(112) DO TRANSGENDER WOMEN TAKING GENDER-AFFIRMING HORMONE THERAPY, AND WITH OR WITHOUT BILATERAL ORCHIECTOMY, EXPERIENCE PENILE ERECTION, AND DO ALL, OR ONLY SOME, REPORT BOTHER FROM ERECTIONS?

Abstract Introduction Gender-affirming (GA) hormone therapy (GAHT) and bilateral orchiectomy (GABO) reduce gender dysphoria in transgender women (TW). A key source of dysphoria in TW is related to erections before patients undergo their vaginoplasty. To date, no studies have described erectile function (EF) among TW pre-vaginoplasty. Objective We aimed to: 1) Evaluate EF in TW only taking GAHT >6 months, and GAHT + >6 months post-GABO; 2) Determine the incidence of erections among TW based upon using their penis for sexual activity; 3) Query interest for any treatment to reduce/eliminate erections pre-vaginoplasty. Methods Pre-vaginoplasty TW on GAHT were surveyed anonymously. Participants were grouped based on GABO status. We queried EF using the Sexual Health Inventory for Men (SHIM) questionnaire pre-GAHT, >6 months on GAHT, and > 6 months post-GABO. We also queried the incidence of any erections in these three states, and, whether patients would undergo a procedure to reduce/eliminate erections. Results 50 participants were surveyed (29 GAHT-only; 21 GAHT+GABO). Median age was 36.5 years (IQR 23.8 years) and median years on GAHT was 5 years (IQR 5 years). 35/50 (70%) participants reported they do not use their penis for sexual activity. TW on GAHT and GAHT+GABO showed reduced SHIM scores, with lowest scores in TW not using their penis for sexual activity (Fig. 1a). Spontaneous erections were significantly reduced in GAHT+GABO women not using their penis during sex, but both groups reported a higher incidence of erections with sexual arousal and activity (b). The majority of TW showed a high interest in any procedure which could reduce/eliminate their erections (c). Conclusions Our study is the first to show that GAHT reduces SHIM scores, with greater reductions in TW who do not use their penis for sexual activity. GAHT+GABO significantly reduced spontaneous erections vs. GAHT, but did not impact erections with sexual arousal/activity. The majority of women reported an interest in surgically reducing/eliminating their erections. Further study with larger numbers is warranted. Disclosure No.