Mapping the evidence on sexual desire and sexual interest in transgender populations: a scoping review.

Abstract

Introduction: Research on sexual desire is limited and inconsistent for transgender populations. This scoping review consolidates findings and clarifies measurement practices, associations, and prevalence for sexual desire in this population. The objective of this scoping review is to map how sexual desire and low sexual desire are measured and defined in transgender populations using validated instruments, including whether distress or impairment is assessed, and to identify limitations of cisgender-validated tools.

Methods: A scoping review following PRISMA-ScR guidelines was registered on the Open Science Framework (https://osf.io/wh2uf/overview). An exhaustive search of ten databases was conducted in October 2025 to identify literature on SD among transgender individuals. Two reviewers independently screened records, and a third resolved conflicts. Data were extracted using a standardized Qualtrics form and synthesized narratively with tabular support; methodological quality was assessed using Johanna Briggs Institute tools.

Results: Of 3780 records screened, 20 studies met inclusion criteria. All used cisgender-validated instruments, mostly treating desire as a continuous variable. Only four assessed distress. Cross-sectional studies found transgender participants scored between cisgender men and women. Longitudinal studies showed early desire decreases in trans women and early increases in trans men following gender-affirming hormone therapy, later stabilizing in both groups. Desire showed inconsistent associations with surgeries, relationship status, body image, gender dysphoria, mood, and sexual history.

Conclusion: Sexual Desire in transgender populations is predominantly measured using instruments validated for cisgender individuals, with low desire treated as a functional dimension rather than as a distress-based disorder. Few studies assessed distress alongside low desire. Desire patterns appear dynamic across medical transitions, particularly with hormone initiation, and are variably influenced by psychosocial factors. Development of gender-inclusive, validated measurement tools is urgently needed to distinguish normative variability from clinically significant disturbances and improve care.