(139) Sexological Characteristics of Transgender Adolescents

Introduction Transgender adolescents face unique circumstances in sexual development and orientation, yet sexological health in this group remains under-researched. Studying sexual health is essential to improve understanding and if necessary, promote sexual health. Objective To describe sexological characteristics of adolescents referred to assessment at a national Gender Identity Service Methods A retrospective cross-sectional analysis was conducted of data from the first clinical assessment of all individuals aged 11–17 years, referred to a national Gender Identity Service between January 1, 2016, and February 1, 2025. Data were extracted from electronic medical records and analyzed descriptively using available-case analysis Results A total of 1,283 adolescents were included, 959 (74.7%) assigned female at birth (AFAB) and 324 assigned male at birth (AMAB), with a median age of 15.3 and 15.9 years respectively. In the AFAB group 88.3% identified as transmasculine and 90.1% of the AMAB as transfeminine, while 6.2% of the AFAB and 4.0 % of the AMAB identified as non-binary. Of the 578 identifying as transmasculine 26.8% reported orientation towards the same sex as their assigned sex at birth, 19.9 % towards the opposite as their assigned sex at birth, 22.8% oriented towards both sexes and 16.4% reported pansexual orientation. In the transfeminine group (n=203) 33.5% were oriented towards the same sex, as their assigned sex at birth, 6.9% towards the opposite of their assigned sex at birth, 28.1% towards both sexes and 12.8 % reported pansexual orientation. At least one change in sexual orientation was reported by 26.5% (57/215) in the transmasculine group and 16.9% (11/65) in the transfeminine group. Among the transmasculine individuals 40.5% (207/512) had never been in a sexual relationship, in the transfeminine group it was 57.6% (99/172). A higher percentage of the transmasculine individuals 67.3% (301/447) reported no sexual debut compared to the transfeminine group 43.7% (71/168). In a small subset no sexual pleasure was reported by 32.1 % (27/84) of the transmasculine and 41.3 % (26/63) of the transfeminine individuals. Body dysphoria was reported by 95% (740/766) of the transmasculine and 91.6% (228/249) of the transfeminine individuals. Conclusions The data provide valuable insight into gender identities, sexual orientation, and experiences among a national cohort of adolescents referred for assessment and gender affirming treatment. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Eli Lilly, Viatris, Freya, Sanofi, Novo Nordic, Lundbeck