Trans sexual health survey: better care, worse testing, violence unchanged

Australia's largest trans and gender diverse sexual health study shows affirming care is up — and STI testing, PrEP uptake and safety from violence are still dangerously low.

Told by Claire Lawson · 16 September 2026

The second Australian Trans and Gender Diverse Sexual Health Survey landed in Melbourne on Tuesday with 4,388 participants and a story that's both encouraging and infuriating in equal measure. Released by the Kirby Institute at UNSW Sydney at the joint Australasian HIV and Sexual and Reproductive Health Conferences, it's the largest study of its kind ever conducted in Australia — three times the size of the 2018 version — and it paints a picture of a community that's more satisfied, better cared for in some places, and still left dangerously exposed in others.

The good news first. Most trans and gender diverse respondents reported satisfying romantic relationships (74%), and satisfaction with sexual lives jumped 42% between 2018 and 2025. More than half — 55% — now report receiving affirming sexual healthcare, up from 36% seven years ago. That's progress across sexual health clinics, community-led services, general practices and hospitals, and it matters. Teddy Cook, the study's co-lead and an Adjunct Senior Lecturer at the Kirby Institute, called it encouraging. "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."

But resilience is not the same as safety, and the gaps in this report are stark.

Only one in three respondents tested for STIs in the year before the study. One in three. People who reported unaffirming care had 59% lower odds of getting tested than those who were treated with respect — which means the quality of care you receive directly determines whether you know your status. Diagnoses of chlamydia, gonorrhoea and syphilis are rising. PrEP uptake has doubled since 2018, from 1.9% to 4.0%, but that's still barely a trickle, and the study found many trans and gender diverse people are getting inaccurate and confusing information about it from the very healthcare providers who should be helping them stay safe.

Non-binary people are falling through the widest gaps. They experienced the least affirming care, the biggest increases in STIs, the lowest rates of testing and the lowest condom use. "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.

And then there's the violence.

Half — 51% — of trans and gender diverse respondents have experienced sexual violence or coercion. That figure is more than three times the rate of the broader Australian population, estimated by other studies at 14%. It has not moved since 2018. Half of respondents also reported intimate partner violence. Jack Khouri, Deputy CEO at Transgender Victoria and a study co-investigator, called it devastating and unacceptable. "It is crucial that we address the social conditions that give rise to violence against trans and gender diverse people."

Here's what that 51% means. It means that if you're reading this and you're trans or gender diverse, there's a coin-flip chance you've been hurt by someone in a way that should never happen to anyone. It means that while affirming care has improved and sexual satisfaction has climbed, the world outside the clinic is still one where half of you are not safe. And it means that seven years of progress in some areas has done nothing — nothing — to shift the violence.

Associate Professor Denton Callander, also from the Kirby Institute, said Australia has made exciting progress. He's right. But he also said this: "At a time when discrimination against trans and gender people is increasing, we must continue to invest in inclusive, safe, and evidence-based healthcare."

The full report is available at tgdsexualhealth.com.au. The data is there. The gaps are documented. What happens next is a question of whether anyone with the power to close them is listening.