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Supporting sexuality and improving sexual function in transgender persons.

Review article
Authors Mats Holmberg
Stefan Arver
Cecilia Dhejne
Published in Nature reviews. Urology
Volume 16
Pages 121–139
ISSN 1759-4820
Publication year 2019
Published at Institute of Medicine
Pages 121–139
Language en
Links dx.doi.org/10.1038/s41585-018-0108-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Endocrinology, Plastic surgery, Urology and andrology, Psychology

Abstract

Sexuality is important for most cisgender as well as transgender persons and is an essential aspect of quality of life. For both the patient and their clinicians, managing gender dysphoria includes establishing a comfortable relationship with sexual health issues, which can evolve throughout the course of gender-affirming treatment. Gender-affirming endocrine treatment of transgender men and women has considerable effects on sex drive and sexual function. Gender-affirming surgery (GAS) can improve body satisfaction and ease gender dysphoria, but surgery itself can be associated with sexual sequelae associated with physical constraints of the new genitals or postsurgical pain, psychological difficulties with accepting the new body, or social aspects of having changed gender. In general, a positive body image is associated with better sexual function and satisfaction, but satisfaction with sexual function after GAS can be present despite dissatisfaction with the surgery and vice versa. Factors involved in the integrated experience of gender-affirming treatment and the way in which sexuality is perceived are complex, and supporting sexuality and improving sexual function in transgender patients is, correspondingly, multifaceted. As the transgender patient moves through their life before, during, and after gender-affirming treatment, sexuality and sexual function should be considered and maximized at all stages in order to improve quality of life.

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