Most men show genital sexual arousal to one preferred gender. Most women show genital arousal to both genders, regardless of their sexual preferences. There is limited knowledge of whether this difference is driven by biological sex or gender identity. Transgender individuals, whose birth sex and gender identity are incongruent, provide a unique opportunity to address this question. We tested whether the genital responses of 25 (female-to-male) transgender men followed their female birth sex or male gender identity. Depending on their surgical status, arousal was assessed with penile gauges or vaginal plethysmographs. Transgender men’s sexual arousal showed both male-typical and female-typical patterns. Across measures, they responded more strongly to their preferred gender than to the other gender, similar to (but not entirely like) 145 cisgender (nontransgender) men. However, they still responded to both genders, similar to 178 cisgender women. In birth-assigned women, both gender identity and biological sex may influence sexual-arousal patterns.

大多数男性对一种首选性别表现​​出生殖器性唤起。大多数女性对两性都表现出生殖器唤醒，无论她们的性取向如何。关于这种差异是由生理性别还是性别认同驱动的，我们知之甚少。出生性别和性别认同不一致的跨性别者提供了一个独特的机会来解决这个问题。我们测试了 25 名（女性对男性）跨性别男性的生殖器反应是否遵循其女性出生性别或男性性别认同。根据他们的手术状态，用阴茎测量仪或阴道体积描记器评估唤醒。跨性别男性的性唤起表现出男性典型和女性典型模式。在各种措施中，他们对自己喜欢的性别的反应比对其他性别的反应更强烈，类似于（但不完全像）145 个顺性别（非跨性别）男性。然而，他们仍然对两种性别都有反应，类似于 178 名顺性女性。在顺产女性中，性别认同和生理性别都可能影响性唤起模式。