Access to gender-affirming hormone therapy is positively associated with uptake of STI testing

Ruby Lucas; Emerson Dusic; Jessie M. Garcia Gutiérrez; Audren J. K. Bambilla; Daphne Suen; Nathaniel M. Widmann; Aleks Martin; Alic Shook; Baer Karrington; Deborah Schwarz; Genya Shimkin; Vanessa Grandberry; Xero Xanadu; Marta G. Wilson-Barthes; Timothy Souza; Stephaun Wallace; Renee Heffron; Omar Galarraga; Don Operario; Kristi E. Gamarel; Arjee Restar

doi:10.1071/SH24238

RESEARCH ARTICLE

Next Contents Vol 22(5)

Access to gender-affirming hormone therapy is positively associated with uptake of STI testing

Ruby Lucas

^A ^* , Emerson Dusic ^A , Jessie M. Garcia Gutiérrez ^A , Audren J. K. Bambilla ^A , Daphne Suen ^A , Nathaniel M. Widmann ^A , Aleks Martin ^B , Alic Shook ^C , Baer Karrington ^D , Deborah Schwarz ^A , Genya Shimkin ^A , Vanessa Grandberry ^B , Xero Xanadu ^A , Marta G. Wilson-Barthes ^E , Timothy Souza ^E ^F , Stephaun Wallace ^A , Renee Heffron ^G , Omar Galarraga ^E , Don Operario ^H , Kristi E. Gamarel ^I ^J and Arjee Restar ^A ^K ^L

+ Author Affiliations

- Author Affiliations

^A Departments of Epidemiology and Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.

^B Public Health – Seattle and King County, Seattle, WA, USA.

^C College of Nursing, Seattle University, Seattle, WA, USA.

^D Seattle Children’s Hospital, Seattle, WA, USA.

^E Center for Global Public Health, Brown University School of Public Health, Providence, RI, USA.

^F Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA.

^G Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

^H Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA.

^I Department of Health Behavior and Health Equity, University of Michigan School of Public Health, Ann Arbor, MI, USA.

^J Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.

^K Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA.

^L Weitzman Institute, Moses Weitzman Health System, Washington, DC, USA.

^* Correspondence to: rlucas2@uw.edu

Handling Editor: Joseph Tucker

Sexual Health 22, SH24238 https://doi.org/10.1071/SH24238

Submitted: 11 December 2024 Accepted: 14 August 2025 Published: 4 September 2025

Abstract

Background

Gender-affirming medical care access may improve the STI care continuum for transgender and nonbinary communities. This study examined the association between gender-affirming hormone therapy (GAHT) and uptake of STI testing.

Methods

The Priority Assessment in Trans Health Project is a community-informed study developed by trans Washingtonians. Data were collected from March to May 2023 through community organizations and media platforms. All recruited participants were included in analysis. Descriptive statistics with chi-squared tests (α = 0.05) were conducted to compare group differences. An adjusted multivariable regression model measured the association between current GAHT and STI testing. Differences across STI status were measured descriptively.

Results

Compared with individuals who did not receive an STI test (n = 59), those who had received an STI test in the past year (n = 738) were more likely to be: aged 25–29 years (48% vs 24%), a woman (86% vs 37%), have private health insurance (81% vs 42%) and currently be using GAHT (78% vs 32%). Individuals who tested positive for an STI (n = 34) were more likely to be aged 18–24 years (24% vs 11%) and to have public health insurance (50% vs 16%) than those who did not test positive for an STI. GAHT use was significantly associated with increased odds of STI testing engagement (OR 4.48, 95% CI: 2.01, 10.26, P = 0.0003).

Conclusion

Our findings suggest the need to explore factors influencing medical gender affirmation and uptake of STI testing and other sexual and reproductive services, and support that access to gender-affirming services can be leveraged for STI prevention.

Keywords: access, barriers, gender-affirming care, gender-affirming hormone therapy, nonbinary, prevention, sexual and reproductive health, STI, transgender.

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Access to gender-affirming hormone therapy is positively associated with uptake of STI testing

Abstract

References

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