Sexual health among transgender people in Sweden

Introduction: Transgender peoples general health and sexual function has previously been studied. However, holistic sexual health-physical, emotional, and relational well-being in relation to sexuality-as both a determinant for and a part of general health is an understudied field in research concerning health among transgender people. There is no research addressing holistic sexual health and sexual health determinants combining quantitative and qualitative data. Aim: To explore and describe holistic sexual health and sexual health determinants among transgender people in Sweden. Methods: For the purpose of this paper, descriptive statistics from a previous web-based survey with 796 respondents and quotes from a previous qualitative interview study with 20 transgender people were combined. Results: Physical, emotional, and relational well-being are all vital aspects for experiencing holistic sexual health; that is, they are all important sexual health determinants, although of different importance to different individuals at different times. Satisfaction with sex life, having an ongoing sexual relationship and having been exposed to disrespectful or discriminatory care are examples of physical, emotional, and relational sexual health determinants that are connected to factors such as condom use, access to respectful STI/HIV-testing and having received reimbursement for sex. Experiences of disrespect and discrimination were reported in both the qualitative and the quantitative data, and in the qualitative data a wish for equity in access to sexual health care is evident. Conclusion: The results provide a broad and extensive insight into transgender peoples sexual health in Sweden. Furthermore it underlines that access to nondiscriminatory health care services is vital, including access to gender-confirming care and different sexual-health-promoting and preventive services such as testing facilities.