Components of Good Sex in Young Urban Trans People Assigned Female at Birth: A Qualitative Interview Study

BACKGROUND: Prevalence of sexual dissatisfaction and dysfunction is high in trans people, as reflected in lower sexual pleasure scores compared to cis people.

AIM: The aim of this study is to explore components of good sex and sexual pleasure in young, urban trans people assigned female at birth (AFAB).

METHODS: 16 semi-structured interviews were conducted with young urban AFAB trans people. The interviews were analysed using qualitative content analysis.

OUTCOMES: Main outcomes were providing participants components of good sex and sexual pleasure.

RESULTS: Regarding components of good sex, the participants of this study described various influences on their ability to relax as well as strategies to increase relaxation during sex. Next to general influences on relaxation, the ability to relax was influenced by the way their partners interacted with them and thus how accepted they felt in their identities and feeling safe. Further, transition and coming-out status, physical and sexual function changes due to hormone therapy and gender affirming surgeries, specific sexual techniques and aids, social constructs and the circumstances in which sex took place were important. Strategies to increase relaxation included using aids such as penis prostheses, preferring certain sexual practices, that is, being more dominant or on eye-level, reducing visual aspects, drinking alcohol, and deconstructing gender and sexual norms.

CLINICAL IMPLICATIONS: When working with trans clients, inhibitors of relaxation should be assessed and addressed, which could include working on clients believes about trans sexuality, gendered sexual scripts or various techniques to reduce body dysphoria, if present, during sexual practices.

STRENGTHS & LIMITATIONS: Following a non-clinical community sampling with no treatment-related dependency between researchers and participants, the sample provides an open access to the participating trans people's sexuality. However, the sample is small, selective, and it includes only able-bodied trans people from Christian religious backgrounds.

CONCLUSION: Next to sexual problems and dysfunctions, future research on the relationship between medical transition and sexuality should additionally address positive aspects of sexuality, such as sexual pleasure and sexual satisfaction, and its possible function as a resource pre, during and post transition. Engelmann AJ, Nicklisch S, Nieder TO. Components of Good Sex in Young Urban Trans People Assigned Female at Birth: A Qualitative Interview Study. J Sex Med 2022;19:1687-1706.