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Sex with a transgender or gender diverse person among patients attending a sexual health centre in Melbourne, Australia
  1. Eoin F Cleere1,2,
  2. Christopher K Fairley1,3,
  3. Launcelot McGrath1,2,
  4. Catriona S Bradshaw1,3,
  5. Marcus Y Chen1,3,
  6. Eric P F Chow1,3
  1. 1Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
  2. 2School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
  3. 3Central Clinical School, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr. Eric P F Chow, Melbourne Sexual Health Centre, Carlton, VIC 3053, Australia; echow{at}


Objectives All males and females attending the Melbourne Sexual Health Centre (MSHC) from August 2017 were asked whether they had had sex with a transgender or gender diverse (TGD) person using computer-assisted self-interviewing (CASI). We aimed to verify the self-reported responses via chart review. The secondary aim of this study was to identify whether having sex with a TGD person was associated with STI risk.

Methods This was a retrospective chart analysis of patients visiting MSHC between August and December 2017. Chart review was performed to verify the self-reported responses. Multivariable logistic regression was performed to examine the association between having sex with a TGD person and patients’ characteristics and STI risk.

Results Of the 10 100 male and female consultations, the proportion who reported having sex with a TGD person was 111 (1.0%) and was higher among males (1.3%) than females (0.6%) (p=0.001). After chart review, we could verify 66.9% of the responses, more for males (75.2%) than females (45.2%) (p<0.001). Of the 6822 males, men aged ≥35 years (adjusted OR=2.2; 95% CI 1.1 to 4.1) were more likely to have sex with a TGD person compared with men aged ≤24 years, after adjusting for confounding factors. Sex with a TGD person was not associated with sexual orientation in males. Of the 3278 females, gay and bisexual females had 13.7-fold (95% CI 5.1 to 37.0) higher odds of having sex with a TGD person than heterosexual females. There was no association between chlamydia positivity and sex with a TGD person in both males and females.

Conclusion When a question on TGD partners is asked as part of routine sexual history using CASI, the majority of responses could be verified. TGD partners were most commonly reported among males. These findings underscore the value of asking patients about sex with TGD partners.

  • sexual health
  • women
  • men
  • transsexual
  • gender

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  • Handling editor Jonathan Ross

  • Contributors CKF and EPFC contributed to the conception of this study. EFC conducted literature review, performed data analysis and wrote the first draft of the manuscript. EPFC assisted with statistical analysis. All authors were involved in data interpretation, revised the manuscript critically for important intellectual content and approved the final version.

  • Funding EPFC is supported by the National Health and Medical Research Council (NHMRC) Early Career Fellowship (1091226).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval was obtained from the Alfred Hospital Ethics Committee, Melbourne, Australia (project number 539/17).

  • Provenance and peer review Not commissioned; externally peer reviewed.