Harm Reduction for Ourselves & Others: Prevention, Protection, Preservation
Our vision for health justice is having all the tools and information we need to protect ourselves and our sexual partners, and build our families and kinship networks. Health justice is sexual self-determination including the freedom from shame, coercion, or violence. Health justice is having support to become pregnant, to prevent and end pregnancies, and parent our children with dignity. This vision builds on and with the reproductive justice movement.
We provide data about participants’ sexual partners to counteract dangerous myths that Transmasculine people do not need sexual or reproductive health information and services. We use this evidence to demonstrate the need to rethink binary gender concepts in sexual and reproductive health care.
TMSHRJ:LA survey participant
Sexual Identity AND sexual partners
Sexual orientation / Identity terms
WE ASKED PARTICIPANTS ABOUT THE TERMS THEY USED TO DESCRIBE THEIR SEXUAL ORIENTATION OR IDENTITY. Participants could select multiple categories and/or write in terms.
multiple selection QUESTION
About 4% of participants selected the term lesbian and 3% selected same-gender loving. Terms that participants wrote in included: demisexual, graysexual, fluid, Free spirit, Gray-asexual, grey-ace, Gynephilic, Heteroflexible, i don’t know, i dont even know at this point anymore!, I love everyone!, Kinky!, Lesbiqueer, mostly into dudes, Queer heterosexual, Quoiromantic, polyamorous, sapiosexual, Trans, Transsensual, and Unsure.
A smaller portion of BIPOC participant identified as bisexual when compared to white participants.
IDENTIFIED AS BISEXUAL
TMSHRJ:LA survey participant
Sexual PARTNERS BY GENDER
WE ASKed participants about the gender(s) of the recent and lifetime sexual partners. Participants could select multiple categories and/or write in Terms.
at least one sexual partner was trans, nonbinary, genderqueer, gender nonconforming, or two-spirit in their lifetime.
LIFETIME SExual partners
% of those who had a sexual partner in their lifetime.
RECENT Sexual partners
% of those who had a sexual partner in the Past six months (n=231)
TMSHRJ:LA survey participant
Sexual FLUIDITY
We asked participants if they noticed changes in their sexuality after taking testosterone.
The majority of survey participants said they experienced changes in libido and sexual activity after taking testosterone. Many participants also experienced shifts in the number of sexual partners and their sexual orientation. Some said they had an increased desire to partner with men or masculine people, some indicated a stronger desire for women or feminine people, and some described being more open or interested in sexual partners of a variety of genders than they were prior to taking testosterone,
after taking testosterone, participants noticed:
TMSHRJ:LA survey participant
SeXUAL NETWORKING
We asked about whether participants used dating sites & hook up apps to find sexual partners and, if so, what platforms people were using.
Most popular sites/apps
among those with a profile
- 60% – okcupid
- 57% – Tinder
- 33% – Grindr
- 23% – Scruff
- 21% – Fetlife
- 15% – craigslist
- 11% – GROWLr
NEGOTIATING Pleasure, HEALTH & SAFETY
connection to self & otherS
We asked everyone if they were satisfied with their current sex life. WE then ASKED THOSE WHO HAD A RECENT SEXUAL PARTNER about how they were experiencing their sexual interactions.
I feel satisified with my sex life
when I engage in sex with another person...
I feel free to be who I am
- 36% - strongly agree
- 41% - somewhat agree
- 8% - neither agree, nor disagree
- 15% - somewhat or strongly disagree
I experience shame about my body
- 19% - strongly disagree
- 19% - somewhat disagree
- 16% - neither agree, nor disagree
- 46% - somewhat or strongly agree
negotiating Safer Sex with partners
We asked participants about their access to information about safer sex and factors influencing establishing safer sex practices with partners.
Safer sex and partner negotiation
I feel informed about how to have safer sex
- 63% - strongly agree
- 28% - somewhat agree
- 4% - neither agree, nor disagree
- 6% - somewhat or strongly disagree
I feel confident in negotiating safer sex with my sexual partner(s)
- 59% - strongly agree
- 29% - somewhat agree
- 7% - neither agree, nor disagree
- 6% - somewhat or strongly disagree
My current sexual partner(s) and I agree on how to practice safer sex
- 57% - strongly agree
- 19% - somewhat agree
- 18% - neither agree, nor disagree
- 6% - somewhat or strongly disagree
I have felt afraid to talk to my sexual partner(s) about safer sex
- 50% - strongly disagree
- 18% - somewhat disagree
- 15% - neither agree, nor disagree
- 19% - somewhat or strongly agree
transactional sex
We asked participants if they had ever exchanged sex for things they needed, like money, food, drugs, or a place to stay. We recognize these as valid survival strategies and as forms of work. We also know that trading sex for survival can make some trans people more vulnerable to harm. Most participants who said they had recently exchanged sex said they did so for money.
EXCHANGED SEX For money, food, shelter or drugs
TMSHRJ:LA survey participant
access to testing & preventive medicine
screening in the past year
We asked participants about THE TIMING OF THEIR MOST RECENT PREVENTIVE HEALTH SCREENINGS. Preventive Pelvic exams are generally recommended every five years for those who have a normal PAP test & HPV Screening
How comfortable were you when getting your most recent pelvic exam?
- Very uncomfortable
- Somewhat uncomfortable
- Neither comfortable nor uncomfortable
- Somewhat comfortable
- Very comfortable
How likely are you to get a pelvic exam in the future?
- Very likely
- Somewhat likely
- Neither likely nor unlikely
- Somewhat unlikely
- Very unlikely
TMSHRJ:LA survey participant
HIV & STI testing
We asked participants about their most recent test for HIV and other sexually transmitted infections. We then focused on participants who had 2 or more sexual partners in the past six months to better understand gaps in access to care for those with current elevated risks of HIV and/or STIs.
RECENT HIV/STI TESTING AMONG ALL
HIV test
STI testing
RECENT HIV/STI TESTING AMONG THOSE WITH 2+ PARTNERS in the PAST SIX MONTHS
HIV test
STI testing
MOST COMMON testing siteS FOR THOSE TESTED IN THE PAST YEAR
- 43% – Primary care provider
- 13% – LA LGBT Center site
- 8% – St. John's Well Child & Family Center*
- 8% – outside of LA County
- 4% – mobile unit or van
- 4% – LA County public health
- 4% – Planned Parenthood
- 2% – A school or college clinic
- 2% – Asian Pacific AIDS Intervention Team (APAIT)
- 4% - another AIDS services organization (Bienestar, Black AIDS Institute, Las Memorias Project, etc.).
TM HEALTH JUSTICE RESEARCH INITIATIVE: Advisor
Access to PrEP for HIV prevention
we asked participants if they heard of prep, talked to a health care professional about Prep, or been given a prep prescription. More than half said that they might take PrEP it were available to them for free, while only 6% had spoken to a provider about PrEP.
For a broader discussion of this how we determined criteria for PrEP, see our earlier report Addressing HIV Prevention Among Transmasculine Californians.
Do you know a provider you could ask for prescription for PrEP if you wanted one?
- 36% - Yes, definitely.
- 38% - Yes, maybe.
- 16% - No, probably.
- 9% - No, definitely.
How likely would you be to take PrEP if it were available to you for free.
- 17% - I would definitely take it
- 11% - I would probably take it.
- 29% - I might take it.
- 29% - I would probably NOT take it
- 14% - I would definitely NOT take it
contraception, pregnancy & family planning
use of contraceptives
We asked about lifetime and recent use of contraceptive medicine for any reason.
About 20% of participants had used emergency contraception in their lifetime, a figure nearly double the estimated 11% of the general population.
Conversely, fairly few had ever accessed long-acting contraceptives such as an Inter-uterine device (IUD). This suggests a gap in access to contraceptive medicine and highlights the need to protect access to emergency options.
LIFETIME USE
* Use of hormonal birth control or IUDs may be used for contraception or other reasons, such as controlling menstruation.
PAST YEAR
** Among those who had the kinds of sex that can result in pregnancy, this is the % of participants who said they used condoms sometimes, frequently, or always.
More participants who were Black, Indigenous and/or People of Color (BIPOC) had used emergency contraception (Plan B) in their lifetimes (24%) compared to white participants (14%).
USED EMERGENCY CONTRACEPTIVES IN THEIR LIFETIME
TM HEALTH JUSTICE RESEARCH INITIATIVE: Advisor
Pregnancy & childbirth
We asked participants about if they had ever been pregnant and given childbirth. We also asked about access to and interest in future fertility treatment. we also asked whether participants had recently talked about planning a pregnancy with a partner.
More participants who were Black, Indigenous, and/or People of Color (BIPOC) said that they might be interested in fertility treatment in the future than white participants.
INTERESTED IN FERTILITY TREATMENT IN THE FUTURE
TM HEALTH JUSTICE RESEARCH INITIATIVE: Advisor
key takeaways
OUr partners
