Gender identity and history

Disclosure of gender identity and history is not necessary for the provision of PEP and should always be optional. This is particularly important for people with trans experience, or who have non-binary or fluid gender identities. It is important to not make assumptions about an individual’s gender identity, the type of sex they may have (e.g. anal, vaginal/front hole) or the level of risk associated with that sex (e.g. a trans man having condomless receptive sex with a cisgender man could be at high risk regardless of whether that sex is anal or front hole). The need for PEP should be assessed based on the type of exposure determined during the clinical assessment. It may be beneficial to use open-ended questions to allow people to choose what information they disclose about the types of sexual interaction in which they engage.