ABSTRACT

Multiple surveys have suggested that transgender individuals show lower sexual well-being than cisgender individuals. Most studies, however, are limited in terms of ecological validity and memory bias and cross-sectional in nature. These issues are less prevalent in diary studies monitoring responses over time at home. For three weeks, 47 transgender (M age = 29.00, SD = 11.62) and 52 cisgender individuals (M age = 32.90, SD = 11.44) reported daily on their sexual behavior, sexual esteem and body image. Using multilevel model analyses, we investigated the daily associations between these variables, and addressed differences between transgender and cisgender individuals. We found that in transgender individuals, intimacy predicted sexual esteem; sexual openness predicted sexual esteem and body image; and sexual esteem predicts intimacy, masturbation, and sexual openness on the daily level. While transgender individuals scored lower on daily sexual esteem and body image than cisgender individuals, groups did not differ in daily sexual behavior. They also did not differ in any of the predictive relations described above, but we did find that the association between masturbation and body image was moderated by a cisgender identity, and sexual esteem predicted sexual activity more positively in cisgender compared to transgender individuals. These results complement findings from cross-sectional studies and indicate how transgender individuals struggling with sexuality can increase sexual openness. Implications for clinical practice are that clinicians discussing sexuality with their transgender patients should not define sexual activity too narrowly, and that sexual esteem might be a relevant factor in determining sexual behavior.

摘要

多项调查表明，跨性别者的性幸福感低于顺性别者。然而，大多数研究在生态有效性、记忆偏差和横截面性质方面都受到限制。这些问题在监测家庭一段时间内反应的日记研究中不太常见。在三周的时间里，47 名跨性别者（M年龄 = 29.00，SD  = 11.62）和 52 名顺性别者（M年龄 = 32.90，SD  = 11.44）每天报告他们的性行为、性自尊和身体形象。使用多层次模型分析，我们研究了这些变量之间的日常关联，并解决了跨性别者和顺性别者之间的差异。我们发现，在跨性别者中，亲密关系预示着性自尊。性开放预示着性自尊和身体形象；性自尊预示着日常的亲密、自慰和性开放。虽然跨性别者在日常性自尊和身体形象方面的得分低于顺性别者，但群体在日常性行为方面没有差异。他们在上述任何预测关系上也没有差异，但我们确实发现手淫和身体形象之间的关联受到顺性别身份的调节，与跨性别个体相比，顺性别的性自尊更能积极地预测性活动。这些结果补充了横断面研究的结果，并表明与性行为作斗争的跨性别者如何提高性开放性。对临床实践的启示是，临床医生与跨性别患者讨论性行为时不应过于狭隘地定义性活动，并且性尊重可能是决定性行为的相关因素。