9 Facts About Trans Sexual and Reproductive Health

In celebration of National LGBT Health Awareness Week, NCTE has released this preview of a fact sheet, Transgender Sexual and Reproductive Health: Unmet Needs and Barriers to Care.  The full fact sheet will include policy recommendations for the medical community to improve the delivery of health care. Join our mailing list to get your copy of the final fact sheet.

Key facts on sexual and reproductive health for transgender people:

1. Transgender people may have sexual partners who are men, women, or both. A transgender person’s partners or sexual history cannot be assumed from their gender identity or the gender they were assigned at birth.

2. Transgender people need preventive health screenings. Standard preventive health screenings are generally recommended for the body parts a patient has regardless of that patient’s gender identity, including breast, cervical, and prostate cancer screenings.

3. Transgender people are at high risk for HIV and other STI infections. According to the CDC, transgender people experience HIV infection at four times the national population level. African-American and Latino/a transgender people are at especially high risk for HIV and other STIs.

4. Many transgender men who have sex with men are at risk for unintended pregnancy as well as STIs. Transgender men who have sex with men report high rates of unprotected vaginal and anal intercourse. Some transgender men report being more concerned about pregnancy than HIV and other STIs.

5. Marginalization and abuse increase health risks for transgender people. Transgender people face high rates of social and economic marginalization, as well as high rates of physical and sexual abuse. Transgender and gender nonconforming youth are particularly at risk for sexual abuse and for engaging in commercial or survival sex.

6. Transgender people are often reluctant to seek sexual and reproductive health care. One in three transgender people, and 48% of transgender men, have delayed or avoided preventive health care such as pelvic exams or STI screening out of fear of discrimination or disrespect. One survey reported that half of transgender men did not receive annual pelvic exams. Reasons included discomfort with the physical exam due to gender issues (40%), lack of money or insurance (13%), lack of a medical provider they were comfortable with (13%), and thinking they did not need pelvic exams (7%). Another survey found that transgender teens, including those at risk for unintended pregnancy, were reluctant to go to a family planning clinic.

7. Transgender people lack access to relevant health information. Sexual health education for youth and adults rarely addresses transgender people’s bodies and identities. For example, transgender men who have sex with men report a lack of adequate information about their sexual health at rates as high as 93.8%.

8. Providers often lack appropriate clinical knowledge. While treating transgender patients does not require special expertise, providers often lack basic knowledge about transgender people and their health needs. In a nationwide survey, 50% of transgender people reported having to teach a health care provider about providing appropriate care.

9. Many providers still turn transgender patients away. In national surveys, 19% to 27% of transgender people report being turned away by health care providers who refused to provide care for them. Outright refusals of care occur across all types of providers, including providers of sexual and reproductive health care.