Effects of Gender-Affirming Hormone Therapy on Orgasm Function of Transgender Men and Women: A Long Term Follow Up

Published:January 13, 2023DOI:



      To assess the reported changes in orgasm quality and function of transgender men (TM) and transgender women (TW) after commencing gender-affirming hormone therapy (GAHT).


      We queried potential changes in orgasm function before and after commencing GAHT (minimum 1 year) among 130 consecutive TW and 33 TM. We queried the following domains under a uniform condition (masturbation): 1. Lead-time to reach orgasm, 2. Duration of orgasm, 3. Body location of orgasm sensation; 4. Description of orgasm as either a single or multiple-peak event, 5. Duration of post-orgasm refractory period, and 6. Overall satisfaction with orgasm quality.


      Within groups by gender, TW and TM reported similar responses to our inventory before starting GAHT. After commencing GAHT, TW reported notable changes in orgasm function: increase in lead-time necessary to reach orgasm, orgasm duration, and overall orgasm satisfaction. Similarly, TM reported an increase in duration of orgasm and increased overall satisfaction with orgasm quality.
      Over half of the TW reported experiencing orgasms in new/additional body locations. Additionally, prior to commencing GAHT, the majority of TM and TW patients reported their orgasms as a short, single-peak event but following GAHT these same patients reported longer and protracted multiple-peak orgasms.


      GAHT has the potential to positively improve orgasm quality for transgender patients undergoing gender transition. It is important to share such data with patients prospectively before treatments.

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