Sexual Health, Transgender Persons
Conditions
Brief summary
Transgender male (TM) is the minority and difficult to reach-up group. Therefore, there is a lack of research on private issues involving TM, such as sex, eroticism, and sexual risk behavior. This study focuses on TM as the research participant, based on Milton Mayeroff's caring theory, to understand the TM's erotic culture and the sexual risks behavior, to evaluate the need for subsequent sexual health care. The research method is a mixed methods research of explanatory design, which recruits participants through purposive sampling and respondent-driven sample (RDS) methods. The first stage is an online questionnaire survey. A total of 321 TMs were recruited. The time of online questionnaire is about 10-15 minutes to get a preliminary understanding of the erotic and sexual risk experience of TM in Taiwan. In the second stage, focus groups and in-depth interviews will be conducted, 2 hours of each group and interview. A total of 29 transgender man and women, and non-binary participants were recruited. The recruitment will be stop when the data are saturated. The analysis of both quantitative and qualitative data can get an in-depth understanding of sex, eroticism, and sexual risk, and violence experiences of the participants. The research results are important for improving the awareness and identification of sexual risk and the assessment of sexual health care needs of TM in health care profession. The results also serve as a reference guide for the development of care needs on sexual health care and anti-violence of transgender people, and for the implement of a gender-friendly environment for medical care.
Interventions
The first stage is an online questionnaire survey. A total of 321 TMs were recruited. The time of online questionnaire is about 10-15 minutes to get a preliminary understanding of the erotic and sexual risk experience of TM in Taiwan. In the second stage, focus groups and in-depth interviews will be conducted, 2 hours of each group and interview. A total of 29 transgender man and women, and non-binary participants were recruited.
Sponsors
Ministry of Science and Technology, Taiwan
National Taiwan University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
First stage: Inclusion Criteria: 1. People who used to or currently self-identified as transgender men, regardless of whether they have sex reassignment surgery. 2. Be over 20 years old. 3. Citizen and live in Taiwan.
Exclusion criteria
1. Not self-identify as transgender men 2. Younger than 20 years old 3. Not citizen and not live in Taiwan. Second stage 1. People who used to or currently self-identified as transgender men, transgender woman or non-binary, regardless of whether they have gender-affirming surgery. 2. Be over 20 years old. 3. Citizen and live in Taiwan.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | At time of entry into study | After signing the online consent form, fill out the demographic information form and transgender affirmation questionnaire on Google Forms to calculate population proportions and averages.(First stage) |
| Ages of Transgender Men | At time of entry into study | After signing the online consent form, fill out the ages on Google Forms to calculate population proportions and averages.(First stage) |
| Experience of Erotic and Sexual Risk of Transgender Men (Short Sexual Well Being Scale) | At time of entry into study | After signing the online consent form, fill out the Short Sexual Well Being Scale on Google Forms to calculate population proportions and averages.(First stage) Short Sexual Well Being Scale:There are a total of five questions, using a Likert 7 lit table, with scores ranging from 5 (minimum) to 35 (maximum), with the higher the score, the better Sexual Well Being. 1\. I disagree completely, 2. I disagree, 3. I disagree a little, 4. Neutral, 5. I somewhat agree, 6. I agree, 7. I completely agree |
| Experience of Erotic and Sexual Risk of Transgender Men (STIs Prevention Questionnaire) | At time of entry into study | After signing the online consent form, fill out the STIs prevention questionnaire on Google Forms to calculate population proportions and averages.(First stage) |
| Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | months3-6(In the second stage) | In the second stage, focus groups and in-depth interviews will be conducted, 2 hours of each group and interview. The interview outline was revised based on the questionnaire analysis results, and TMs who met the research requirements were selected from the questionnaire respondents to conduct physical focus groups or in-depth face-to-face or video semi-structured interviews on the theme of violence experience. We also recruited Trans woman and non-binary gender groups to conduct focus groups and in-depth interviews to compare the differences in their experiences of violence. The data were categorized into two main themes:Experiences of Abuse & Coping Strategies. |
Countries
Taiwan
Participant flow
Recruitment details
TM participants were recruited using Respondent-Driven Sampling (RDS), starting with individuals who expressed willingness to participate. These participants then referred others to ensure heterogeneity and diversity in the sample. In Stage 2, qualitative interviews with Tran woman and non-binary individuals were conducted using snowball and purposive sampling methods. These groups served as experiential references to complement the qualitative and survey findings from the TM group.
Participants by arm
| Arm | Count |
|---|---|
| Stage 1: Online Survey Transgender Transgender individuals | 321 |
| Stage 2: Focus Groups Transgender Transgender individuals | 29 |
| Total | 350 |
Baseline characteristics
| Characteristic | Stage 1: Online Survey Transgender | Total | Stage 2: Focus Groups Transgender |
|---|---|---|---|
| Age, Continuous | 29.81 years STANDARD_DEVIATION 5.764 | 29.81 years STANDARD_DEVIATION 5.764 | — |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 321 Participants | 350 Participants | 29 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants |
| Region of Enrollment Taiwan | 321 participants | 350 participants | 29 participants |
| Sex/Gender, Customized Male | 269 Participants | 278 Participants | 9 Participants |
| Sex/Gender, Customized Non-binary | 32 Participants | 42 Participants | 10 Participants |
| Sex/Gender, Customized Other | 20 Participants | 20 Participants | 0 Participants |
| Sex/Gender, Customized Trans woman | 0 Participants | 10 Participants | 10 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 350 |
| other Total, other adverse events | 0 / 350 |
| serious Total, serious adverse events | 0 / 350 |
Outcome results
Primary
Ages of Transgender Men
After signing the online consent form, fill out the ages on Google Forms to calculate population proportions and averages.(First stage)
Time frame: At time of entry into study
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Transgender | Ages of Transgender Men | 29.81 years |
Primary
Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire)
After signing the online consent form, fill out the demographic information form and transgender affirmation questionnaire on Google Forms to calculate population proportions and averages.(First stage)
Time frame: At time of entry into study
Population: Transgender individuals
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Gender identity :male | 269 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Gender identity:other | 52 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Sexual orientation:heterosexual | 166 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Sexual orientation:gay | 37 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Sexual orientation:bisexuality | 77 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Sexual orientation:pansexuality | 33 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Sexual orientation:asexuality | 6 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Sexual orientation:other | 2 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Transgender Status:gender dysphoria | 164 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Transgender Status:GAHT | 169 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Transgender Status: chest reconstruction surgery | 138 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Transgender Status: GAS | 43 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men(Demographic Data, Transgender Affirmation Questionnaire) | Transgender Status: genital reconstruction | 6 Participants |
Primary
Experience of Erotic and Sexual Risk of Transgender Men (Short Sexual Well Being Scale)
After signing the online consent form, fill out the Short Sexual Well Being Scale on Google Forms to calculate population proportions and averages.(First stage) Short Sexual Well Being Scale:There are a total of five questions, using a Likert 7 lit table, with scores ranging from 5 (minimum) to 35 (maximum), with the higher the score, the better Sexual Well Being. 1\. I disagree completely, 2. I disagree, 3. I disagree a little, 4. Neutral, 5. I somewhat agree, 6. I agree, 7. I completely agree
Time frame: At time of entry into study
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men (Short Sexual Well Being Scale) | 20.42 score on a scale |
Primary
Experience of Erotic and Sexual Risk of Transgender Men (STIs Prevention Questionnaire)
After signing the online consent form, fill out the STIs prevention questionnaire on Google Forms to calculate population proportions and averages.(First stage)
Time frame: At time of entry into study
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men (STIs Prevention Questionnaire) | HIV screening | 69 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men (STIs Prevention Questionnaire) | HPV screening | 43 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men (STIs Prevention Questionnaire) | Pap smear | 55 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men (STIs Prevention Questionnaire) | STIs | 46 Participants |
| Transgender | Experience of Erotic and Sexual Risk of Transgender Men (STIs Prevention Questionnaire) | used PrEP within a year | 3 Participants |
Primary
Violence Experience of Transgender (Experiences of Abuse & Coping Strategies)
In the second stage, focus groups and in-depth interviews will be conducted, 2 hours of each group and interview. The interview outline was revised based on the questionnaire analysis results, and TMs who met the research requirements were selected from the questionnaire respondents to conduct physical focus groups or in-depth face-to-face or video semi-structured interviews on the theme of violence experience. We also recruited Trans woman and non-binary gender groups to conduct focus groups and in-depth interviews to compare the differences in their experiences of violence. The data were categorized into two main themes:Experiences of Abuse & Coping Strategies.
Time frame: months3-6(In the second stage)
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Experiences of Abuse:verbal abuse | 20 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Experiences of Abuse:physical violence | 6 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Experiences of Abuse:sexual violence | 18 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Experiences of Abuse:microaggression | 19 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Experiences of Abuse:Forced to come out | 8 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:avoiding crowds | 26 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:compromise requirements | 11 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:fits the stereotype | 6 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:communication explanation | 9 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:advance explanation | 11 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:initiative | 6 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:change mindset | 19 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:social welfare and psychological assistance | 11 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:legal assistance | 4 Participants |
| Transgender | Violence Experience of Transgender (Experiences of Abuse & Coping Strategies) | Coping Strategies:peer support | 9 Participants |