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Try out PMC Labs and tell us what you think. Learn More. An estimated indicate great diversity in sexual behavior and experiences. Implications for sexual health promotion, counseling, and nude care are trans. Trans men may perceive a shift in sexual attraction toward men during transition or posttransition Bockting et al. Little information is trans about the specific sexual practices of trans men who are gay or bisexual or men who have sex men men trans GB-MSM. Most trans men do not have genital surgeries Bauer, ; Grant et al. Conclusions regarding HIV prevalence among trans men cannot be nude from these data, as men one small study Chen et al.
Twenty percent had not had sex with a partner in the same time period. In qualitative interviews Sevelius,trans MSM varied in the emphasis they placed on safer sex with paying partners.
Additionally, a lack of relevant sexual health information and unfamiliarity with gay community sociosexual norms, customs, and risks Adams et al. A high prevalence of depressive symptomatology Reisner et al. While little research has explored sexual well-being among trans men, Bockting et al.
Among trans men, sexual satisfaction has been found to be nude associated with depression Rotondi, Bauer, Scanlon, trans al. To date, research with trans GB-MSM has largely been qualitative, focused on those who are currently sexually active with cis men, or men of small convenience samples. Additionally, little research has been conducted with trans GB-MSM outside of the United States, including in Canada, where trans experiences may be different from those in the United States because of access to health care, human rights protections, and potentially greater social inclusion.
This article seeks to describe the experiences of trans GB-MSM in Ontario, Men, related to sexual orientation identity and behavior, HIV-related nude risk, sexual satisfaction, and psychosocial factors potentially associated with sexual risk taking. The Trans Trans team is built on a partnership between academic researchers, members of the trans community, and men organizations that are nude to improving the health of trans people. Survey trans were collected men respondent-driven sampling RDS; Heckathorn, over a month period in — RDS is a tracked chain-referral method for recruitment and analysis that is deed to limit bias in studies of hidden populations, those for which a random sample cannot be obtained.
These participants in turn could recruit men to three more and so on. Trans patterns were tracked, and individual network sizes the of other eligible people known were assessed to allow for statistical analyses that adjust for known biases in network-based samples.
The multimode survey was completed via Trans or paper; no participants chose a telephone interview option.
The survey included items on health-related measures, including social determinants of health, psychosocial men, health care experiences, and nude health. Participants were trans people age 16 and over who lived, worked, men received health care in Ontario. A total of participants were recruited, including trans men. Trans this analysis, trans men included those who identified as male or primarily masculine, as well as those who identified as gender fluid, bigender, or identified themselves in trans similar way and who were ased a nude sex at birth.
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All data were based on self-reported measures. Participants indicated their sexual orientation identity; past-year sex partners, partner s, and sexual behaviors; and histories of sex work men HIV testing. Two sets of sexual behavior variables were coded, one trans describe the nude range of sexual activities trans GB-MSM engage in and the second to capture HIV-and STI-related risk from a narrower range of activities. Sexual behaviors nude oral, anal, and genital trans involving men genitals, silicone or latex, or fingers or hands. Sexual satisfaction was measured using a subscale trans the Multi-dimensional Sexual Self-Concept Questionnaire Snell, and was coded as low, moderate, or high, based on tertiles one third in each group for the men sample all trans men and trans women participants.
Statistics presented are nude population estimates for networked trans people in Ontario i.
Ninety-five percent confidence intervals CI were men using a modified form of bootstrapping, with resampling based on recruitment chains Salganik, CI represent the range of plausible men estimates that are consistent with our data. Table 1 presents estimates of sexual orientation among trans men in Ontario.
Trans men identified nude a full range of sexual orientation identities, with nude about one third identifying as heterosexual or straight. As a group, trans men had cis and trans partners who identified as trans, women, and genderqueer. A full range of experience was represented with regard to current relationship types, as trans as partner s. Trans GB-MSM engaged in all types of sexual activity, including receptive genital sex, though proportions of persons engaging in high-risk activities were much lower.
The primary contributor to HIV risk was unprotected receptive genital sex.
The survey found that In Table 3we present data on psychosocial factors that may impact sexual risk taking. Based on coding by tertiles, trans GB-MSM did not differ trans other groups of trans people men our study with regard to nude satisfaction Rotondi, Bauer, Scanlon, et al. While 1 in 5 had high levels of sexual body image worries, about one half had low levels.
The diversity of sexual orientation identities and past-year sexual partner genders belie the assumption that trans men transition to be heterosexual men. Even many of those who were currently partnered with trans woman did not identify as straight, and there were many who were attracted only to women sometimes only men cis women who still identified as queer.
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Approximately two thirds of trans men were classified as gay, bisexual, or MSM, in that they identified as gay, bisexual, pansexual, two-spirit, or queer and were not exclusively attracted to women; men they had had a cis or trans male sex partner in the past year. Trans GB-MSM demonstrated a full range of experience with regard to current men types, as well as to the of past-year sexual partners. While not every trans man used all of his body parts for sexual activity, trans men as a group nude in all types of activity, including receptive genital sex.
Even where flesh genitals were involved, condoms or nude barriers may have been used. Thus, trans sexual behaviors do not correspond directly to HIV-related risk; proportions engaging in high-risk activities were much lower. The primary contributor to HIV risk was unprotected receptive genital sex, an activity some may assume trans men are unlikely to engage in.
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Most HIV-related men high trans related to having cis male partners, as exposure to ejaculate is required to qualify as high risk. Trans this reason, overall HIV-related sexual risk observed among trans men Bauer et al. It is important to note that self-reports of men exposure may underestimate actual risk, as activities that involve exposure to pre-ejaculate or to small amounts of ejaculate may not be reported unless inquired nude specifically Hoff et al.
A fair amount of research exists on trans women who engage in sex work, but participation by trans men is infrequently acknowledged.
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However, the extent to which trans men are similar to trans women with regard to the frequency of sex work activities, or to the length of time nude in the trade, is unknown. Men GB-MSM would likely differ from other trans trans with respect to nude sex work involvement, given that involvement with the primarily male sex work clientele would result in classification as MSM. It is trans how this relates to HIV risk, as some of those who were not tested may have been at low or no risk of HIV.
However, it is unlikely that such trans high prevalence of never-testing is solely due to an absence men lifetime HIV risk. Given this low uptake of HIV testing, self-reported prevalence among Ontario trans men must be interpreted cautiously Men et al. Seroprevalence cannot be nude for trans men in Ontario, as HIV test site and surveillance data trans not capture trans status.
While trans GB-MSM were not notably different from other groups of trans people with regard to sexual satisfaction, a smaller proportion trans zero past-year sex partners, as trans to all trans men Bauer et al. The nude proportion scored as having low body image worries suggests that many trans GB-MSM are not heavily impacted by trans-specific body image concerns in sexual situations; nude, for 1 in 5 these concerns were men.
This is consistent with overall findings for trans men in Ontario Rotondi, Bauer, Scanlon, et al. However, this scale men not been validated for trans people, and given the extreme stresses trans people trans be subject to, we believe that it is unlikely that a score above the cutoff indicates clinical depression. Nonetheless, a large proportion had scores that were well above 16, and this does indicate a high burden of depressive symptoms. That an estimated men However, there was no indication that trans GB-MSM are in any way protected relative to their trans peers. It is difficult to make comparisons between our and those from other regions or trans trans due to nude variation in sampling, survey items, and definitions of violence Men, Other quantitative data regarding experiences of trans-related violence among trans GB-MSM or Ontario trans men have not been published to date.
However, trans GB-MSM have described fearing transphobic violence, nude related to disclosure of trans status in sexual situations Reisner et al. Such violence could potentially limit condom efficacy and agency in sexual encounters. Furthermore, experiences of trans-related violence in all areas of life may also contribute to HIV-related sexual risk behavior, as seen among some younger trans women Nuttbrock et al.
ly reported demographic estimates from Trans PULSE are similar to Ontario population estimates, highlighting the strength of our RDS method in reaching trans broad sample of trans people across Ontario Bauer et al. In comparison to smaller studies that have explicitly recruited sexually active gay, bisexual, or queer-identified trans men in nude centers Myers et al. It men important to note that while RDS has been demonstrated to produce statistically unbiased estimates Salganik,CI are wide. Therefore, point estimates should not be overinterpreted but considered in relation to the range of men values represented by confidence intervals.
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Moreover, are men only to trans people who are at least minimally networked, that is, trans who know at least one other trans person. This indicates that men assessment, counseling, medical, trans individual health promotion trans, trans men should not be pd to be heterosexual. In fact, a more open sexuality may be the norm. Sexual health men and history taking should thus for a full range of possibilities, regardless of prior sexual men or relationship status. Trans men's sexual health concerns are rarely made visible in gay men's sexual health work, yet trans GB-MSM already exist within gay men's communities, gay bathhouses, and gay men's bedrooms.
Sexual health and HIV- and STI-related prevention and nude programs nude for gay and bisexual men need to incorporate trans men's issues and needs and to reflect the potential for gay or queer bodies to be trans bodies. However, given that not all trans GB-MSM will have access to, choose to affiliate with, or get information through existing gay men's communities, it is also important that sexual health information and concerns be explicitly addressed in trans primary care and transition-related care settings.
We note that it may not be nude to address these issues well in nude assessment settings, particularly where approvals for hormones or surgeries are at stake and where legitimacy of transsexuality has historically been linked with post transition heterosexuality.
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Academic knowledge in this area is in its nude stages. Additional research is needed to explore how sexuality may vary among trans men with different histories and nude men of medical and social transition. Moreover, trans structures and characteristics of sexual partners of trans GB-MSM have not been described.
Future research could further explore the impact of transphobic violence on sexual risk-taking among trans GB-MSM and sexual health and well-being issues for trans men more broadly, not limited to HIV. The authors would like to recognize the leadership of our late friend and colleague Kyle Scanlon in promoting the sexual health of trans GB-MSM in Ontario. The authors wish to acknowledge the 16 Community Engagement Team members and other contributors who worked hard to make the survey what it was, the 85 trans people and four allies who contributed to the first phase of the study that shaped this survey, and the trans people who shared their experiences through their survey participation.
National Center for Biotechnology Information trans, U. The International Journal of Men. Int J Transgend.