Australia’s largest survey of trans and gender diverse sexual health finds significant improvements in healthcare experiences, sexual well-being and relationship satisfaction, while highlighting priorities for continued progress.
The second Australian Trans and Gender Diverse Sexual Health Survey, released today by the Kirby Institute at UNSW Sydney at the joint Australasian HIV and Sexual and Reproductive Health Conferences in Melbourne, paints an encouraging picture of progress for trans and gender diverse people in Australia.
This project is the largest study of its kind ever conducted in Australia, recruiting 4,388 participants from every state and territory in 2025. Three times more people participated in the study compared with the last version conducted in 2018. It compiles Australia’s only national data on sex, relationships, and health for trans and gender diverse people.
Improvements in sexual and romantic satisfaction
Most trans and gender diverse respondents reported satisfying romantic relationships (74%). From 2018 to 2025, those satisfied with their sexual lives increased by 42%.
“It’s really encouraging to see that trans and gender diverse people in Australia are leading fulfilling intimate lives,” said Teddy Cook, study co-lead and Adjunct Senior Lecturer at the Kirby Institute at UNSW Sydney.
“We also found low rates of depression and high rates of gender satisfaction, which speaks to our community’s resilience and the positive lives people are building.”
Further reflecting progress, the study reported improvements in sexual education and health care for trans and gender diverse people.
More trans people receiving affirming sexual health care
More than half (55%) of trans respondents reported receiving affirming sexual health care, up from 36% in 2018. Such improvements were seen in sexual health clinics, community-led services, general practices, and hospitals.
“It is wonderful to see trans and gender diverse people have more positive experiences in sexual health care, showing that investing in inclusive care can really pay off,” said Cook.
“However, it remains that one in five people still received unaffirming care, which was most common among non-binary people.”
Mixed data on sexually transmissible infections and HIV
While affirming care has improved, according to the report, other aspects of sexual health for trans and gender diverse people are not as encouraging.
Testing for STIs remains low, with only one in three respondents tested in the year prior to the study. Participants also reported an increase in diagnoses of chlamydia, gonorrhoea and syphilis. These data are supported by newly released findings from the nationally representative Australian Study of Health and Relationships (ASHR), which show trans and gender diverse people have higher rates of STIs than their cisgender counterparts.
“Rising STIs along with low testing rates are concerning and indicate where we need to focus our health promotion efforts,” said study co-investigator Mai Nguyen, a trans and gender diverse public health professional.
“What we do know is that people who reported unaffirming care had 59% lower odds of a recent STI test than those with affirming experiences, underscoring the importance of respectful care.”
The report shows an increase in the uptake of the HIV prevention medicine ‘PrEP’, doubling between the two surveys (1.9% in 2018 to 4.0% in 2025). Despite this increase, uptake remains low. Further, the study found many trans and gender diverse people received inaccurate and confusing information on PrEP from healthcare providers.
“PrEP is an incredibly effective and safe HIV prevention tool, but more work is needed to demonstrate its safety and utility for trans and gender diverse people at risk of HIV,” said Jorj Kelly, a LGBTIQA+ strategy professional and study co-investigator. “There is a lot of opportunity for PrEPto support our communities, but we need to invest in targeted and effective implementation.”
Non-binary people experience greater barriers to sexual health care
Across the study, non-binary people reported greater challenges to sexual health and well-being than trans men and trans women. Non-binary people experienced less affirming sexual health care and the greatest increases in STIs, while also reporting less diagnostic testing and lower use of condoms.
“Non-binary people deserve access to safe and inclusive services, but they are currently falling through gaps of services built around rigid ideas of gender,” said Mish Pony, CEO of Flat Out and a study co-investigator.
“Improving affirming sexual health care for all trans people and particularly those who are nonbinary requires appropriately resourced approaches developed with non-binary communities.”
Sexual violence remains a major threat
Half (51%) of trans and gender diverse respondents to the survey had experienced sexual violence or coercion, which remained unchanged over time. That is more than three times the rate of the broader Australian population (estimated by other studies to be 14%), representing a representing a significant and ongoing public health concern. Half of trans and gender diverse people also reported experiences of intimate partner violence.
“Violence continues to be a devastating and unacceptable theme throughout our research, with unacceptably high rates across genders. It is crucial that we address the social conditions that give rise to violence against trans and gender diverse people,” said Jack Khouri, Deputy CEO at Transgender Victoria and study co-investigator.
While challenges remain, the report points to encouraging signs of progress for trans and gender diverse people, according to the Kirby Institute’s Associate Professor Denton Callander.
“Australia has made some exciting progress in supporting the sexual health of trans and gender diverse people,” said Associate Professor Callander.
“I’m heartened to share evidence of resilient, engaged and empowered trans and gender diverse communities. However, at a time when discrimination against trans and gender people is increasing, we must continue to invest in inclusive, safe, and evidence based healthcare.”
