"Research into the impact of transition on sexuality reports that, following the commencement of HT, some trans women experience a temporary change in sexual desire (Defreyne et al., 2020). Research has found that trans women are less likely to engage in sexual activities before accessing gender-affirming care (Scheim & Bauer, 2019), and some experience a reduction in sexual activities after starting HT (Knezevich et al., 2012). Rosenberg et al. (2019) also found a difference in orgasm experience after commencing HT in trans women. One clinic-based study further found that as many as 32% of trans women may experience a change in sexual orientation during medical transition (Auer et al., 2014). Barcelos et al. (2022) conducted a systematic review of the available literature concerning trans women’s sexual functioning. They found that, of the 17 available studies, there was a large divergence in how sexual functioning was measured, and overall, there was limited evidence that gender-affirming surgery improved sexual functioning overall."