(146) Mapping The Evidence On Hypoactive Sexual Desire Disorder And Sexual Desire/Interest In Transgender Populations: A Scoping Review

Abstract Introduction Despite the importance of sexual health to overall quality of life, research on disorders of sexual desire (SD) remains limited and inconsistent for transgender individuals. Understanding SD in transgender people requires accounting for biopsychosocial influences and gender-affirming interventions. This scoping review consolidates findings and clarifies measurement practices, associations, and prevalence, without restricting its scope to DSM criteria for Hypoactive Sexual Desire Disorder (HSDD). Objective The aim was to map how SD and related disorders are measured in transgender populations, evaluate consistency in definitions (eg, cutoffs, distress criteria), and identify cis-normative instrument limitations. Methods A scoping review following PRISMA-ScR guidelines was registered on the Open Science Framework. An exhaustive search of ten databases was conducted in March 2025 to identify literature on SD among transgender individuals. Only primary studies published between 1995 to 2025 using validated instruments to assess sexual desire in transgender participants were included. Two reviewers independently screened records, and a third resolved conflicts. Data were extracted using a standardized form and synthesized narratively with tabular support; methodological quality was assessed using JBI tools. Results Of 3369 records screened, 16 studies met inclusion criteria. All used cisgender-validated instruments, mostly treating desire as a continuous variable. Only five assessed distress. Cross-sectional studies found transgender participants scored between cisgender men and women. Longitudinal studies showed early desire decreases in trans women and early increases in trans men following GAHT, later stabilizing in both groups. One study reported HSDD prevalence; none used DSM criteria. Desire showed inconsistent associations with surgeries, relationship status, body image, gender dysphoria, mood, and sexual history. Conclusions SD in transgender populations is predominantly measured using instruments validated for cisgender individuals, with low desire treated as a functional dimension rather than as a distress-based disorder. Few studies assessed distress alongside low desire. Desire patterns appear dynamic across medical transitions, particularly with hormone initiation, and are variably influenced by psychosocial factors. No transgender-validated framework exists for diagnosing low sexual desire. Development of gender-inclusive, validated measurement tools is urgently needed to distinguish normative variability from clinically significant disturbances and improve care. Disclosure No.