DIY transgender hormone therapy (DIY HRT) is a phenomenon where transgender people obtain and self-administer transgender hormone therapy as part of their gender transition without the guidance of a licensed medical provider. This may be caused by various problems accessing healthcare which transgender people face. DIY HRT can refer to either prescription HRT obtained without a prescription or homebrew HRT. The prevalence of DIY hormone therapy in the trans community varies between studies, from 11%[1] to 79%.[2]
DIY transgender hormone therapy involves transgender people "seek[ing] to access [transgender hormone therapy] through friends, peers, and the internet, without consulting a health worker."[3] Trans people can obtain information about hormone therapy from online sources, some of which are generated by the trans community.[4][5][6]
In rare cases, some transgender people have attempted DIY surgeries.[7]
Causes
A 2022 review article concluded that DIY hormone replacement therapy "is related to challenges finding knowledgeable and non-stigmatising health workers, lack of access to appropriate services, exclusion, discomfort managing relationships with health workers, cost and desire for a faster transition."[3]
Prevalence
Estimates of the prevalence of DIY hormone therapy in the trans community vary significantly. One survey in Ontario found that 25% currently or formerly obtained DIY hormones, whereas for trans people of color living in San Francisco a different survey found that 63% had relied on DIY.[3][5] According to a 2022 review, at the low end, 11% of Ontarian transgender people report having used DIY HRT; at the other extreme, 79% of trans women from Rio de Janeiro have done the same. In between lie London at 31% of transgender people, and 49% of trans women in San Francisco.[3] The use of DIY increased during the COVID-19 pandemic although it had been common before.[6] The prevalence of DIY hormone usage has been estimated to be higher among trans women than trans men.[8] A possible explanation is that testosterone is a controlled substance in many places, and is therefore harder to obtain and use without a prescription, legally.[9]
Effectiveness
A 2022 review identified no peer-reviewed studies on the effectiveness of self-administered gender-affirming hormones.[3]
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