Abstract: What information do people need to support self-managed gender affirming hormone therapy (GAHT) in the US? A qualitative exploration of Reddit posts

November 2024

Abstract: What information do people need to support self-managed gender affirming hormone therapy (GAHT) in the US? A qualitative exploration of Reddit posts

Youm A, Reese S, Braine NE, Carter-Bolick I, Hastings J, Moseson H. Contraception. November 2024. DOI: 10.1016/j.contraception.2024.110668

Abstract

Objectives

As barriers to gender-affirming hormone therapy (GAHT) in the US proliferate alongside restrictions on abortion and fertility care (sites of GAHT provision), we sought to characterize the informational needs of people who self-manage their GAHT.

Methods

We used Apify to pull 500 posts with the most engagement between January-December 2023 from an anonymous, public Reddit thread devoted to experiences with self-managed GAHT. We excluded posts if they were image-only or from outside the US. We coded eligible posts in MAXQDA and interpreted results as a team.

Results

In preliminary analysis of 422 eligible Reddit posts, users focused predominantly on clinical questions related to blood work interpretation and hormone dosing/administration, personal transition goals and physical changes, and experiences with uninformed clinicians and anonymous vendors. Users sought technical and lived expertise from other Reddit community-members about where to begin, specific administration techniques, hormone supply sourcing and management, and reassurance about whether what they were experiencing was safe or normal. Posts reveal a spectrum of self-managed GAHT–from those who exclusively self-managed their GAHT, to those who sourced hormones clinically but customized their dosing regimen, to others who self-managed only intermittently to manage gaps in clinical access.

Conclusions

People self-managing their GAHT seek detailed information from anonymous online peers on how to safely tailor their GAHT to meet their goals–information that they are struggling to find in clinical settings. Addressing the informational needs of people self-managing their GAHT is integral to protecting bodily autonomy, with implications for fertility and family planning goals.

Tagged with Comprehensive SRH info & services, Other Areas, United States