“Sex is not just an act but also a place to be human, to be authentic.” A qualitative interview study on practices of healthcare professionals in sexological care for transgender and non-binary people

Background: Transgender or non-binary (TNB) individuals face specific challenges regarding their sexual well-being. Transition is associated with changes in sexual self-concept, sexual development and sexual experiences. Scientific literature and clinical guidance on sexological care provision tailored to TNB clients who experience sexual problems is limited. However, healthcare professionals (HCPs) with experience in sexological care for TNB clients may hold valuable practice-based knowledge that could inform HCPs’ training in sexology. Methods: To elucidate these practices, we conducted a qualitative interview study among 13 respondents. We analyzed these findings using thematic analysis. Results: While sexological care for TNB and cisgender clients was not considered fundamentally different, HCPs described specific practices related to 1) reflecting on one’s positionality, practices, and the care context, 2) addressing societal narratives and personal sexual encounters, 3) providing inclusive information on sexuality, 4) unraveling entanglements between body image, transition, and sexual experiences, and 5) encouraging positive sexual experiences. HCPs highlight the importance of a biopsychosocial and positive approach to sexological care in all clients. Additionally, providing sexological care to TNB clients requires HCPs to be cognizant of how societal and identity-related factors may contribute to the experience of a sexual problem. Conclusion & discussion: While little clinical guidance is available, HCPs with experience in sexological care provision to TNB individuals hold practice-based knowledge that can be used to inform tailored sexological care provision. Integrating these findings into medical and sexological curricula can promote expertise and critical reflection on the provision of tailored sexological care to TNB individuals.