Use of unprescribed hormones in the body modification of travestis and transsexual women in Salvador/Bahia, Brazil

Silva, Ricardo Araújo da; Silva, Luís Augusto Vasconcelos da; Soares, Fabiane; Dourado, Inês

doi:10.1590/1413-81232022272.44342020

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ARTICLE • Ciênc. saúde coletiva 27 (02) • Feb 2022 • https://doi.org/10.1590/1413-81232022272.44342020 copy

Use of unprescribed hormones in the body modification of travestis and transsexual women in Salvador/Bahia, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This article aims to analyze the use of non-prescribed hormones among travestis and transgender women (TrTGW) in Salvador, Bahia, Brazil. This cross-sectional study used the Respondent Driven Sampling (RDS) methodology to recruit TrTGW from 2014 to 2016 in Salvador and the Metropolitan Region. A comparative analysis was carried out between sociodemographic, behavioral, and gender declaration conditions using hormones. The RDS-II estimator weighted the data. Stata version 14 was used for statistical analyses. One hundred twenty-seven TrTGW were recruited. From the studied sample, 69.1% of participants used non-prescribed hormones, which was associated with industrial liquid silicone use and body satisfaction. The TrTGW who were comfortable with the penis and felt pleasure with the penis used hormone less. The seropositive participants reported a higher proportion of hormone use. The non-prescribed use of hormones was used by most TrTGW. This use is likely associated with better satisfaction with self-image and body among TrTGW. Elevated and exacerbated use of these hormones was identified, probably due to the rare access to public health services.

Key words:
Travestis; Transgender women; Hormone

Variables	N	%	%*
Sociodemographic
Gender identity
Travesti	60	47.2	31.5
Transgender woman	67	52.8	47.9
Age
≥ 25 years	60	47.2	42.8
< 25 years	67	52.8	57.2
Ethnicity/skin color
White	63	49.6	48.4
Black/brown	64	50.4	51.6
Schooling
> 8 years	78	61.4	73.2
≤ 8 years	49	31.6	23.8
Income
≥ 1,000 BRLs	71	55.9	51
< 1,000 BRLs	56	44.1	49
Marital status
Married	35	27.6	36.5
Single	92	72.4	63.5
Sex work history
No	37	29.1	22.4
Yes	90	70.9	77.6
Suffered discrimination for being TrTGW
No	26	20.5	16.3
Yes	101	79.5	83.7
Used illicit drugs
No	62	48.8	35.6
Yes	65	51.2	64.4
Uses or has used hormones
Yes	118	92.9	94.8
No	9	7.1	5.2
Age of onset of hormone use
≥ 18 years	48	37.8	40.4
< 18 years	70	55.1	59.6
Used hormone in the last 3 months
No	38	32.2	31.1
Yes	80	67.8	68.9
Hormone use frequency
Three times a month or less	41	51.2	31.9
1-7 times a week	39	48.8	68.1
Hormone acquisition place
Pharmacy without prescription
No	10	8.5	6.1
Yes	108	91.5	93.9
Received guidance on hormone use?
No	68	57.6	66.4
Yes	50	42.4	33.6

Pharmaceutical forms*	n	%
Doesn’t know which pharmaceutical form of hormone was used	11	9.3
Used one type of hormone pharmaceutical form	10	8.5
Used more than one type of hormone pharmaceutical form	97	82.2
Total	118	100

Variables	Hormone use
	n/N	% Weighted	OR	95% CI
Sociodemographic data
Gender identity
Travesti	39/60	31.5	1.00
Transgender woman	52/67	47.9	3.78	1.06-13.40
Age
≥ 25 years	38/60	32.8	1.00
15-24 years	53/67	46.7	1.37	0.36-5.27
Years of study
≤ 8 years	33/49	15.9	1.00
> 8 years	58/78	63.5	0.22	0.06-0.80
Skin color
White	46/63	41.4	1.00
Black/brown	45/64	38.1	0.48	0.13-1.70
Income
≥ 1,000 BRLs	52/71	38.73	1.00
< 1,000 BRLs	39/56	40.73	1.57	0.43 - 5.64
Sex work
No	25/37	16.9	1.00
Yes	66/90	62.5	1.32	0.34 - 5.06
Gender affirmation
Used industrial liquid silicone
No	61/83	51.6	1.00
Yes	30/44	27.9	1.27	0.35 - 4.53
Body image satisfaction
No	43/61	41.4	1.00
Yes	48/66	38.1	1.15	0.31 - 4.31
Feels comfortable with penis
No	27/34	21.8	1.00
Yes	64/93	57.7	0.45	0.10 - 2.03
Sexual practice and condom use
Feels pleasure with penis
No	30/40	25.6	1.00
Yes	61/87	53.8	0.63	0.16 - 2.46
Sexual practice
Sex with only men in the last 6 months	75/104	60.3	1.00
Sexo with M, W* and Trans*** in the last 6 months	16/23	19.2	2.67	0.64 - 11.10
Condom use in receptive anal sex with steady partners
Always uses	30/42	16.6	1.00
Never uses/irregular use	53/74	62.5	3.06	0.72 - 12.94
Condom use in receptive anal sex with casual partners
Always uses	69/95	64.9	1.00
Never uses/irregular use	22/32	14.6	0.59	0.16 - 2.14
Serology
HIV
Negative	79/112	71.3	1.00
Positive	12/15	8.1	2.48	0.47 - 12.85

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[1] Collaborations

Ricardo Araújo da Silva: main author, contributed to the literature review, construction of tables; statistical analysis and organization of the work of this research. Maria Inês da Costa Dourado: supervisor of the PhD research work, revised the text and tables and contributed with the theme. Luís Augusto Vasconcelos da Silva: doctoral co-advisor, revised the text and contributed with the theme. Fabiane Soares: revised the text and contributed with the theme content.