Sexual and reproductive health of transgender and non-binary individuals: a scoping review

Abstract


Transgender individuals (TG) are individuals whose gender identity does not correspond to the sex assigned to them at birth. Non-binary individuals (NB) are individuals with a non-binary gender identity (different from female or male). Because of an unusual set of gender/sex characteristics TG and NB have peculiar needs in the sphere of sexual and reproductive health (SRH) which have not been properly explored. The review aims to collect published data on SRH of TG and NB except for topics related HIV/STI, since those topics have already been covered in Russian. A systematic search was conducted in PubMed, Scopus and Web of Science; 64 articles were selected for review. TG and NB have different sexual orientations and engage in various sexual practices. Their sexual quality of life is lower than that in the general population. The reasons include: being unable to accept one's body because of gender dysphoria, fear of rejection on behalf of the partner and complications after surgeries. Most respondents mentioned difficulties finding credible information about SRH for individuals with their bodies and identities. Testosterone is not a reliable form of contraception; for many respondents the choice of contraception methods depended on their experience with gender dysphoria. Hormone-replacement therapy and surgeries lead to decreased fertility or its permanent loss, for which reason some gender clinics provide patients with options for fertility preservation. TG usually rely on assisted reproductive technologies to get pregnant. Pregnancy necessitated stopping using testosterone and could provoke gender dysphoria. Some TG and NB who got pregnant accidentally need access to abortion. TG and NB face significant barriers in access to medical care related to SRH because of binary segregation of such services based on biological sex and negative attitudes of medical personnel.

About the authors

Yana Kirey-Sitnikova

Eurasian Coalition on Health, Rights, Gender and Sexual Diversity, Tallinn, Estonia

Email: yana.kirey.sitnikova@gmail.com

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