Recognizing the diversity of the Portuguese transgender population: A cross-sectional study

The transgender population comprises anyone who wishes to be socially recognized as a distinct gender from their birth-assigned sex, with or without the desire of undergoing gender-affirming treatments. Its complexity is recognized, but remains an understudied topic, particularly in Portugal. The main goal of this study was to recognize and characterize the heterogeneity of this population, by exploring the possible gender identities, sexual orientations, and perspectives on the available treatments for gender dysphoria, including psychotherapy, hormone therapy, and sex-reassignment surgery. We applied an in-person, self-completion survey to 46 transgender individuals followed at the Psychiatry Department of the University Hospital Center of São João. The typical profile of our respondents was a young person, the majority being assigned female at birth, with upper secondary or higher education. Most of the patients were currently undergoing psychotherapy (89.1%) and hormone therapy (60.9%), but only a quarter had breast surgery in the past (26.1%). Satisfaction was lower towards breast surgery, but overall median satisfaction with all procedures was high. This study effectively demonstrates the diversity of the transgender population, pointing out differences in terms of sociodemographic data, gender expression, sexual attraction, treatment adherence and related satisfaction, while also gathering the necessary feedback to improve healthcare.