Prevalence of Vulvar Pain and Dyspareunia in Trans Masculine Individuals

Purpose: The prevalence of vulvar pain and dyspareunia has not been studied in trans masculine individuals. The aim of this study was to determine the prevalence of self-reported vulvar pain symptoms and dyspareunia in this population and investigate its relationship to gender-affirming hormone therapy with testosterone. Methods: Trans masculine individuals of ages 18-64 years participated in a voluntary online survey including questions about demographics, hormone therapy, and whether they experienced vulvar pain symptoms. The study was conducted between May 2017 and October 2018. Descriptive statistics were used to analyze the data. Results: A total of 782 trans masculine individuals completed the survey. The mean age was 27 years (standard deviation 8.6). The majority was White (661/778, 85.0%) and had private health insurance (517/781, 66.2%). Testosterone use was reported by 468 of 782 (59.8%) individuals, and 566 of 672 (84.2%) individuals had been sexually active in their lifetime. Unintentional pain with sexual intercourse was experienced by 372 of 605 (61.5%) participants. A total of 236 of 399 (59.1%) individuals utilized testosterone compared with 136 of 206 (66.0%) individuals who did not (p = 0.11). Of survey respondents, 68 of 710 (9.6%) individuals reported vulvar pain symptoms, and 42 of 452 (9.3%) individuals were on testosterone compared with 26 of 258 (10.1%) individuals not on testosterone (p = 0.79). Of all participants experiencing vulvar pain symptoms, 42 of 68 (61.8%) individuals were on testosterone. Conclusion: In this study, trans masculine individuals had a higher prevalence of dyspareunia than the general population, whereas the prevalence of vulvar pain was similar to that reported in cisgender women. The use of testosterone did not appear to increase the risk of developing unintentional pain with intercourse or vulvar pain symptoms.