A landmark review published in the peer-reviewed journal Archives of Sexual Behaviour has examined twelve years of research on sexuality, sexual health, and relationship satisfaction among non-binary people. Conducted by Fraedan Mastrantonio, Hanna Kovshoff, and Heather Armstrong from the University of Southampton’s School of Psychology, the paper Non-Binary People’s Sexuality, Sexual Health and Relationship Satisfaction: A Review of 12 Years of Quantitative Research (2012–2024), highlights major gaps in current knowledge and calls for more inclusive approaches in future research.

The authors screened more than 26,000 papers from major scientific databases, identifying just 44 quantitative studies that included non-binary participants. Of these, 39 were classed as high quality and five as moderate. The researchers concluded that “literature with a specific focus on non-binary individuals is still severely lacking.”

Most of the studies were conducted in Western countries, often using online surveys and convenience samples. While the inclusion of non-binary participants has grown, many papers failed to report detailed demographic data or analyse non-binary participants separately from binary transgender participants. As the authors note, “gender-minority individuals were often grouped together for analysis, hiding likely within-group differences.”

When sexual and romantic relationships were explored, non-binary people reported “similar levels of sexual and relationship satisfaction (to) binary transgender people.” Several studies found they were more likely to engage in non-monogamous relationships and report attraction to multiple genders. However, the review found that research tools often did not reflect this diversity, relying on binary measures of attraction or language designed for cisgender populations.

Only a handful of studies investigated sexual assertiveness, consent, fantasies, or sexual function. Among these, non-binary participants were more likely to emphasise consent and reported distinctive experiences around body image and sexual self-esteem aspects not well captured by existing scales.

The review also uncovered disparities in access to gender-affirming healthcare. Non-binary individuals were less likely than binary transgender people to seek or receive medical interventions such as hormone therapy or surgery, and some reported being denied care entirely. In sexual healthcare, discrimination and discomfort in clinical settings were common, prompting some to turn to community-based providers viewed as more inclusive.

The researchers called for “future research (to) use gender-neutral language and measures, and consider non-binary individuals separately,” to better understand their unique sexual health, well-being, and relationship needs. They emphasised the need for inclusive research and resources to address these disparities in a “meaningful way.”

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