Associations between recalled childhood gender nonconformity and adult sexual dysfunction in Denmark: baseline assessment in the Project SEXUS cohort study

TY - JOUR

T1 - Associations between recalled childhood gender nonconformity and adult sexual dysfunction in Denmark: baseline assessment in the Project SEXUS cohort study

AU - Koops, Thula

AU - Bernhard Andresen, Josefine

AU - Graugaard, Christian

AU - Briken, Peer

AU - Bahnsen, Mikkel Kjær

AU - Andersson, Mikael

AU - Frisch, Morten

PY - 2023/11/30

Y1 - 2023/11/30

N2 - BACKGROUND: Sexual dysfunctions may negatively affect an individual's self-perceived womanhood or manhood, but whether gender nonconformity in childhood or adolescence can influence adult sexual functioning has not been examined so far.AIM: To explore the possible link between recalled childhood gender nonconformity and sexual dysfunctions in adulthood in a large sample.METHODS: We analyzed baseline questionnaire data from Project SEXUS, a nationally representative cohort study on sexual health among 15- to 89-year-old Danish citizens. Our sample included sexually active participants aged ≥18 years who were queried about gender nonconformity in childhood or adolescence (N = 21 390). To capture sexual dysfunctions, we assessed (1) difficulties with lubrication, orgasm, vaginal cramps precluding sexual intercourse, and/or genital pain during partnered sexual activity in women and (2) difficulties with erection, premature ejaculation, orgasm, and/or genital pain during partnered sexual activity in men. Furthermore, we assessed whether such difficulties were perceived as problematic. The 6-item Female Sexual Function Index and the 5-item International Index of Erectile Function served as standardized measures. Polytomous logistic regression analyses yielded demographically weighted adjusted odds ratios (aORs) with 95% CIs for associations between childhood gender nonconformity and sexual dysfunctions, controlling for age, sociodemographics, health-related factors, and other potential confounders.OUTCOMES: Sexual difficulties and dysfunctions, as well as scores on the Female Sexual Function Index and International Index of Erectile Function.RESULTS: Age-adjusted odds ratios indicated that sexual dysfunctions were significantly more common among childhood gender-nonconforming than conforming participants. After controlling for additional potential confounders, most sexual dysfunctions-notably, vaginal cramps in women (aOR, 2.12; 95% CI, 1.25-3.60) and genital pain dysfunction in men (aOR, 2.99; 95% CI, 1.79-4.99)-remained significantly increased among childhood gender-nonconforming respondents.CLINICAL IMPLICATIONS: Findings suggest that self-perceived gender nonconformity in childhood or adolescence may negatively affect sexual functioning in adult life. If confirmed by future studies, they may warrant a clinical emphasis on such issues in sexologic treatment and care.STRENGTHS AND LIMITATIONS: Our study is the first to report associations between childhood gender nonconformity and adult sexual dysfunction, building on data from a large-scale, nationally representative cohort study. The retrospective assessment of childhood gender nonconformity via one item might have neglected significant dimensions of this construct.CONCLUSION: The present study is the first to show that individuals who recall being gender nonconforming in childhood or adolescence may be at a greater risk of experiencing sexual dysfunctions, particularly sexual pain disorders, as adults.

AB - BACKGROUND: Sexual dysfunctions may negatively affect an individual's self-perceived womanhood or manhood, but whether gender nonconformity in childhood or adolescence can influence adult sexual functioning has not been examined so far.AIM: To explore the possible link between recalled childhood gender nonconformity and sexual dysfunctions in adulthood in a large sample.METHODS: We analyzed baseline questionnaire data from Project SEXUS, a nationally representative cohort study on sexual health among 15- to 89-year-old Danish citizens. Our sample included sexually active participants aged ≥18 years who were queried about gender nonconformity in childhood or adolescence (N = 21 390). To capture sexual dysfunctions, we assessed (1) difficulties with lubrication, orgasm, vaginal cramps precluding sexual intercourse, and/or genital pain during partnered sexual activity in women and (2) difficulties with erection, premature ejaculation, orgasm, and/or genital pain during partnered sexual activity in men. Furthermore, we assessed whether such difficulties were perceived as problematic. The 6-item Female Sexual Function Index and the 5-item International Index of Erectile Function served as standardized measures. Polytomous logistic regression analyses yielded demographically weighted adjusted odds ratios (aORs) with 95% CIs for associations between childhood gender nonconformity and sexual dysfunctions, controlling for age, sociodemographics, health-related factors, and other potential confounders.OUTCOMES: Sexual difficulties and dysfunctions, as well as scores on the Female Sexual Function Index and International Index of Erectile Function.RESULTS: Age-adjusted odds ratios indicated that sexual dysfunctions were significantly more common among childhood gender-nonconforming than conforming participants. After controlling for additional potential confounders, most sexual dysfunctions-notably, vaginal cramps in women (aOR, 2.12; 95% CI, 1.25-3.60) and genital pain dysfunction in men (aOR, 2.99; 95% CI, 1.79-4.99)-remained significantly increased among childhood gender-nonconforming respondents.CLINICAL IMPLICATIONS: Findings suggest that self-perceived gender nonconformity in childhood or adolescence may negatively affect sexual functioning in adult life. If confirmed by future studies, they may warrant a clinical emphasis on such issues in sexologic treatment and care.STRENGTHS AND LIMITATIONS: Our study is the first to report associations between childhood gender nonconformity and adult sexual dysfunction, building on data from a large-scale, nationally representative cohort study. The retrospective assessment of childhood gender nonconformity via one item might have neglected significant dimensions of this construct.CONCLUSION: The present study is the first to show that individuals who recall being gender nonconforming in childhood or adolescence may be at a greater risk of experiencing sexual dysfunctions, particularly sexual pain disorders, as adults.

U2 - 10.1093/jsxmed/qdad129

DO - 10.1093/jsxmed/qdad129

M3 - SCORING: Journal article

C2 - 37812247

VL - 20

SP - 1451

EP - 1458

JO - J SEX MED

JF - J SEX MED

SN - 1743-6095

IS - 12

ER -