2.7 Gender: Sexual History

Trans and gender diverse people express their sexuality just like everyone else. It’s important trans and gender diverse patients get checked up too. Consider the following scenario.

Jesse is a 22 year old patient presenting for a regular sexual screen check up”

The standard sexual histories often aren’t inclusive of gender diverse patients. Without the use of safe and sensitive language, clinicians might miss out on key information about the patient’s sexual health. Insensitive and disrespectful language makes good rapport nigh impossible and can cause acute distress in some patients. Many transgender and gender diverse patients report having to educate clinicians about themselves and their health. Gender identity is protected by law and as such discrimination against transgender and gender diverse individuals in clinical setting could be unlawful. It is therefore extremely important for clinicians to have basic communication skills with transgender and gender diverse patients in order for them to provide accessible healthcare.


Transgender patients may have a wide range of bodies!

It is of tremendous importance to keep an open mind and a non-judgemental attitude towards patient’s bodies and sexual practices. While gay, lesbian and bisexual sexual experiences have gained relatively more awareness amongst the medical profession and general public, transgender individuals still face a range of health inequalities which may result from ignorance, judgement and prejudices about their bodies and sexual behaviours.

  •         Transgender individuals can affirm their gender both socially and medically. For example, trans women could undergo several years of oestrogen treatment, breast augmentation, chondrolaryngoplasty and vaginoplasty.
  •         Transgender individuals can undergo hormone replacement therapy and some degree of gender affirmation surgery. For example, a man who has had a double mastectomy, but chooses not to have a phalloplasty.
  •         Transgender individuals may only take hormone replacement therapy as part of their gender transition, with no other surgical treatment. For example, a man who has been on testosterone for a couple of years, but uses breast binders and does not wish to undergo gender affirmation surgery.

In any case, the two key principles to keep in mind are:

  1.   Transgender and gender diverse individuals will affirm their gender through different types of medical support. This does not make transgender and gender diverse individuals any less of a man or a woman if they identify as such.
  2.   Everyone’s transition is different. What works for some individuals may not work for others.

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