Hormone use among Nepali transgender women: a qualitative study
Hormone use among Nepali transgender women: a qualitative study
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DOI：
10.1136/bmjopen-2019-030464
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发表时间：
2019-10-01
期刊：
影响因子：
2.9
通讯作者：
Marahatta, Sujan Babu
中科院分区：
文献类型：
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作者：
Regmi, Pramod R.;van Teijlingen, Edwin;Marahatta, Sujan Babu
目的关于尼泊尔跨性别者的信息缺乏，特别是探索他们使用激素疗法的研究。因此，这项研究的目的是探索(1)激素是如何使用的，(2)使用的激素类型，以及(3)跨性别女性在使用激素后所经历的副作用。这是尼泊尔第一次针对这一重要的公共卫生问题进行此类研究。这项研究是在尼泊尔的四个地区进行的：加德满都、顺赛、班克和卡斯基。设计和参与者这项定性研究包括八个焦点小组讨论(FGD)和九个访谈。对18岁及以上的变性人妇女进行了FGD和3次面对面访谈，对与这一群体共事和倡导的利益攸关方进行了6次访谈。研究在2016年9月至2017年3月期间进行。结果受试者均为年轻人。大多数FGD参与者已经完成了学校教育，40%的人已经使用激素1到3年。研究确定了五个相互重叠的主题：(1)使用激素的原因和动机；(2)激素的可及性和使用；(3)副作用；(4)医疗保健服务的使用；(5)停止使用激素。大多数人在网上和通过他们的同龄人网络收到关于激素治疗的信息。少数研究参与者寻求医生开出的激素治疗处方，但激素更有可能从当地私人药店或通过朋友在国外购买。这种自我用药与变性人身心健康的一系列风险有关。将有关激素治疗的信息、教育和交流纳入针对这一人群的现有健康促进干预措施，可能有助于变性人做出更好的知情选择。
Objectives There is a dearth of information on transgender individuals in Nepal, particularly studies exploring their use of hormone therapies. The objectives of this study therefore were to explore (1) how hormones are used, (2) types of hormones used and (3) side effects experienced by transgender women after hormone use. This is the first study of its kind in Nepal addressing this important public health issue.Setting The study was conducted in four districts of Nepal: Kathmandu, Sunsai, Banke and Kaski.Design and participants This qualitative study comprises eight focus group discussions (FGDs) and nine interviews. FGDs and three face-to-face interviews were held with transgender women aged 18 years and older and six interviews with stakeholders working with and advocating on behalf of this population. The study was conducted between September 2016 and March 2017.Results Our participants were young. The majority of FGD participants had completed school-level education and 40% had been using hormones for 1 to 3 years. Five overlapping themes were identified: (1) reasons and motivations for hormone use; (2) accessibility and use of hormones; (3) side effects; (4) utilisation of healthcare services and (5) discontinuation of hormone use.Conclusion Hormone use was common in our sample. Most received information on hormone therapy online and through their peer networks. A few study participants sought doctors' prescriptions for hormone therapy, but hormones were more likely to be bought from local private pharmacies or abroad through friends. This kind of self-medication is associated with a range of risks to the physical and mental health of transgender individuals. Incorporating information, education and communication about hormone therapy into existing health promotion interventions targeted to this population may help transgender people to make better informed choices.