Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional study
Objectives We aimed to describe the gender-affirming hormonal therapy (GAHT) intake behaviour and regimen and the factors associated with the use of hormones inconsistent with reference GAHT regimen among transgender people in the Philippines.Design Cross-sectional study.Setting Transgender communit...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/9/e072252.full |
| _version_ | 1797669411908222976 |
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| author | Emmanuel S Baja John Danvic T Rosadiño Ronivin G Pagtakhan Zypher Jude G Regencia Patrick C Eustaquio Jan Dio Miguel Dela Cruz Yanyan Araña Bubbles Rosos |
| author_facet | Emmanuel S Baja John Danvic T Rosadiño Ronivin G Pagtakhan Zypher Jude G Regencia Patrick C Eustaquio Jan Dio Miguel Dela Cruz Yanyan Araña Bubbles Rosos |
| author_sort | Emmanuel S Baja |
| collection | DOAJ |
| description | Objectives We aimed to describe the gender-affirming hormonal therapy (GAHT) intake behaviour and regimen and the factors associated with the use of hormones inconsistent with reference GAHT regimen among transgender people in the Philippines.Design Cross-sectional study.Setting Transgender community clinic in Metro Manila, Philippines from March 2017 to December 2019.Participants Gender-affirming care-seeking individuals of at least 18 years old, who self-identified as transgender or non-binary, and who self-reported current or previous use of GAHT at baseline consult.Primary outcome measures Reported drugs and/or administration routes not congruent with the World Professional Association for Transgender Health Standard of Care eighth edition were classified as hormone use outside the reference regimen.Results 253 transgender people reported current or previous intake of GAHT. Many trans women and transfeminine people (TWTFP; 58.9%, 86/146) reported using oral contraceptive pills (OCPs), whereas most trans men (TM; 73.8%, 79/107) reported injecting testosterone esters. Furthermore, 59.7% (151/253) used hormones outside the reference regimen, widely using OCP and anabolic steroids among TWTFP and TM, respectively. TWTFP (crude prevalence ratio, PR, 3.52; 95% CI 2.35 to 5.49) and those who take unprescribed GAHT (crude PR 2.37; 95% CI 1.08 to 6.68) were more likely to use hormones outside the reference regimen than TM and taking healthcare provider-prescribed GAHT, respectively. On adjusting for covariates, the prevalence of using hormones outside the reference regimen was approximately three times higher (adjusted PR 3.22; 95% CI 2.09 to 5.12) among TWTFP than TM.Conclusion Trans people act on their high unmet gender-affirming care needs by taking unprescribed GAHT, many outside the reference regimen. Structural changes in the health system are warranted, including strengthened community-based self-administration practices. |
| first_indexed | 2024-03-11T20:43:59Z |
| format | Article |
| id | doaj.art-f79cbacf3c004290a9a9fcbae6012dfc |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T20:43:59Z |
| publishDate | 2023-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-f79cbacf3c004290a9a9fcbae6012dfc2023-10-01T21:05:08ZengBMJ Publishing GroupBMJ Open2044-60552023-09-0113910.1136/bmjopen-2023-072252Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional studyEmmanuel S Baja0John Danvic T Rosadiño1Ronivin G Pagtakhan2Zypher Jude G Regencia3Patrick C Eustaquio4Jan Dio Miguel Dela Cruz5Yanyan Araña6Bubbles Rosos7Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, PhilippinesLoveYourself Inc, Mandaluyong City, PhilippinesLoveYourself Inc, Mandaluyong City, PhilippinesInstitute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, PhilippinesLoveYourself Inc, Mandaluyong City, PhilippinesLoveYourself Inc, Mandaluyong City, PhilippinesLoveYourself Inc, Mandaluyong City, PhilippinesLoveYourself Inc, Mandaluyong City, PhilippinesObjectives We aimed to describe the gender-affirming hormonal therapy (GAHT) intake behaviour and regimen and the factors associated with the use of hormones inconsistent with reference GAHT regimen among transgender people in the Philippines.Design Cross-sectional study.Setting Transgender community clinic in Metro Manila, Philippines from March 2017 to December 2019.Participants Gender-affirming care-seeking individuals of at least 18 years old, who self-identified as transgender or non-binary, and who self-reported current or previous use of GAHT at baseline consult.Primary outcome measures Reported drugs and/or administration routes not congruent with the World Professional Association for Transgender Health Standard of Care eighth edition were classified as hormone use outside the reference regimen.Results 253 transgender people reported current or previous intake of GAHT. Many trans women and transfeminine people (TWTFP; 58.9%, 86/146) reported using oral contraceptive pills (OCPs), whereas most trans men (TM; 73.8%, 79/107) reported injecting testosterone esters. Furthermore, 59.7% (151/253) used hormones outside the reference regimen, widely using OCP and anabolic steroids among TWTFP and TM, respectively. TWTFP (crude prevalence ratio, PR, 3.52; 95% CI 2.35 to 5.49) and those who take unprescribed GAHT (crude PR 2.37; 95% CI 1.08 to 6.68) were more likely to use hormones outside the reference regimen than TM and taking healthcare provider-prescribed GAHT, respectively. On adjusting for covariates, the prevalence of using hormones outside the reference regimen was approximately three times higher (adjusted PR 3.22; 95% CI 2.09 to 5.12) among TWTFP than TM.Conclusion Trans people act on their high unmet gender-affirming care needs by taking unprescribed GAHT, many outside the reference regimen. Structural changes in the health system are warranted, including strengthened community-based self-administration practices.https://bmjopen.bmj.com/content/13/9/e072252.full |
| spellingShingle | Emmanuel S Baja John Danvic T Rosadiño Ronivin G Pagtakhan Zypher Jude G Regencia Patrick C Eustaquio Jan Dio Miguel Dela Cruz Yanyan Araña Bubbles Rosos Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional study BMJ Open |
| title | Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional study |
| title_full | Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional study |
| title_fullStr | Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional study |
| title_full_unstemmed | Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional study |
| title_short | Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional study |
| title_sort | prevalence of and factors associated with the use of gender affirming hormonal therapy outside the reference regimen among transgender people in a community led clinic in metro manila philippines a retrospective cross sectional study |
| url | https://bmjopen.bmj.com/content/13/9/e072252.full |
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