Initial Psychometric Evaluation of a Brief Sexual Functioning Screening Tool for Transmasculine Adults: Transmasculine Sexual Functioning Index.

Introduction: Evaluation of sexual functioning in transmasculine (TM) adults-those who identify as men, male, transmen, or non-binary yet were assigned a female sex at birth-is limited by lack of availability of brief screening measures.

Aim: Study aims were to (i) conduct initial psychometric evaluation of a brief screening tool to assess sexual functioning in TM adults for easy use in outpatient visits, epidemiologic studies, and assessment of treatment and surgical outcomes and (ii) assess the correlates of sexual functioning.

Methods: The 6-item version of the Female Sexual Function Index was adapted and piloted for use with TM adults. The resulting scale, the Transmasculine Sexual Functioning Index (TM-SFI), was administered to 150 TM adults via computer-assisted self-interview. A multivariable model was fit to assess demographic, psychosocial, and gender affirmation correlates of sexual functioning.

Main Outcome Measure: The main outcomes of this study were the calculated reliability and validity of the TM-SFI and fit cumulative logit models to estimate associations of medical gender affirmation (chest surgery) and body image self-consciousness with level of sexual functioning.

Results: Internal consistency reliability was good (Cronbach's alpha = 0.80). Item correlations ranged from 0.21 to 0.80 (P < .05). All scale items loaded onto a single factor (eigenvalue = 11.13; factor loadings > 0.50), evidence of good construct validity. After controlling for potential confounders, participants who had chest surgery exhibited significantly higher odds of being in the highest sexual functioning tertile relative to those without chest surgery (adjusted odds ratio = 2.46; 95% confidence interval = 1.08-5.64; P = .033). Moderate-to-high body image self-consciousness was associated with lower odds of sexual functioning (adjusted odds ratio = 0.42; 95% confidence interval = 0.18-0.94; P = .035).

Conclusion: Initial evaluation of the TM-SFI warrants formal psychometric validation against clinical diagnoses of sexual functioning concerns in TM patients. The brief screener can be used to assess sexual functioning in TM adults and may identify TM who could benefit from clinical interventions to improve sexual functioning. Reisner SL, Pletta DR, Potter J, et-al. Initial Psychometric Evaluation of a Brief Sexual Functioning Screening Tool for Transmasculine Adults: Transmasculine Sexual Functioning Index. J Sex Med 2020;8:350-360.