Abstract Introduction Transgender and gender-diverse individuals often avoid gynecological care due to fear of discrimination and dysphoria. To address this gap, a gender-neutral gyneco-sexological outpatient service was established in 2023 within a sexual medicine center. The aim was to combine expert gynecological and sexual health care in an inclusive, respectful environment. The clinic’s design, communication, and electronic systems were adapted for gender neutrality. Over two years, more than 200 transmasculine and non-binary individuals were examined, making this the largest cohort of its kind in the Czech Republic. The service quickly gained excellent feedback from both clients and professionals. Objective The project aimed to (1) create a safe and non-stigmatizing space for gynecological and sexual health care, (2) address complications related to testosterone therapy, (3) analyze barriers to preventive care, and (4) develop a transferable model of inclusive clinical practice. A holistic approach integrating gynecology, endocrinology, sexual medicine, and psychological support was emphasized. Another goal was to strengthen patient trust and improve adherence to regular examinations, which many had previously postponed for years. Methods A retrospective observational study was conducted with 200 transmasculine and gender-diverse patients aged 16–45. Each underwent a comprehensive assessment including medical and hormonal history, gynecological examination, ultrasound, cytology. Common complications associated with long-term testosterone use-such as vaginal atrophy, dryness, spotting, dyspareunia, and infections-were monitored. Qualitative interviews explored patient experiences, previous barriers to care, and satisfaction with the gender-neutral environment. All staff were specifically trained in trans-affirmative communication and adapted record systems allowed patients to choose names and pronouns. Results In total, 200 examinations were performed. The most frequent findings included vaginal atrophy and urogenital syndroma, dyspareunia, recurrent infections and irregular bleeding. Pathological findings requiring intervention occurred in 2 of cases. Anxiety before the first visit was reported by most of patients but decreased significantly during follow-ups. Conclusions This two-year experience confirms that a gender-neutral gyneco-sexological model substantially improves access, adherence, and outcomes for transmasculine and gender-diverse patients. Most gynecological complications are manageable in an affirming outpatient setting. The success of this service demonstrates that professional competence combined with empathy and inclusive communication is crucial for equitable healthcare. The clinic now serves as an educational hub and a model for expanding gender-inclusive practice within sexual and reproductive medicine. Disclosure No
Cahova et al. (Mon,) studied this question.