INTRODUCTION: Some transsexuals choose, usually because it's the only option available to them, to self-prescribe sex hormones for the purpose of bringing one's secondary sexual characteristics more in line with their gender identity. The impact of unregulated cross-sex hormones on the lipid profile and cardiovascular function in Male-to-Female transgender (MtF) who probably have sex hormone imbalances do not appear to have been well investigated.
OBJECTIVE: The main objective of this study is to determine the clinical metabolic profile of MtF transgenders on self-prescribed cross-sex hormone therapy in Zamboanga Peninsula.
METHODS: This is cross-sectional study among Male Filipino adults self-proclaimed to be MfF transgenders. Participants have been identified thru snowball techniques and have been recruited on a voluntary basis. Demographic, clinical characteristics and practices of cross-sex hormone therapy among MtF transgender including physical changes and side effects are determined through interview, physical examination and focus group discussion Blood samples have been collected to determine the Metabolic profile.
RESULTS: Forty six percent (46%) of the respondents (n=30) belong to the age group of 26-35 with a mean age of 26.9 (sd=+5.92), finished high school (16,60%) and are self-employed (25,80%). Mean BMI (21.7 ± 3.64), Systolic (113 ± 6.06) and Diastolic (77.3 ± 6.91) BP have been found to be within normal limit. They are non-smokers (60%), non-alcoholic drinkers (76%) with no history of hypertension (86%) and diabetes mellitus (100%). Current users have been found to be younger than previous users. Previous users have higher rates of pre-diabetic HBA1c values than current users. No other remarkable difference has been observed between the two groups. All of the respondents indulge self-prescribed practices on cross-sex hormone therapy. Ethinyl Estradiol (Trust Pills) is the most common hormone drug used and endorsed by friends (100%). Respondents purchase feminizing drugs from pharmacies (60%) and health centers (13%). Morning erection (100%), decreased libido (100%) breast pain (93%0, acne (20%), mood swings (17%) and headaches (10%) have been perceived as side-effects. Breast enlargement (100%), decreased muscle mass (76%), smoother skin (70%), weight gain (66%) and change in voice (10%) have been observed to be physical changes that occur while taking cross-sex hormone drugs.
CONCLUSION: All respondent confess that that they self-prescribed cross-sex hormones and their friends are their source of their knowledge about cross-sex hormone therapy. Oral administration is the major route of administration and Ethinly Estradiol 30mcg+ levonorgestrel 125 mcg + Fe (Trust Pills) as their chosen drug for cross-sex hormone therapy. Doses of cross-sex hormone is tailored from their friends instead of a qualified medical practitioners, and the majority of their source is the pharmacy.