title: Sexual desire in trans persons: associations with sex reassignment treatment.
abstract: BACKGROUND
  Sex steroids and genital surgery are known to affect sexual desire, but little research has focused on the effects of cross-sex hormone therapy and sex reassignment surgery on sexual desire in trans persons.
  
  
  OBJECTIVE
  This study aims to explore associations between sex reassignment therapy (SRT) and sexual desire in a large cohort of trans persons.
  
  
  METHODS
  A cross-sectional single specialized center study including 214 trans women (male-to-female trans persons) and 138 trans men (female-to-male trans persons).
  
  
  METHODS
  Questionnaires assessing demographics, medical history, frequency of sexual desire, hypoactive sexual desire disorder (HSDD), and treatment satisfaction.
  
  
  RESULTS
  In retrospect, 62.4% of trans women reported a decrease in sexual desire after SRT. Seventy-three percent of trans women never or rarely experienced spontaneous and responsive sexual desire. A third reported associated personal or relational distress resulting in a prevalence of HSDD of 22%. Respondents who had undergone vaginoplasty experienced more spontaneous sexual desire compared with those who planned this surgery but had not yet undergone it (P = 0.03). In retrospect, the majority of trans men (71.0%) reported an increase in sexual desire after SRT. Thirty percent of trans men never or rarely felt sexual desire; 39.7% from time to time, and 30.6% often or always. Five percent of trans men met the criteria for HSDD. Trans men who were less satisfied with the phalloplasty had a higher prevalence of HSDD (P = 0.02). Trans persons who were more satisfied with the hormonal therapy had a lower prevalence of HSDD (P = 0.02).
  
  
  CONCLUSIONS
  HSDD was more prevalent in trans women compared with trans men. The majority of trans women reported a decrease in sexual desire after SRT, whereas the opposite was observed in trans men. Our results show a significant sexual impact of surgical interventions and both hormonal and surgical treatment satisfaction on the sexual desire in trans persons.
authors.affiliation: Department of Endocrinology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Wierckx
authors.forename: Els
authors.initials: E
authors.lastname: Elaut
authors.forename: Birgit
authors.initials: B
authors.lastname: Van Hoorde
authors.forename: Gunter
authors.initials: G
authors.lastname: Heylens
authors.forename: Griet
authors.initials: G
authors.lastname: De Cuypere
authors.forename: Stan
authors.initials: S
authors.lastname: Monstrey
authors.forename: Steven
authors.initials: S
authors.lastname: Weyers
authors.forename: Piet
authors.initials: P
authors.lastname: Hoebeke
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007989:Libido / Q000187:drug effects / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D015995:Prevalence; D057829:Gender-Affirming Procedures; D012725:Sexual Behavior / Q000187:drug effects; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*; D014621:Vagina / Q000601:surgery
chemical_list: D012739:Gonadal Steroid Hormones
keywords: Cross-Sex Hormone Therapy; Gender Identity Disorder; Sexual Desire; Sexual Functioning; Transsexual