At the time of the writing, Nooshin Khobzi Rotondi was with the Health Systems and Health Equity Research Group, Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario. At the time of the study, Kyle Scanlon was with the 519 Church Street Community Centre, Toronto. Matthias Kaay is with the Addictions Program, Centre for Addiction and Mental Health. Robb Travers is with the Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario. Anna Travers is with Rainbow Health Ontario, Toronto.
Am J Public Health. 2013 Oct;103(10):1830-6. doi: 10.2105/AJPH.2013.301348. Epub 2013 Aug 15.
We examined the extent of nonprescribed hormone use and self-performed surgeries among transgender or transsexual (trans) people in Ontario, Canada.
We present original survey research from the Trans PULSE Project. A total of 433 participants were recruited from 2009 to 2010 through respondent-driven sampling. We used a case series design to characterize those currently taking nonprescribed hormones and participants who had ever self-performed sex-reassignment surgeries.
An estimated 43.0% (95% confidence interval = 34.9, 51.5) of trans Ontarians were currently using hormones; of these, a quarter had ever obtained hormones from nonmedical sources (e.g., friend or relative, street or strangers, Internet pharmacy, herbals or supplements). Fourteen participants (6.4%; 95% confidence interval = 0.8, 9.0) reported currently taking nonprescribed hormones. Five indicated having performed or attempted surgical procedures on themselves (orchiectomy or mastectomy).
Past negative experiences with providers, along with limited financial resources and a lack of access to transition-related services, may contribute to nonprescribed hormone use and self-performed surgeries. Promoting training initiatives for health care providers and jurisdictional support for more accessible services may help to address trans people's specific needs.
我们调查了加拿大安大略省跨性别或变性（trans）人群中非处方激素使用和自行进行性别重置手术的程度。
我们呈现了来自 Trans PULSE 项目的原始调查研究。2009 年至 2010 年期间，通过受访者驱动抽样共招募了 433 名参与者。我们采用病例系列设计来描述目前正在使用非处方激素的人群和曾经自行进行性别重置手术的参与者。
估计有 43.0%（95%置信区间=34.9，51.5）的安大略省跨性别者目前正在使用激素；其中，四分之一的人曾从非医疗来源（例如朋友或亲戚、街头或陌生人、互联网药店、草药或补品）获得过激素。有 14 名参与者（6.4%；95%置信区间=0.8，9.0）报告称目前正在服用非处方激素。有 5 人表示曾自行进行或尝试过手术（睾丸切除术或乳房切除术）。
过去与提供者的负面经历，加上有限的财务资源和获得与过渡相关服务的机会有限，可能导致非处方激素使用和自行进行手术。促进医疗保健提供者的培训计划和司法支持更便捷的服务，可能有助于满足跨性别者的特殊需求。
