title: Sexual orientation of trans adults is not linked to outcome of transition-related health care, but worth asking.
abstract: Since the beginning of contemporary transition-related care at the outset of the 20th century, sexual orientation has ben considered to be closely connected with gender identity and the developmental trajectories of trans people. Specifically, health professionals have regarded the anticipated post-transitional heterosexual behaviour of trans adults as predictive of a good outcome of cross-sex hormones and gender-confirming surgeries. This article reviews the current literature according to the question of whether the sexual orientation of trans people is linked to outcome measures following transition-related interventions. A comprehensive review was undertaken using the Medline database, searching for empirical studies published between 2010 and 2015. Out of a total of 474 studies, only 10 studies reported a follow-up of trans adults and assessed sexual orientation in the study protocol at all. Sexual orientation was predominantly assessed as homosexual versus non-homosexual related to sex assigned at birth. Only one 1 of 10 follow-up studies found a significant association according to the outcome between groups differentiated by sexual orientation. Empirically there is no link between sexual orientation and outcome of transition-related health care for trans adults. In order to provide comprehensive health care, we recommend asking for sexual behaviours, attractions and identities, as well as for gender experiences and expressions; however, this knowledge should not drive, but simply inform, such comprehensive care.
authors.affiliation: a Interdisciplinary Transgender Health Care Centre Hamburg, Department for Sex Research and Forensic Psychiatry , University Medical Centre Hamburg-Eppendorf (UKE) , Germany ;
authors.forename: Timo O
authors.initials: TO
authors.lastname: Nieder
authors.affiliation: b Centre for Sexology and Gender, Ghent University Hospital , Belgium ;
authors.forename: Els
authors.initials: E
authors.lastname: Elaut
authors.affiliation: c Nottingham Centre for Gender Dysphoria , Nottingham , UK ;|d Charing Cross Gender Identity Clinic , London , UK.
authors.forename: Christina
authors.initials: C
authors.lastname: Richards
authors.affiliation: a Interdisciplinary Transgender Health Care Centre Hamburg, Department for Sex Research and Forensic Psychiatry , University Medical Centre Hamburg-Eppendorf (UKE) , Germany ;
authors.forename: Arne
authors.initials: A
authors.lastname: Dekker
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D057829:Gender-Affirming Procedures; D012725:Sexual Behavior / Q000523:psychology*; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome
keywords: Trans; follow-up; gender dysphoria; outcome; sexual orientation; transgender