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People with gender dysphoria who self-prescribe cross-sex hormones: Prevalence, sources, and side effects knowledge

Mepham, Nick; Bouman, Walter P.; Arcelus, Jon; Hayter, Mark; Wylie, Kevan R.


Nick Mepham

Walter P. Bouman

Jon Arcelus

Kevan R. Wylie


Introduction: There is a scarcity of research into the use of non-physician-sourced cross-sex hormones in the transgender population. However, when medication is not prescribed by health professionals, users' knowledge of such medication may be adversely affected. Aims: This study aims to define the prevalence of Internet-sourced sex hormone use in a population attending for initial assessment at a gender identity clinic, to compare the prevalence between gender-dysphoric men and women, and to compare knowledge of cross-sex hormone side effects between users who source cross-sex hormones from medical doctors and those who source them elsewhere. Methods: In the first part of the study, a cross-sectional design is used to measure the overall prevalence of sex hormone use among individuals referred to a gender clinic. The second part is a questionnaire survey aiming at measuring sex hormone knowledge among individuals referred to this clinic. Main Outcome Measures: Main outcome measures were (i) categorical data on the prevalence and source of cross-sex hormone use and (ii) knowledge of sex hormone side effects in a population referred to a gender clinic. Results: Cross-sex hormone use was present in 23% of gender clinic referrals, of whom 70% sourced the hormones via the Internet. Trans men using testosterone had a sex hormone usage prevalence of 6%; one-third of users sourced it from the Internet. Trans women had a sex hormone usage prevalence of 32%; approximately 70% of users sourced hormones from the Internet. Cross-sex hormone users who sourced their hormones from physicians were more aware of side effects than those who used other sources to access hormones. Conclusion: One in four trans women self-prescribe cross-sex hormones before attending gender clinics, most commonly via the Internet. This practice is currently rare among trans men. Self-prescribing without medical advice leaves individuals without the knowledge required to minimize health risks.

Journal Article Type Article
Publication Date Dec 16, 2014
Journal The journal of sexual medicine
Print ISSN 1743-6095
Electronic ISSN 1743-6109
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 11
Issue 12
Pages 2995-3001
APA6 Citation Mepham, N., Bouman, W. P., Arcelus, J., Hayter, M., & Wylie, K. R. (2014). People with gender dysphoria who self-prescribe cross-sex hormones: Prevalence, sources, and side effects knowledge. The journal of sexual medicine, 11(12), 2995-3001. doi:10.1111/jsm.12691
Keywords Gender Dysphoria; Transsexualism; Transgender; Cross‐Sex Hormones; Prevalence; Internet
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