Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Arjee Restar; E J Dusic; Henri Garrison-Desany; Elle Lett; Avery Everhart; Kellan E Baker; Ayden I Scheim; S Wilson Beckham; Sari Reisner; Adam J Rose; Matthew J Mimiaga; Asa Radix; Don Operario; Jaclyn M W Hughto

doi:10.1057/s41599-022-01291-5

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Humanit Soc Sci Commun. 2022;9(1):304. doi: 10.1057/s41599-022-01291-5. Epub 2022 Sep 7.

Authors

Arjee Restar^{1

2

3}, E J Dusic⁴, Henri Garrison-Desany⁵, Elle Lett^{3

6}, Avery Everhart^{3

7}, Kellan E Baker^{5

8}, Ayden I Scheim⁹, S Wilson Beckham¹⁰, Sari Reisner¹¹, Adam J Rose¹², Matthew J Mimiaga^{13

14}, Asa Radix^{2

15

16}, Don Operario¹⁷, Jaclyn M W Hughto^{17

18}

Affiliations

¹ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
² Department of Behavioral and Social Sciences, Yale University School of Public Health, New Haven, CT, USA.
³ Center for Applied Transgender Studies, Chicago, IL, USA.
⁴ Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA.
⁵ Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁶ Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁷ Population, Health, & Place Program, Spatial Sciences Institute, Dornsife College of Letters, Arts, & Sciences, University of Southern California, Los Angeles, CA, USA.
⁸ Whitman-Walker Institute, Washington, DC, USA.
⁹ Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
¹⁰ Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹¹ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
¹² Hebrew University School of Public Health, Jerusalem, Israel.
¹³ UCLA Center for LGBTQ+ Advocacy, Research & Health, Los Angeles, CA, USA.
¹⁴ Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
¹⁵ Department of Epidemiology, Columbia University, New York, NY, USA.
¹⁶ Callen-Lorde Community Health Center, New York, NY, USA.
¹⁷ Departments of Behavioral and Social Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA.
¹⁸ Fenway Health, The Fenway Institute, Boston, MA, USA.

Abstract

Gender-affirming hormones have been shown to improve psychological functioning and quality of life among transgender and nonbinary (trans) people, yet, scant research exists regarding whether and why individuals take more or less hormones than prescribed. Drawing on survey data from 379 trans people who were prescribed hormones, we utilized multivariable logistic regression models to identify factors associated with hormone-dosing behaviors and content analysis to examine the reasons for dose modifications. Overall, 24% of trans individuals took more hormones than prescribed and 57% took less. Taking more hormones than prescribed was significantly associated with having the same provider for primary and gender-affirming care and gender-based discrimination. Income and insurance coverage barriers were significantly associated with taking less hormones than prescribed. Differences by gender identity were also observed. Addressing barriers to hormone access and cost could help to ensure safe hormone-dosing behaviors and the achievement trans people's gender-affirmation goals.

Abstract

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