Journal
CURRENT OPINION IN ENDOCRINOLOGY DIABETES AND OBESITY
Volume 28, Issue 6, Pages 595-603Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MED.0000000000000680
Keywords
anabolic-androgenic steroids; gender; systematic review; transgender
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Recent research on nonprescribed androgen use among women and trans men reveals differences in characteristics such as mental health, motivations, and sexual side effects. Some female users are able to access male-dominated knowledge sources and have created a pharmacology that prioritizes women's experiences. Further studies with a gender perspective, inclusive of transgender individuals, are needed in health research.
Purpose of review To summarize the most recent evidence regarding nonprescribed androgen use among women and trans men. Recent findings Fourteen heterogeneous studies met inclusion criteria. Three provided lifetime prevalence estimates among particular subgroups (from 0.5 to 8%), whereas one longitudinal study found adverse childhood experiences predicted later nonprescribed androgen use. Mental health and substance problems appear to correlate with severity of use, but evidence is mixed as to whether female users had lower or equal mental health burdens compared to male users. Studies that discuss motivation highlighted the dynamic risk management that underlies decisions to continue use; benefits have to outweigh undesired effects, whereas some sexual side effects are re-framed to be positive. Finally, a theme among qualitative studies is the gendered experiences of nonprescribed androgen use, and the search for knowledge and communities created by women. Prevalence, side effects, and trajectories of use appear to be different for women than men. Women users need gender-specific information, although some are able to navigate male-dominated knowledge sources and are creating a female ethnopharmacology that privileges women's experiences. Health research, including epidemiology, gravely needs a gender perspective when examining nonprescribed androgen use, and one that is inclusive of transgender people.
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