Pleasure please! Sexual pleasure and influencing factors in transgender persons: An ENIGI follow-up study

Noor C Gieles; Tim C van de Grift; Els Elaut; Gunter Heylens; Inga Becker-Hebly; Timo O Nieder; Ellen T M Laan; Baudewijntje P C Kreukels

doi:10.1080/26895269.2022.2028693

Pleasure please! Sexual pleasure and influencing factors in transgender persons: An ENIGI follow-up study

Int J Transgend Health. 2022 Jan 31;24(2):212-224. doi: 10.1080/26895269.2022.2028693. eCollection 2023.

Authors

Noor C Gieles¹, Tim C van de Grift², Els Elaut^{3

4}, Gunter Heylens³, Inga Becker-Hebly⁵, Timo O Nieder⁵, Ellen T M Laan⁶, Baudewijntje P C Kreukels²

Affiliations

¹ Department of Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
² Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
³ Center for Sexology and Gender, University Hospital Ghent, Ghent, Belgium.
⁴ Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
⁵ Interdisciplinary Transgender Health Care Center, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁶ Department of Sexology and Psychosomatic Obstetrics and Gynaecology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Abstract

Background: While the importance of sexual pleasure for physical and mental health becomes increasingly evident, research on sexual pleasure in transgender persons is lacking. Recently, the first version of the Amsterdam Sexual Pleasure Index (ASPI Vol. 0.1) was validated in cisgender persons. This questionnaire aims to assess the tendency to experience sexual pleasure independent of gender, sexual orientation or anatomy. Aim: The aims of this study were threefold. First, to perform exploratory scale validation analyses of the ASPI in transgender persons. Secondly, to compare transgender sexual pleasure scores to reference data in cisgender persons. Finally, to identify factors that are associated with sexual pleasure. Methods: In a follow-up study conducted within the European Network for the Investigation of Gender Incongruence (ENIGI), online questionnaires were distributed to persons who had a first clinical contact at gender clinics in Amsterdam, Ghent or Hamburg four to six years earlier. Internal consistency of the ASPI was assessed by calculating McDonald's omega (ω_t). ASPI scores were compared to scores from the cisgender population using a one sample t-test, and linear regressions were conducted to study associations with clinical characteristics, psychological wellbeing, body satisfaction and self-reported happiness. Results: In total, 325 persons filled out the ASPI. The ASPI showed excellent internal consistency (ω_t, all: 0.97; transfeminine: 0.97, transmasculine: 0.97). Compared to data from cisgender persons, transgender participants had significantly lower total ASPI scores (i.e., lower sexual pleasure; transgender vs. cisgender, mean(SD): 4.13(0.94) vs. 4.71(0.61)). Lower age, current happiness and genital body satisfaction were associated with a higher tendency to experience sexual pleasure. Conclusion & discussion: The ASPI can be used to assess the tendency to experience sexual pleasure and associated factors in transgender persons. Future studies are needed to understand interplaying biopsychosocial factors that promote sexual pleasure and hence transgender sexual health and wellbeing.

Keywords: Gender incongruence; gender dysphoria; gender-affirming therapy; sexual health; sexual pleasure.