title: Transgender transitioning and change of self-reported sexual orientation.
abstract: OBJECTIVE
  Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known.
  
  
  METHODS
  We included 115 transsexual persons (70 male-to-female "MtF" and 45 female-to-male "FtM") patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition phase. The questionnaire focused on sexual orientation and recalled time points of changes in sexual orientation in the context of transition. Participants were further asked to provide a personal concept for a potential change in sexual orientation.
  
  
  RESULTS
  In total, 32.9% (n = 23) MtF reported a change in sexual orientation in contrast to 22.2% (n = 10) FtM transsexual persons (p = 0.132). Out of these patients, 39.1% (MtF) and 60% (FtM) reported a change in sexual orientation before having undergone any sex reassignment surgery. FtM that had initially been sexually oriented towards males ( = androphilic), were significantly more likely to report on a change in sexual orientation than gynephilic, analloerotic or bisexual FtM (p = 0.012). Similarly, gynephilic MtF reported a change in sexual orientation more frequently than androphilic, analloerotic or bisexual MtF transsexual persons (p =0.05).
  
  
  CONCLUSIONS
  In line with earlier reports, we reveal that a change in self-reported sexual orientation is frequent and does not solely occur in the context of particular transition events. Transsexual persons that are attracted by individuals of the opposite biological sex are more likely to change sexual orientation. Qualitative reports suggest that the individual's biography, autogynephilic and autoandrophilic sexual arousal, confusion before and after transitioning, social and self-acceptance, as well as concept of sexual orientation itself may explain this phenomenon.
authors.affiliation: Department of Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany.
authors.forename: Matthias K
authors.initials: MK
authors.lastname: Auer
authors.affiliation: Institute for Sex Research and Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Fuss
authors.affiliation: Department Molecular Psychology, Max Planck Institute of Psychiatry, Munich, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Höhne
authors.affiliation: Department of Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany.
authors.forename: Günter K
authors.initials: GK
authors.lastname: Stalla
authors.affiliation: Department of Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Sievers
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000502:physiology; D005260:Female; D006716:Homosexuality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D057829:Gender-Affirming Procedures; D057830:Gender-Affirming Surgery; D012725:Sexual Behavior / Q000502:physiology* / Q000523:psychology; D019529:Sexuality / Q000502:physiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000627:therapeutic use; D063106:Transgender Persons
chemical_list: D013739:Testosterone