Learning about the sexual and romantic lives of trans and gender diverse people.
Thank you to everyone who participated in The Australian Trans and Gender Diverse Sexual Health Survey.
Your support helped make this survey the largest study of trans and gender diverse people to have been conducted in Australia to-date! With participants from every state and territory, the survey findings are a powerful new source of data that can be used to guide policy, enhance service delivery, and inform strategies for improving the sexual health and well-being of all trans and gender diverse people.
Key findings, implications and recommendations
Trans and gender diverse people in Australia reported diverse experiences, practices and identities in the context of sex and romance. The survey found that many trans and gender diverse people lead fulfilling sexual and romantic lives. The survey also found, however, a number of areas requiring urgent attention. These include:
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The prevalence of sexual violence or coercion among trans and gender diverse people is exceptionally high. Survey participants reported lifetime rates of sexual violence or coercion nearly four times higher than has been found among the general Australian public. Steps must be taken to (i) review and enhance sexual violence support services to ensure that they meet the needs of trans and gender diverse people, (ii) engage with trans and gender diverse communities to develop and implement targeted models of support for those who experience sexual violence or coercion, and (iii) conduct research to identify the root causes of sexual violence and coercion, including to understand its perpetrators.
When accessing care related to sexual health, trans and gender diverse people experience marginalisation because of their gender. Experiences of gender-insensitivity undermine confidence care and were associated with less uptake of testing for HIV and other STIs. Steps must be taken to (i) amend health systems nationally to properly collect gender details, (ii) reinforce a culture where health providers do not make assumptions about patients’ bodies nor their sexual partners or practices, instead letting people use their own language to describe their experiences, and (iii) amend strategies for preventing and managing HIV, other STIs and hepatitis C to meaningfully include trans and gender diverse people.
Trans and gender diverse people are unable to access some or all of the medical processes they seek to affirm their gender. Survey findings suggest that lack of access to gender affirmation has a negative impact on sexual satisfaction and overall mental health. Steps must be taken to (i) implement the ‘informed consent model’ in order to facilitate greater access to gender affirming care, (ii) improve training and mentorship for clinicians to provide accurate information on gender affirming care in general practice, and (iii) expand Medicare and the Pharmaceutical Benefits Scheme to simplify access to medical gender affirming processes.
Sex education does not support the needs of trans and gender diverse people. To address this gap, specific attention to the sexual lives of trans and gender diverse people should be included in Australian curricula, including greater emphasis on consent and the diversity of genders and sexualities. Further, the development and dissemination of resources that support the sexual and romantic lives of trans and gender diverse people should be undertaken.
This study is a collaboration between researchers, community advocates, clinicians, and health experts. It is a study led by trans and gender diverse investigators in partnership with their cisgender colleagues, coordinated centrally by the Kirby Institute for Infection and Immunity in Society at UNSW Sydney.