average values in the range of mental, physical and sexual health. Sta-tistical comparisons revealed no significant group differences in mental and physical health. oTW who referred a worse sexual function also reported worse overall mental well-being and higher levels of depressive symptoms. FSFI scores were negatively associated with years since surgery, but not with age. Multiple regression analysis showed that FSFI Pain accounted for a significant unique variance proportion of risk of depression in oTW. FSFI Sexual Pain was the strongest estimator of inter-individual differences in BDI-PC among oTW (P < .01). Clinical Implications: No significant differences in the levels of depressive symptoms, physical and mental well-being were found in oTW and cis-W. The relation between depressive symptoms and sexual function in oTW is stronger than in cisW, and sexual pain substantially predicts risk of depression in oTW. Strengths & Limitations: The evaluation of outcomes using validated questionnaires and the relatively large sam-ple size. The convenience control group reported mental, physical and sexual health levels within the range of Italian normative data. Since this is a cross-sectional study, we must be careful in drawing conclusions from our results. Conclusions: Sexual pain and lubrication difficulties are the main causes of worse sexual function in oTW, highlighting the importance of perioperative counseling to make surgical expectations realistic and to educate to a proper neovagina management. (C) 2021, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.
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关键词
Sexual Function,Questionnaire,Transgender,Functional Outcomes
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