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Gender-affirming hormone therapy in Portugal: knowledge, safety and adherence
Rafael Baptista Santos1, Carolina Lemos2, Miguel Saraiva3
1Instituto de Ciências Biomédicas de Abel Salazar, Porto, Portugal.
International Journal of Transgender Health
|February 21, 2025
Summary
Transgender individuals often rely on the internet for gender-affirming hormone therapy (GAHT) information, facing access barriers and insufficient guidance. Improved healthcare professional involvement is crucial for safety, adherence, and comprehensive care.
Area of Science:
- Endocrinology
- Public Health
- Transgender Health
Background:
- Understanding knowledge, experiences, safety, and adherence in gender-affirming hormone therapy (GAHT) is crucial for transgender individuals.
- The Portuguese National Health System's role in GAHT initiation requires examination.
Purpose of the Study:
- To assess knowledge of GAHT among the Portuguese transgender population.
- To examine experiences of initiating GAHT through the Portuguese National Health System.
- To evaluate safety, monitoring, and adherence to GAHT.
Main Methods:
- Cross-sectional study involving Portuguese transgender adults undergoing GAHT.
- Original questionnaire using a Likert-style scale (0-6) to assess various aspects of GAHT.
- Descriptive statistics and non-parametric tests for data analysis (significance level p<0.05).
Main Results:
- Participants rated their GAHT knowledge highly (median 5/6) but primarily used the internet, with 14.1% feeling uninformed.
- 71.2% faced obstacles obtaining GAHT, primarily long waiting times; feminizing therapy was more expensive.
- Informed consent (43.3%) and pretreatment blood tests (11.3%) were often lacking; fertility discussions were infrequent (53.2%), with low uptake (8.0%).
- Regular monitoring (79.6%) and endocrinologist follow-up (87.3%) were common, but 6.3% discontinued therapy due to adverse effects or access issues.
Conclusions:
- Internet is a primary GAHT information source, highlighting the need for healthcare professionals to guide patients to reliable resources.
- Limited provider knowledge and access barriers, including primary care physician underinvolvement, raise safety concerns.
- Inadequate fertility counseling and follow-up necessitate comprehensive care models to improve GAHT safety and adherence.
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