Exploring Transfeminine Youth Health Disparities in Thailand: An Online Survey Analysis of Characteristics and Hormonal Use Patterns.

Abstract

Background: Transgender youth in Thailand often encounter limitations when accessing gender services, leading many to use nonprescribed hormones.

Objectives: This study aimed to explore 1) the pattern of Gender-Affirming Hormone Treatment (GAHT) use among Thai transfeminine youth, 2) the baseline characteristics of transfeminine youth, and 3) the self-reported happiness score and depression screening.

Methods: We conducted a cross-sectional online survey among Thai transfeminine youth aged 12 to 25 years. Data were collected using a self-administered questionnaire distributed via social media platforms from September 2021 to October 2022.

Results: Of the 256 participants, 226 (88%) reported having used hormones. The average age at which participants first used hormones was 15.5 years (SD 2.5). A majority (94.6%) of those who had used hormones disclosed their gender identity, compared with a lower percentage (60%) in the nonhormone use group. Among those with hormone use experience, only 36.1% reported use that strictly aligned with the recommended regimen, according to the 2017 Endocrine Society Clinical Practice Guideline, which includes an antiandrogen agent (oral cyproterone acetate) and estrogen (either oral estradiol valerate, oral 17 beta-estradiol, or estrogen gel). Furthermore, the average happiness scores and PHQ-A scores showed no significant differences between individuals who have or have not used GAHT.

Conclusion: Thai transfeminine youth have started using GAHT during adolescence. However, many of them use it in ways that deviate from the recommended standard of gender care. The findings underscore the urgent need to enhance medical access, education, and supervision for gender health care among transfeminine youth.