Use of Hormones Among Trans Women in the West Coast of Peninsular Malaysia: A Mixed Methods Study

PURPOSE: There are no national data on hormone use by trans women in Malaysia. The objective of this study was to determine hormone use and the associated factors by trans women in Malaysia. METHODS: This mixed method (quantitative and qualitative) study (JPEC 03-18-0021) was conducted using a self-administered questionnaire among trans women who used hormones and recruited using snow ball sampling method. All participants had undergone a blood test in an assigned laboratory. Besides total testosterone and total estradiol blood levels, renal and liver function tests and lipid profile were done. RESULTS: A total of 111 out of the 141 respondents who participated were taking hormones. The main reason for not taking hormones was the concern for side effects. The main source of information concerning hormones was friends, and most procured the hormones from pharmacy without prescription and without first undergoing a physical or blood examination. All were on estrogens and only about half were on progesterone. The common mode of intake was oral and by injection. Most were on <4 mg of estrogens and did not report any major complication. Most rated the hormone affordability and satisfaction as good. Most had inadequate testosterone and estradiol blood levels. Except for total cholesterol and low-density lipoproteins, all other blood tests were normal. Correlation between serum testosterone and estradiol (R(2) 0.012. B−9.273 (95% confidence interval −16.44 to −2.11). p=0.012) was statistically significant. CONCLUSION: The prevalence of hormone use was high, mostly nonprescription use and with no medical supervision.