Sociodemographic determinants of sexuality among transmasculine and transfeminine individuals: A cross‐sectional study in São Paulo, Brazil

Abstract Objective This study assessed the associations between gender identity (transmasculine vs transfeminine) and sexuality‐related variables, including marital status, sexual partners, sex work, and age at first intercourse. Methods We conducted a cross‐sectional retrospective study at a specialized transgender clinic in São Paulo, Brazil, analyzing medical records from March 2020 to August 2023. Data were routinely collected during clinical consultations through standardized questions for individualized care. Group assignment was based on self‐identified gender identity documented in medical records. Chi‐square and t ‐tests were applied ( P < 0.05). Results We evaluated 74 individuals (trans men = 49, trans women = 25). Trans women were more frequently single (76% vs 44.9%, P = 0.014). Most reported one to five partners, but trans women more frequently reported no partners (16.7%) or >15 partners (11.1%) ( P = 0.043). Sex work was more common among trans women (21.7% vs 6.3%, P = 0.049). No significant difference in age at first intercourse was observed ( P = 0.298). Conclusion Gender identity significantly influences relationship status, sexual behavior, and sex work engagement among transgender individuals. Trans women experienced greater sexual vulnerability, reflecting social exclusion and structural transphobia. These findings underscore the need for inclusive sexual health strategies and policies reducing structural inequalities.