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Over 70% of trans, gender diverse people report at least 2 negative experiences in sexual health care

Over 70% of trans and gender diverse people report at least two negative experiences in sexual health care.

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Even if transgender and gender diverse people have unique risks and needs in the context of sexual health, little is known about sexual health care for this population. This is according to a study coming out of Australia, which found that – exactly because of this issue – over 70% of trans and gender diverse people report at least two negative experiences in sexual health care.

The study – “Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey” by Shoshana Rosenberg, Denton Callander, Martin Holt, Liz Duck-Chong, Mish Pony, Vincent Cornelisse, Amir Baradaran, Dustin T. Duncan, and Teddy Cook – appeared in PLOS ONE.

For this study, the researchers used data from 2018, when a survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analyzed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia.

To analyze, the experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of ‘gender insensitivity’, which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation.

The study found:

  • Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%)
  • Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p<0.001)
  • When controlling for sociodemographic factors, social networks, general access to health care, and sexual practices, higher levels of gender insensitivity in previous sexual health care encounters were associated with a lower likelihood of recent HIV/STI testing (adjusted prevalence ratio = 0.92, 95% confidence interval [CI]:091,0.96, p<0.001) and less-frequent HIV/STI testing (B = -0.07, 95%CI:-0.10,-0.03, p = 0.007)

“Given the high rates of HIV and other STIs among trans and gender diverse people… eliminating cisgenderism and transphobia in sexual health care may help improve access to diagnostic testing to reduce infection rates and support the overall sexual health and well-being of these populations,” the researchers stated.


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