Sexual health care barriers and HIV/STI prevention for transgender people in Japan

Primary care and sexual health services for transgender people in Japan are lacking. We surveyed 233 transgender patients (57 [24.5%] assigned male at birth [AMABs] and 176 [75.5%] assigned female at birth [AFABs]) at the Personal Health Clinic to collect data on sexually transmitted infections (STI) and human immunodeficiency virus (HIV) risk, as well as lifestyle, stigma, and health literacy. Among respondents, 55% reported a sexual intercourse history, and 7.6% noted a previous STI. Only 62.2% underwent free STI testing. Current smoking rates were 19.3% higher in AFABs. Hospital visit hesitation was reported by 59.6%, and 83.3% experienced daily mental struggles. Awareness of post-exposure prophylaxis and pre-exposure prophylaxis was low. Our findings highlight the urgent need for improved primary care and sexual health services for transgender people in Japan, emphasizing the necessity to increase sexual health care facilities, reduce primary care access barriers, and improve knowledge among health care providers.