The eunuchs of India: An endocrine eye opener

Kalra, Sanjay

doi:10.4103/2230-8210.95676

Cited by 20 publications

(19 citation statements)

References 11 publications

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“…Transgender women, also known as trans women, may use different therapies to medically affirm their gender identity through feminisation of their appearance. Hormone therapy, injecting silicone, gender-affirmation surgery, breast augmentation, mechanical therapy for body or facial hair, and voice therapy are thought to be common 25–27. However, due to the high costs especially for gender-affirming surgery and the experience of healthcare-related stigma, many transgender people in LMICs cannot or would not seek gender-affirming care 28–30…”

Section: Introductionmentioning

confidence: 99%

Hormone use among Nepali transgender women: a qualitative study

Regmi

Teijlingen

Neupane³

et al. 2019

BMJ Open

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ObjectivesThere is a dearth of information on transgender individuals in Nepal, particularly studies exploring their use of hormone therapies. The objectives of this study therefore were to explore (1) how hormones are used, (2) types of hormones used and (3) side effects experienced by transgender women after hormone use. This is the first study of its kind in Nepal addressing this important public health issue.SettingThe study was conducted in four districts of Nepal: Kathmandu, Sunsai, Banke and Kaski.Design and participantsThis qualitative study comprises eight focus group discussions (FGDs) and nine interviews. FGDs and three face-to-face interviews were held with transgender women aged 18 years and older and six interviews with stakeholders working with and advocating on behalf of this population. The study was conducted between September 2016 and March 2017.ResultsOur participants were young. The majority of FGD participants had completed school-level education and 40% had been using hormones for 1 to 3 years. Five overlapping themes were identified: (1) reasons and motivations for hormone use; (2) accessibility and use of hormones; (3) side effects; (4) utilisation of healthcare services and (5) discontinuation of hormone use.ConclusionHormone use was common in our sample. Most received information on hormone therapy online and through their peer networks. A few study participants sought doctors’ prescriptions for hormone therapy, but hormones were more likely to be bought from local private pharmacies or abroad through friends. This kind of self-medication is associated with a range of risks to the physical and mental health of transgender individuals. Incorporating information, education and communication about hormone therapy into existing health promotion interventions targeted to this population may help transgender people to make better informed choices.

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Section: Introductionmentioning

confidence: 99%

Hormone use among Nepali transgender women: a qualitative study

Regmi

Teijlingen

Neupane³

et al. 2019

BMJ Open

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“…[9] “Hizras” live a ghetto-like existence, in their own communities and commonly use oral contraceptive pills among themselves. [9] In our center, most MTF transgender were effectively managed with estrogen only (68%) [Table 2]. We had used estrogen (conjugated or ethinyl estrogen) mostly as oral tablets.…”

Section: Discussionmentioning

confidence: 99%

“…[9] SRS may be the necessary last step toward achieving the ultimate goal of living successfully in the desired gender role among some but not all MTF transgender. Nine subjects had orchiectomy without vaginoplasty before presenting to our center, six by some unqualified persons who dishonestly pretended to have medical skills and surprisingly three, by medically qualified surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…These people are far too quick to the knife and irreversible surgeries, rather than helping patients deal with the deeper issues of their dysphoria, and this may lead to suboptimal physical, social, and sexual results. [9] We are yet to plan for genital reconstructive surgery for these nine poorly managed subjects with mutilating surgery. Another five subjects (total = 14, 25.5%) were managed with planned genital surgery as per standard of care [Table 1].…”

Section: Discussionmentioning

confidence: 99%

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Outcome and preferences in male–to–female subjects with gender dysphoria: Experience from Eastern India

Majumder

Sanyal

2017

Indian J Endocr Metab

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Context:Gender dysphoria (GD) is an increasingly recognized medical condition in India, and little scientific data on treatment outcomes are available.Aims:Our objective is to study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD in male–to–female (MTF) transgender subjects in Eastern India.Subjects and Methods:This is a retrospective study of treatment preferences and outcome in 55 MTF transgender subjects who were presented to the endocrine clinic.Statistical Analysis Used:Descriptive statistical analysis is carried out in the present study, and Microsoft Word and Excel are used to generate graphs and tables.Results:The mean follow-up was 1.9 years and 14 subjects (25.5%) were lost to follow-up after a single or 2–3 contact sessions. Rest 41 subjects (74.5%) desiring treatment had regular counseling and medical monitoring. All 41 subjects were dressing to present herself as female and all of them were receiving cross-sex hormone therapy either estrogen only (68%), or drospirenone in combination with estrogen (12%) or gonadotropin-releasing hormone agonist (GnRH) in combination with estrogens (19.5%). Most of the subjects preferred estrogen therapy as it was most affordable and only a small number of subjects preferred drospirenone or GnRH agonist because of cost and availability. 23.6% subjects underwent esthetic breast augmentation surgery and 25.5% underwent orchiectomy and/or vaginoplasty. Three subjects presented with prior breast augmentation surgery and nine subjects presented with prior orchiectomy without vaginoplasty, depicting a high prevalence of poorly supervised surgeries.Conclusions:Standards of care documents provide clinical guidance for health professionals about the optimal management of transsexual people. The lack of information among health professionals about proper and protocolwise management leads to suboptimal physical, social, and sexual results.

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“…Adrenal and gonadal diseases are frequently researched topics in endocrine academia, and case reports of rare (and not so rare) DSD are published frequently. [12] Polycystic ovarian syndrome and obstetric endocrine topics, such as diabetes in pregnancy, are large enough subspecialties to merit their own national and international, conferences. We cannot explain our inactivity by lack of resources, either.…”

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confidence: 99%