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Establishment of Rat Models Mimicking Gender-affirming Hormone Therapies
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Assessment of Sexual Activity and Contraceptive Counseling Among Transgender Individuals Initiating Testosterone
Frances W Grimstad1,2,3, Elizabeth R Boskey1,4,5, Rachael S Clark6,7
1Division of Gynecology, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
Perspectives on Sexual and Reproductive Health
|June 18, 2025
Summary
Transgender and non-binary individuals starting testosterone therapy often receive counseling on contraception. Most individuals engaging in penile-vaginal intercourse were documented using contraception, with condoms being most common.
Area of Science:
- Reproductive Health
- Endocrinology
- Gender-Affirming Care
Background:
- Testosterone therapy is used for gender affirmation by some transgender and non-binary (TGNB) individuals assigned female at birth.
- Testosterone is not a contraceptive, and gaps exist in understanding contraceptive counseling for TGNB individuals initiating this therapy.
Purpose of the Study:
- To evaluate the documentation of contraceptive needs assessment and counseling for TGNB individuals starting testosterone therapy.
- To identify patterns in sexual activity assessment and contraceptive use among this population.
Main Methods:
- Retrospective analysis of IRB-approved charts of TGNB individuals undergoing testosterone therapy.
- Evaluation of documentation regarding sexual activity (penile-vaginal intercourse) and contraceptive counseling/use.
Main Results:
- Of 280 individuals, 83% had documented sexual activity assessment.
- 87% of those currently engaging in penile-vaginal intercourse received counseling and 89% used contraception.
- Individuals with a history of intercourse had lower rates of documented counseling (41%) and contraceptive use (49%).
Conclusions:
- Most TGNB individuals initiating testosterone had documented assessments of sexual activity.
- The majority of those at risk for pregnancy received contraceptive counseling and used contraception, primarily condoms.
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