Publication Date




Download Full Text (365 KB)


Introduction Previous studies of transgender/gender diverse (TGD) youth indicate differences in rates of sexual behaviors between TGD youth and their cisgender peers. However, few studies have reported the sexual behavior and preferences of TGD youth in a large clinic sample, and no studies, to our knowledge, have utilized questionnaires that do not assume the sex or gender of one’s sexual partner. The current study aims to explore the self-reported sexual behavior of TGD youth presenting for gender-affirming medical care. Methods Retrospective chart review of 589 patients (ages 12-22, M= 15.92, SD= 1.54; 72.9% assigned female sex at birth (SAB)) presenting for an initial visit at a pediatric transgender clinic from 2015-2021. Patients self-reported their gender identity, sexual behavior, sexual partners, and sexual interests via a REDCap electronic survey. Results Rates of dating (39.3% v 68.3%; X2=216.06, p< 0.0001) and sexual intercourse (22.9% vs 39.5% X2=65.69, p< 0.0001) among TGD youth were significantly lower than national norms (Kann et al., 2018). Rates of self-reported being forced to have sex among TGD youth was 7.6% and did not differ significantly from national norms (6.9%, ns; Kann et al., 2018). In the last year, TGD youth reported having one sexual partner (58.2%), 2-3 partners (19.4%), no partners (11.2%), 4-7 partners (8.2%), 8-10 partners (2.2%), and more than 10 partners (0.7%). Most TGD reported they were not likely to have sex in the next year (60.2%). TGD youth reporting using their mouth (11.2%), vagina (7.1%), penis (2.5%), anus (2.2%), or none of these body parts (0.7%) during sex. The gender of TGD youth partners included cisgender female (6.6%), cisgender male (5.8%), gender nonconforming female SAB (2.2%), transgender male (2.0%), gender nonconforming male SAB (1.4%), and transgender female (0.8%). Conclusions Results suggest that rates of dating and sexual intercourse among TGD youth are significantly lower than national norms. Clinically, results support screening for sexual behaviors and health among TGD youth and utilizing measures that do not assume the sex or gender of one’s partners. Future research should aim to develop a standardized measure of sexual behavior that addresses the unique needs of TGD youth to improve the accuracy of reporting in this population.


Behavioral Medicine | Pediatrics


Presented at the Society of Pediatric Psychology Annual Conference; Phoenix, AZ; April 7-9, 2022.

Self-Reported Sexual Behavior in A Pediatric Gender Clinic Sample