Nonprescribed Hormone Use and Self-Performed Surgeries: “Do-It-Yourself” Transitions in Transgender Communities in Ontario, Canada

Rotondi, Nooshin Khobzi; Bauer, Greta R.; Scanlon, Kyle; Kaay, Matthias; Travers, Robb; Travers, Anna

doi:10.2105/ajph.2013.301348

Cited by 186 publications

(144 citation statements)

References 27 publications

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“…It is clear that the endocrine possibilities or limitations for this specific group are, so far, not described in the medical literature and indeed it is likely that a proportion of this group are self-medicating with the attendant risks (Rotondi et al, 2013). Further, cosmetic interventions may be sufficient to achieve partial feminization.…”

Section: A Discussion Of the Literaturementioning

confidence: 99%

Non-binary or genderqueer genders

Richards

Bouman²,

Seal

et al. 2016

International Review of Psychiatry

619

361

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Some people have a gender which is neither male nor female and may identify as both male and female at one time, as different genders at different times, as no gender at all, or dispute the very idea of only two genders. The umbrella terms for such genders are 'genderqueer' or 'non-binary' genders. Such gender identities outside of the binary of female and male are increasingly being recognized in legal, medical and psychological systems and diagnostic classifications in line with the emerging presence and advocacy of these groups of people. Population-based studies show a small percentage -but a sizable proportion in terms of raw numbers -of people who identify as non-binary. While such genders have been extant historically and globally, they remain marginalized, and as such -while not being disorders or pathological in themselves -people with such genders remain at risk of victimization and of minority or marginalization stress as a result of discrimination. This paper therefore reviews the limited literature on this field and considers ways in which (mental) health professionals may assist the people with genderqueer and non-binary gender identities and/or expressions they may see in their practice. Treatment options and associated risks are discussed. ARTICLE HISTORY

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Section: A Discussion Of the Literaturementioning

confidence: 99%

Non-binary or genderqueer genders

Richards

Bouman²,

Seal

et al. 2016

International Review of Psychiatry

619

361

View full text Add to dashboard Cite

show abstract

“…10 A study by Rotundi found that transgender people ready but not able to medically transition are more likely to have depressive symptoms than peers who have begun the process. 11 The ensuing combination of hopelessness and depression results in participation in high-risk sexual behaviors. 12 Nuttbrock et al recently found that gender-related abuse also caused depressive symptoms that predicted HIV and STIs for young transwomen.…”

Section: Introductionmentioning

confidence: 99%

Connecting the Dots: Examining Transgender Women’s Utilization of Transition-Related Medical Care and Associations with Mental Health, Substance Use, and HIV

et al. 2014

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Findings on access to general healthcare for transgender people have emerged, but little is known about access to transition-related medical care for transwomen (i.e., hormones, breast augmentation, and genital surgery). Transgender women have low access to general medical care and are disproportionately at risk for substance use, mental illness, and HIV. We conducted an analysis to determine if utilization of transition-related medical care is a protective factor for health risks to transgender women and to investigate if care differs by important demographic factors and HIV status. A secondary analysis was conducted using data from a 2010 HIV surveillance study using respondent-driven sampling to recruit 314 transwomen in San Francisco. Survey-corrected logistic regression models were used to estimate odds ratios for six psychosocial health problems-binge drinking, injection drug use, anxiety, depression, suicidal ideation, and high-risk intercourse-comparing various levels of utilization of transition-related medical care. Odds ratios were also calculated to determine if utilization of transition-related medical care was related to less overlap of risk domains. We found that Latina and African American transwomen had significantly lower estimated utilization of breast augmentation and genital surgery, as did transwomen who identified as transgender rather than female. Overall, utilization of transition-related medical care was associated with significantly lower estimated odds of suicidal ideation, binge drinking, and non-injection drug use. Findings suggest that utilization of transition-related medical care may reduce risk for mental health problems, especially suicidal ideation, and substance use among transwomen. Yet, important racial/ethnic and gender identity disparities in utilization of transition-related medical care need to be addressed.

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“…[1][2][3] Despite a 34-fold higher likelihood of having HIV among TW in the United States compared with the general population, 4 transgender people (approximately 0.4%-0.6% of the U.S. population 5,6 ) have comparatively low healthcare utilization rates 7 and may seek gender-affirming therapies (including HT and body modification services) outside of traditional, supervised medical settings. 8,9 Both HT and ART have potential side effects, and drug-drug interactions (DDI) may exist between some ART medications (such as nonnucleoside reverse transcriptase inhibitors [NNRTI] and protease inhibitors [PIs]) and HT (particularly ethinyl estradiol), 10 making unsupervised or uncoordinated HT and ART use potentially risky for TW taking feminizing HT. Limited data exist that address knowledge and consequences of ART and/or HT side effects and ART-HT DDIs among TW.…”

mentioning

confidence: 99%

Transgender Women Living with HIV Frequently Take Antiretroviral Therapy and/or Feminizing Hormone Therapy Differently Than Prescribed Due to Drug–Drug Interaction Concerns

et al. 2017

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Purpose: Both hormone therapy (HT) and antiretroviral therapy (ART) can be lifesaving for transgender women (TW) living with HIV, but each has side effects and potential drug-drug interactions (DDI). We assessed how concerns about HT-ART interactions affect treatment adherence. Methods: This study used a cross-sectional survey of TW (n = 87) in Los Angeles, CA. Results: Fifty-four percent were living with HIV; 64% used HT. Only 49% of TW living with HIV discussed ART-HT DDI with their provider; 40% reported not taking ART (12%), HT (12%), or both (16%) as directed due to DDI concerns. Conclusion: Imperfect HT/ART use and limited provider communication suggests a need for improved HT-ART integration.

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Nonprescribed Hormone Use and Self-Performed Surgeries: “Do-It-Yourself” Transitions in Transgender Communities in Ontario, Canada

Cited by 186 publications

References 27 publications

Non-binary or genderqueer genders

Non-binary or genderqueer genders

Connecting the Dots: Examining Transgender Women’s Utilization of Transition-Related Medical Care and Associations with Mental Health, Substance Use, and HIV

Transgender Women Living with HIV Frequently Take Antiretroviral Therapy and/or Feminizing Hormone Therapy Differently Than Prescribed Due to Drug–Drug Interaction Concerns

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