Introduction Sexual health services targeted towards specific populations have been an effective way of responding to complex needs. As demand for gender identity services increases, a trend in hormone self-medicating has become more apparent with patients obtaining treatment from internet pharmacies, friends or illicit sources. This study highlights the healthcare needs of patients attending a clinic service for transgender patients.
Methods Clinical audit of a sexual health service for transgender people in 2015 and 2016.
Results 81 attendances were recorded (56 unique patients). Median age was 32 (IQR 24–41). Reported gender identity: Trans male (Assigned Female At Birth [AFAB]) 29 (51.8%), Trans female (Assigned Male at Birth [AMAB]) 15 (26.8%), Non-Binary (AFAB) 9 (16.1%), Non-Binary (AMAB) 3 (5.4%). AMAB patients were older than AFAB – Median age 39 vs. 29 years (p=0.03). Most attendances were for STI screening or genital health issues – 47 (58%). 6 (7.4%) attended for psychosexual assessment. 31 (38.3%) attended for endocrine advice and monitoring of hormone therapy. 13 (38.3%) patients were self-medicating (10 Trans male/Non-Binary AFAB, 3 Trans female/Non-Binary AMAB). 7 of the trans male and 1 of the trans female patients were using intramuscular hormones. Only 2 of the patients self-medicating had informed another healthcare professional.
Discussion The number of patients self-medicating without medical supervision raises concerns about adverse effects and unsafe injecting practice. Identifying such patients and meeting their needs raises novel issues for sexual health services. The study highlights the need for additional education for clinicians working with transgender patients.