Physical, Mental and Sexual Health Among Transgender Women: A Comparative Study Among Operated Transgender and Cisgender Women in a National Tertiary Referral Network.


Journal

The journal of sexual medicine
ISSN: 1743-6109
Titre abrégé: J Sex Med
Pays: Netherlands
ID NLM: 101230693

Informations de publication

Date de publication:
05 2021
Historique:
received: 23 06 2020
revised: 11 02 2021
accepted: 15 02 2021
pubmed: 28 3 2021
medline: 21 5 2021
entrez: 27 3 2021
Statut: ppublish

Résumé

Few studies have investigated how physical, mental and sexual function are associated with each other in operated transgender women (oTW). To provide information on the physical, mental and sexual health of oTW in comparison with a group of cisgender women (cisW). An age-matched control study was carried out, recruiting 125 oTW in 7 national referral centers and 80 volunteer women. Beck Depression Inventory Primary Care (BDI-PC), General Health Survey (SF-36), Female Sexual Function Index (FSFI) and operated Male to Female Sexual Function Index (oMtFSI) questionnaires were web-based administered. Data included: age, area of origin, educational level, sexual orientation, years since surgery and hormone therapy. T-test was applied to inspect mean score differences between oTW and cisW, in mental, sexual and physical health; simple correlations and multiple regression analysis revealed how mental, sexual and physical health were concurrently associated in the two groups RESULTS: Response rate 60% (52% oTW, 71% cisW). oTW mean age 38.5 years (SD = 9.3), cisW 37.7 years (SD = 11.5). Both cisW and oTW reported average values in the range of mental, physical and sexual health. Statistical comparisons revealed no significant group differences in mental and physical health. oTW who referred a worse sexual function also reported worse overall mental well-being and higher levels of depressive symptoms. FSFI scores were negatively associated with years since surgery, but not with age. Multiple regression analysis showed that FSFI Pain accounted for a significant unique variance proportion of risk of depression in oTW. FSFI Sexual Pain was the strongest estimator of inter-individual differences in BDI-PC among oTW (P < .01). No significant differences in the levels of depressive symptoms, physical and mental well- being were found in oTW and cis-W. The relation between depressive symptoms and sexual function in oTW is stronger than in cisW, and sexual pain substantially predicts risk of depression in oTW. The evaluation of outcomes using validated questionnaires and the relatively large sample size. The convenience control group reported mental, physical and sexual health levels within the range of Italian normative data. Since this is a cross-sectional study, we must be careful in drawing conclusions from our results. Sexual pain and lubrication difficulties are the main causes of worse sexual function in oTW, highlighting the importance of perioperative counseling to make surgical expectations realistic and to educate to a proper neovagina management. Vedovo F, Di Blas L, Aretusi F, et al. Physical, Mental and Sexual Health Among Transgender Women. A comparative Study Among Operated Transgender and Cisgender Women in a National Tertiary Referral Network. J Sex Med Rev 2021;18:982-989.

Sections du résumé

BACKGROUND
Few studies have investigated how physical, mental and sexual function are associated with each other in operated transgender women (oTW).
AIM
To provide information on the physical, mental and sexual health of oTW in comparison with a group of cisgender women (cisW).
METHODS
An age-matched control study was carried out, recruiting 125 oTW in 7 national referral centers and 80 volunteer women. Beck Depression Inventory Primary Care (BDI-PC), General Health Survey (SF-36), Female Sexual Function Index (FSFI) and operated Male to Female Sexual Function Index (oMtFSI) questionnaires were web-based administered. Data included: age, area of origin, educational level, sexual orientation, years since surgery and hormone therapy.
OUTCOMES
T-test was applied to inspect mean score differences between oTW and cisW, in mental, sexual and physical health; simple correlations and multiple regression analysis revealed how mental, sexual and physical health were concurrently associated in the two groups RESULTS: Response rate 60% (52% oTW, 71% cisW). oTW mean age 38.5 years (SD = 9.3), cisW 37.7 years (SD = 11.5). Both cisW and oTW reported average values in the range of mental, physical and sexual health. Statistical comparisons revealed no significant group differences in mental and physical health. oTW who referred a worse sexual function also reported worse overall mental well-being and higher levels of depressive symptoms. FSFI scores were negatively associated with years since surgery, but not with age. Multiple regression analysis showed that FSFI Pain accounted for a significant unique variance proportion of risk of depression in oTW. FSFI Sexual Pain was the strongest estimator of inter-individual differences in BDI-PC among oTW (P < .01).
CLINICAL IMPLICATIONS
No significant differences in the levels of depressive symptoms, physical and mental well- being were found in oTW and cis-W. The relation between depressive symptoms and sexual function in oTW is stronger than in cisW, and sexual pain substantially predicts risk of depression in oTW.
STRENGTHS & LIMITATIONS
The evaluation of outcomes using validated questionnaires and the relatively large sample size. The convenience control group reported mental, physical and sexual health levels within the range of Italian normative data. Since this is a cross-sectional study, we must be careful in drawing conclusions from our results.
CONCLUSIONS
Sexual pain and lubrication difficulties are the main causes of worse sexual function in oTW, highlighting the importance of perioperative counseling to make surgical expectations realistic and to educate to a proper neovagina management. Vedovo F, Di Blas L, Aretusi F, et al. Physical, Mental and Sexual Health Among Transgender Women. A comparative Study Among Operated Transgender and Cisgender Women in a National Tertiary Referral Network. J Sex Med Rev 2021;18:982-989.

Identifiants

pubmed: 33771479
pii: S1743-6095(21)00249-6
doi: 10.1016/j.jsxm.2021.02.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

982-989

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Francesca Vedovo (F)

Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy. Electronic address: francesca.vedovo@gmail.com.

Lisa Di Blas (L)

Department of Life Sciences, University of Trieste, Italy.

Francesco Aretusi (F)

Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy; Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina, Italy.

Marco Falcone (M)

Department of Urology, AO Health and Science City, University of Turin, Italy.

Chiara Perin (C)

Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy; Clinical Psychology Unit, AIED, Pordenone, Italy.

Nicola Pavan (N)

Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.

Michele Rizzo (M)

Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.

Girolamo Morelli (G)

Department of Urology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.

Andrea Cocci (A)

Department of Urology, Careggi Hospital, University of Florence, Italy.

Chiara Polito (C)

Department of Urology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.

Giorgio Gentile (G)

Andrology-Unit, Department of Gynaecology and Urology, University Hospital S. Orsola-Malpighi, Bologna, Italy.

Fulvio Colombo (F)

Andrology-Unit, Department of Gynaecology and Urology, University Hospital S. Orsola-Malpighi, Bologna, Italy.

Massimiliano Timpano (M)

Department of Urology, AO Health and Science City, University of Turin, Italy.

Paolo Verze (P)

Department of Urology, University of Naples, Federico II, Italy.

Ciro Imbimbo (C)

Department of Urology, University of Naples, Federico II, Italy.

Carlo Bettocchi (C)

Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Italy.

Elisabetta Pascolo Fabrici (E)

Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina, Italy.

Alessandro Palmieri (A)

Department of Urology, University of Naples, Federico II, Italy.

Carlo Trombetta (C)

Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.

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