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Brain Sci. 2018, 8(5), 88; https://doi.org/10.3390/brainsci8050088

Transitioning Bodies. The Case of Self-Prescribing Sexual Hormones in Gender Affirmation in Individuals Attending Psychiatric Services

1
Camden and Islington NHS Foundation Trust, London NW1 0PE, UK
2
Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
3
Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
*
Author to whom correspondence should be addressed.
Received: 23 March 2018 / Revised: 24 April 2018 / Accepted: 11 May 2018 / Published: 14 May 2018
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Abstract

Self-prescribing of sexual hormones for gender affirmation is a potentially widespread and poorly studied phenomenon that many clinicians are unaware of. The uncontrolled use of hormones poses significant health hazards, which have not been previously reported in the literature. We have collected seven clinical cases in general adult psychiatry settings (both inpatient and outpatients), describing transgender and gender non-conforming individuals’ (TGNC) self-prescribing and self-administering hormones bought from the Internet without any medical consultation. Among these cases, two were taking androgens, and the rest were taking oestrogens. The main reason for self-administration of hormones seems to be the lack of access to specialised care due to discrimination and long waiting lists. We advocate for clinicians to be aware of the phenomenon and proactively help TGNC individuals by enquiring about self-prescribing of hormones, providing information and referring to the most appropriate treatment centre as well as encourage a public debate on the discrimination and the stigma that TGNC population suffer from. Overall, there is an urgent need for the implementation of different and innovative health care services for TGNC individuals as well as more targeted prevention strategies on such underreported and highly risky behaviours. Furthermore, it is necessary for every clinician involved in the care for TGNC people to be aware of their special needs and be able to be an allied and an advocate to help in reducing stigma and discrimination that affect the access to care for this often underserved population. View Full-Text
Keywords: transgender; gender reassignment; gender affirmation; self-medication; hormonal replacement therapy (HRT); LGTBQ health; gender dysphoria; do it yoursfelf (DIY); identity; barriers to care; discrimination transgender; gender reassignment; gender affirmation; self-medication; hormonal replacement therapy (HRT); LGTBQ health; gender dysphoria; do it yoursfelf (DIY); identity; barriers to care; discrimination
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Metastasio, A.; Negri, A.; Martinotti, G.; Corazza, O. Transitioning Bodies. The Case of Self-Prescribing Sexual Hormones in Gender Affirmation in Individuals Attending Psychiatric Services. Brain Sci. 2018, 8, 88.

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