Impact of transsexualizing process centers on self-medication of transgender individuals

Arthur Machado Geiger Dias de  Moraes; Caren Nariel Pereira Santos  Souza; Luiza Taddeo Marques; João Fernando Nascimento de Barcelos; Felipe Barros  Oliveira; Rafaela Góes Bispo; Rodrigo Gomes Santos; Ailton  da Silva Santos; José Antônio Diniz Faria Júnior; Luciana Mattos Barros Oliveira

doi:10.11606/s1518-8787.2024058005791

Autores/as

Arthur Machado Geiger Dias de Moraes Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0000-0001-8049-7413
Caren Nariel Pereira Santos Souza Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0000-0002-0126-3764
Luiza Taddeo Marques Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0000-0001-7035-6158
João Fernando Nascimento de Barcelos Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0000-0003-2617-4108
Felipe Barros Oliveira Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0000-0001-5942-1537
Rafaela Góes Bispo Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0000-0002-4146-2602
Rodrigo Gomes Santos Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0009-0006-0373-2153
Ailton da Silva Santos Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa. Salvador, BA, Brasil https://orcid.org/0000-0001-6146-8174
José Antônio Diniz Faria Júnior Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0000-0003-4322-4568
Luciana Mattos Barros Oliveira Universidade Federal da Bahia. Instituto de Ciências da Saúde. Departamento de Biorregulação. Salvador, BA, Brasil https://orcid.org/0000-0001-5346-8449

DOI:

https://doi.org/10.11606/s1518-8787.2024058005791

Palabras clave:

Health Services for Transgender Persons, Transgender Persons, Self Medication, Hormone Therapy

Resumen

OBJECTIVE: The transgender population in Brazil faces marginalization and difficulties in accessing education and health, leading many individuals to self-medicate. This study aimed to evaluate the impact of the implementation of Specialized Centers in the Transsexualizing Process (SCTP) on the use of cross-sex hormone therapy (CSHT) without medical prescription, as well as the level of education and mental health profile of these individuals.

METHODS: This is a cross-sectional study with data from physical and electronic medical records between September 2017 and February 2023 regarding the use of CSHT before and after the implementation of two SCTP in the state of Bahia, Brazil, in addition to data on education level, previous diagnosis of anxiety and depression of patients.

RESULTS: A total of 219 participants, 127 transgender men (TM) and 92 transgender women and travestis (TrTW), were assessed. A significant reduction in the prevalence of self-medication was observed in both TrTW (92.98% before and 51.43% after, p<0.001), and TM (47.17% before and 25.67% after, p = 0.010) with the implementation of SCTP. Transgender individuals who used CSHT before accessing the service were found to have a lower prevalence of depression. Self-medication was not significantly associated with education or anxiety in our sample.

CONCLUSION: The results indicate the need for the expansion of SCTP, as they were associated with lower rates of self-medication in the transgender population.

Referencias

Pham A, Kerman H, Albertson K, Crouch JM, Inwards-Breland DJ, Ahrens KR. Understanding the complex relationship between one’s body, eating, exercise, and gender-affirming medical care among transgender and nonbinary adolescents and young adults. Transgend Health. 2023 Mar;8(2):149-58. https://doi.org/10.1089/trgh.2021.0112

Ministério da Saúde (BR). Portaria 2.803 de 19 de novembro de 2013. Redefine e amplia o Processo Transexualizador no Sistema Único de Saúde (SUS). 2013 [cited 2013, Nov 19]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt2803_19_11_2013.html

Conselho Federal de Medicina. Resolução CFM nº no 2.265/2019. Dispõe sobre o cuidado específico à pessoa com incongruência de gênero ou transgênero e revoga a Resolução CFM nº 1.955/2010. Diario Oficial Uniao, 2020, Jan 9.

Lima T. Educação básica e o acesso de transexuais e travestis à educação superior. Rev Inst Estud Bras. 2020;977):70-87. https://doi.org/10.11606/issn.2316-901X.v1i77p70-87

Andrade LN. Travestis na escola: assujeitamento e resistência à ordem normativa. Fortaleza: Metanoia; 2012.

Scote FD. será que temos mesmo direitos a universidade? O desafio do acesso e a permanência de pessoas transexuais no ensino superior [dissertation]. Sorocaba: Universidade Federal de São Carlos; 2017.

Krüger A, Sperandei S, Bermudez XP, Merchán-Hamann E. Characteristics of hormone use by travestis and transgender women of the Brazilian Federal District. Rev Bras Epidemiol. 2019 Sep;22(22 Suppl 1):e190004. https://doi.org/10.1590/1980-549720190004.supl.1

Arrais PS, Fernandes ME, Pizzol TD, Ramos LR, Mengue SS, Luiza VL, et al. Prevalence of self-medication in Brazil and associated factors. Rev Saude Publica. 2016 Dec;50 suppl 2:13s. https://doi.org/10.1590/s1518-8787.2016050006117

Mepham N, Bouman WP, Arcelus J, Hayter M, Wylie KR. People with gender dysphoria who self-prescribe cross-sex hormones: prevalence, sources, and side effects knowledge. J Sex Med. 2014 Dec;11(12):2995-3001. https://doi.org/10.1111/jsm.12691

Rotondi NK, Bauer GR, Scanlon K, Kaay M, Travers R, Travers A. Nonprescribed hormone use and self-performed surgeries: “do-it-yourself” transitions in transgender communities in Ontario, Canada. Am J Public Health. 2013 Oct;103(10):1830-6. https://doi.org/10.2105/AJPH.2013.301348

Ministério da Saúde (BR). Sectretaria de Políticas de Saúde. Departamento de Forumulação de Políticas de Saúde. Política nacional de medicamentos. Brasília, DF: Ministério da Saúde; 2001.

Bunn JY, Solomon SE, Miller C, Forehand R. Measurement of stigma in people with HIV: a reexamination of the HIV Stigma Scale. AIDS Educ Prev. 2007 Jun;19(3):198-208. https://doi.org/10.1521/AEAP.2007.19.3.198

Haan G, Santos GM, Arayasirikul S, Raymond HF. Non-prescribed hormone use and barriers to care for transgender women in San Francisco. LGBT Health. 2015 Dec;2(4):313-23. https://doi.org/10.1089/lgbt.2014.0128

Rocon PC, Rodrigues A, Zamboni J, Pedrini MD. Difficulties experienced by trans people in accessing the Unified Health System. Cien Saude Colet. 2016 Aug;21(8):2517-26. https://doi.org/10.1590/1413-81232015218.14362015

Glick JL, Andrinopoulos KM, Theall KP, Kendall C. “Tiptoeing around the system”: alternative healthcare navigation among gender minorities in New Orleans. Transgend Health. 2018 Jul;3(1):118-26. https://doi.org/10.1089/trgh.2018.0015

Andrade CAA, Loureiro AR, Lima Neto, ER, Vasconcelos EMR, Araújo EC. Selfcare requirements of transsexual women using sex hormones, according to the orem selfcare theory. Cogitare Enferm, 2018;23(3):e55748. http://dx.doi.org/10.5380/ce.v23i3.55748

Mota M, Santana AD, Silva E, Melo LPLR, Melo LP. “Clara, esta sou eu!” Nome, acesso à saúde e sofrimento social entre pessoas transgênero. Interface Comunicacao Saude Educ. 2022;26:e210017. https://doi.org/10.1590/interface.210017

Connelly PJ, et al. Gender-affirming hormone therapy, vascular health and cardiovascular disease in transgender adults. Hypertension. ;2019;74:1266-74. Preprint https://doi.org/10.1161/HYPERTENSIONAHA.119.13080

Stone T, Stachenfeld NS. Pathophysiological effects of androgens on the female vascular system. Biol Sex Differ. 2020;11: 45; Volume 11. Preprint 2020. https://doi.org/10.1186/s13293-020-00323-6

Baker KE, Wilson LM, Sharma R, Dukhanin V, McArthur K, Robinson KA. Hormone therapy, mental health, and quality of life among transgender people: a systematic review. J Endocr Soc. 2021 Feb;5(4):bvab011. https://doi.org/10.1210/jendso/bvab011

Aldridge Z, Patel S, Guo B, Nixon E, Pierre Bouman W, Witcomb GL, et al. Long-term effect of gender-affirming hormone treatment on depression and anxiety symptoms in transgender people: a prospective cohort study. Andrology. 2021 Nov;9(6):1808-16. https://doi.org/10.1111/andr.12884

Witcomb GL, Bouman WP, Claes L, Brewin N, Crawford JR, Arcelus J. Levels of depression in transgender people and its predictors: results of a large matched control study with transgender people accessing clinical services. J Affect Disord. 2018 Aug;235:308-15. https://doi.org/10.1016/j.jad.2018.02.051

Costa R, Colizzi M. The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review. Neuropsychiatr Dis Treat. 2016 Aug;12:1953-66. https://doi.org/10.2147/NDT.S95310

Impact of transsexualizing process centers on self-medication of transgender individuals

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