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Background: A dearth of research to date has examined the sexual health of transgender men (female-to-males or FTMs), individuals born or assigned female at birth but who identify as male.
Objectives: The purpose of this formative study was to examine initial associations related to HIV and STD sexual risk behavior, including psychosocial risk factors, among FTMs.
Methods: A retrospective chart review was conducted of all transgender patients (n=23) born or assigned female at birth but identifying as FTM who were screened for STDs between July-December 2007 at an urban community health center in Boston, Massachusetts.
Results: Patients had a mean age of 32 years (SD=7) and 48% were non-white. Almost half (48%) were on hormone therapy (testosterone) and 39% had undergone gender-related surgery. One individual was HIV-infected, and two had a history of prior STDs. The majority (57%) identified as bisexual; 30% reported sex with men only in the prior 3 months. Overall, 26% engaged in sexual risk behavior (i.e., unprotected sex with a non-transgender man, condom breakage, anonymous sex) in the prior 3 months. Current alcohol use, history of psychosocial distress, and having sex with men only (versus having had sex with both men and women) were associated with sexual risk behavior (all p’s <0.05).
Conclusions: Providers should not assume FTMs are at low or negligible risk for HIV and STDs, and should be aware that many FTMs identify as bisexual and may have sex with non-transgender males who identify as MSM. Psychosocial health issues may contribute to HIV and STD sexual risk behavior for transgender men.
Implications for Programs, Policy, and/or Research: These data serve as a starting point for additional research investigations with FTM transgender men, in the hope of informing the design of culturally appropriate HIV and STD prevention interventions for this population.