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There’s no pamphlet for the kind of sex i have: hiv-related risk factors and protective behaviors among transgender men who have sex with non-transgender men

A majority of the participants reported inconsistent condom use during receptive vaginal and anal sex with non-trans male partners; HIV prevalence was 2. Risk factors included barriers to sexual negotiation including unequal power dynamics, low self-esteem, and need for gender identity affirmation.

Protective strategies included meeting and negotiating with potential partners online. of this study provide initial evidence that current risk behaviors could lead to rising HIV prevalence rates among trans MSM. Prevention programs must tailor services to include issues unique to trans MSM and their non-trans male partners. This body of work has clearly demonstrated that HIV infection disproportionately affects trans women, especially persons of color Herbst et al.

Trans men, like other men, claim a variety of sexual orientations and have sex with various types of sexual partners Schleifer, However, preliminary evidence has suggested that there is a ificant subgroup of trans men who engage in unprotected sex with non-trans men i. In this article, trans men who have sex with non-trans men will be referred to as trans MSM. Some trans men who use testosterone have reported increased sex drive and increased interest in sex with non-trans men after beginning hormone use and have cited these factors as contributing to their willingness to take sexual risks Clements et al.

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Low self-esteem has been cited as a primary reason for sexual risk taking among trans men Adams et al. Rates of depression, substance use, and suicide attempts are also high in this population, but multiple barriers exist to accessing culturally competent treatment Clements-Nolle et al. Trans men have different types of bodies, depending on their use of testosterone and gender confirmation surgeries e. This diversity creates unique needs and barriers to adhering to safer sex practices that are not addressed by current HIV prevention programs.

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The phenomenon of high-risk sex among trans MSM has not yet been fully explored despite the fact that trans men have been repeatedly identified as a group that lacks access to accurate and culturally appropriate sexual health information Clements et al. In addition, very little is known about alcohol and drug use among trans men and the extent to which risky sexual behavior might take place in the context of alcohol and drug use. Quantitative data were collected from a cross-sectional sample of 45 trans MSM living in various cities across the United States Phase I ; 15 of those 45 trans MSM were subsequently selected to participate in in-depth, semi-structured qualitative interviews Phase II.

Participants for the Phase II qualitative interviews were purposively sampled from the Phase I sample based on recency and frequency of sexual encounters with non-trans MSM. Participants with more recent and frequent sexual experience with non-trans men were sought for the qualitative interviews in addition to participants who added demographic variance in order to provide context for the qualitative data and achieve a diverse and balanced sample.

Data collection occurred between March and November of Participants across the United States were recruited via snowball sampling, listservs, and Web sites of interest to trans MSM; two trans men-focused national conferences; and flyer distribution at community events and spaces frequented Trans man getting fucked trans MSM. All participants who met the following criteria were considered eligible for study participation: a ased female gender at birth, b current gender identity is male, transgender male, or another gender identity that the interviewer and participant both agreed falls under the umbrella term transgender and is on the trans masculine spectrum, c age 18 years or older, d English-speaking, and e has ever had sex with a non-trans male as a transgender male.

No restrictions were put on the degree to which the participant had transitioned physically or legally i. However, despite efforts to recruit a diverse sample in regard to testosterone use, only one participant who was not currently using testosterone volunteered for participation. After screening participants and obtaining verbal informed consent, the interviewers administered a to minute structured survey that was conducted either in person or by telephone, depending on the method of recruitment.

Participants who were recruited at conferences or in the San Francisco Bay Area were more likely to be interviewed in person than participants who lived in other locations. Demographic and background information that was collected included age, current zip code, gender identity, sexual orientation, ethnicity, education level, income sources in the past year, and history of incarceration.

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Gender identity and sexual orientation questions were phrased as open-ended questions so that participants could describe these characteristics in their own words i. Hormone use was assessed by asking if the participant had ever used hormones, was currently using hormones, how long the participants had been using hormones if currently using or how long the participant had used hormones if not currently usingand other questions regarding hormone use that were not relevant to the present analysis.

Sexual behaviors were assessed using a series of questions about sex with non-trans men in their lifetime and in the past year, including oral, vaginal, and anal sex, both with and without condoms. Language used to describe genitalia and sex acts was introduced in the section on sexual behavior, and participants were asked to specify their preferences for language to ensure sensitivity and accuracy of responses e.

Following administration of the quantitative survey, participants who were selected for Phase II participation were invited to participate and were scheduled for a qualitative interview. Fifteen trans MSM were selected using data from the Phase I quantitative survey and were scheduled for a minute qualitative interview.

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All participants who were invited to participate in Phase II agreed to participate. Two experienced interviewers, both of whom identified as genderqueer i. Prior to the interviews, the interviewer explained to each participant that participation would be strictly confidential and that all contact information would be destroyed upon completion of the interview.

Participants gave verbal consent so that their names would not be linked to study data.

Interviewers followed an interview guide, which was expanded and refined in response to emergent themes identified by the data analysis process outlined below. Qualitative interviews were digitally recorded and transcribed for detailed analysis of the social context of trans MSM's sexual risk and protective behaviors and perceptions of the impact of their gender identity and gender expression on sexual decision-making and negotiation of safer sex with non-trans MSM.

Descriptive statistics from the quantitative survey included frequencies and percentages for categorical variables and measures of central tendency and variability for continuous variables.

Qualitative interviews were analyzed using Atlas. Analysis of the interview data began immediately following the first interview so that emergent themes identified in initial interviews, such as colloquial language used in trans MSM communities, could be incorporated into subsequent interviews when appropriate. The memos were then used to construct concepts about the data, against which additional data were compared and contrasted, and to synthesize and explain larger segments of data. These memos were then organized into broader themes that addressed the Trans man getting fucked aims of this study.

Of the 45 trans MSM who participated in this study, 37 Participants ranged in age from 18 to 60 years, although the majority of participants were between 18 and 35 years of age see Table 1. Twenty-nine participants More than two thirds When asked the open-ended questions, What is your gender identity?

Twenty-one In response to the gender identity question, 33 Interview participants elaborated on how they experienced their sexual orientation and whether or not that experience remained consistent throughout their transition. Many participants commented on the general sense in the community that many trans MSM experience a shift in their sexual orientation after initiating testosterone use. A few participants commented on their sense of loss of a queer identity when other people perceived them as straight men. One participant stated:.

In the back of my head or subconsciously, I think I always realized that I would be a fag. I mean, sort of anecdotal stuff. For me, I actually had a pretty major shift in who I was attracted to or who I was dating when I originally came out as trans.

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How do we deal with this? What do we do with this? All but one participant were currently taking hormones see Table 2. Participants had been using hormones for an average of 5. Thirty-two participants All participants who were using injectable testosterone reported that they usually obtained their needles from a pharmacy; 5 participants Six None of the participants reported needle sharing for hormone use.

Twelve participants One participant currently using hormones had never had a blood workup. The phenomenon of being socially accepted as male i.

The role of the illusion in the construction of erotic desire: narratives from heterosexual men who have occasional sex with transgender women

The importance of this phenomenon to each individual varied widely; some participants stressed the importance of having their male identity validated in this way, and others expressed ambivalence about people assuming they are a non-trans man. Several participants highlighted the importance of being accepted or socially recognized in non-trans gay male spaces because of the desire to meet people and be seen as a potential sexual partner.

One participant conveyed:. So in that sense, in terms of meeting people or being out in the world, I think that passing has opened things up a lot. Many of the participants described meeting their non-trans male sexual partners over the Internet.

For : trans man

By meeting partners through personal advertisements, they could describe their body and gender identity upfront if they chose to do so and have a dialogue with potential partners to ensure their own safety. Most participants stated that knowing that a potential partner was aware of his trans status and was knowledgeable, accepting, and respectful of his identity were the most important determinants of whether or not he would pursue a sexual relationship or encounter with a non-trans man. Some participants reported that the language they used to describe their gender seemed to have a considerable effect on how people responded.

A few reported experimenting with different terms in different contexts in attempts to reduce surprise and potential stigma. Some participants reported that potential sexual partners sometimes struggled with what it meant about their own sexual identity that they were attracted to or were having sex with a trans man. For all participants, it was clear that language was often inadequate to describe their bodies and identities accurately.

One participant explained:. There was a period of time when I used to say that I was born female. And I noticed when I used those words, it brought up a lot of stuff for them. Their [sexual orientation] was now in question. They came on to me, and if I was born female, what did that mean? Were they gay? Were they bi? What did my body look like? How was this gonna work? If I am in gay male sexual space, the words that I will use to describe myself are more appropriate to that space. So in those situations, I may identify Trans man getting fucked queer; in some of those situations, I will probably more than likely identify as gay.

My ID says male. Some participants described disclosing only on a need-to-know basis with sexual partners. I kind of jerk them off or something like that. Many participants discussed the anxieties related to discussing their bodies and gender identities with potential sexual partners.

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