Self-Medicating Sex: Social, Ethical, and Historical Aspects of Do-It-Yourself Hormone Therapies in Trans and Non-Binary Communities

Trans and non-binary people frequently use hormones as part of gender-affirming care. However, access to hormone replacement therapies (HRT) is often associated with significant barriers—such as long waiting times, complex bureaucratic procedures, a lack of competent healthcare providers, or discrimination within the healthcare system. Those who face multiple marginalization—such as trans people with disabilities, without stable housing, from refugee or migrant communities —are particularly affected. For these reasons, many trans and non-binary people turn to so-called “do-it-yourself” hormone replacement therapies (DIY HRT)—that is, self-medication without medical prescription or supervision. For some, this is the only way to access HRT. While professional medical associations have warned about the health risks of DIY HRT, community organizations and trans and non-binary advocacy groups emphasize the emancipatory potential of this practice.

The project “Self-Medicating Sex” approaches the topic of DIY HRT in six interdisciplinary workshops with trans community members, healthcare professionals, medical ethicists and historians. These workshops offer an opportunity for joint reflection upon social, ethical, and historical aspects of DIY HRT. The goal is to gain a deeper understanding of current practices within trans and non-binary communities. Additionally, the project aims to discuss the potential of “harm reduction” approaches to promote the safe use of hormones. The ultimate objective is to develop context-sensitive recommendations for medical care and health policy.

Methodological approach

The project follows a community-based approach, where a seven-member participatory research team coordinates and carries out all steps —from conception to execution and dissemination of results. The initial project idea emerged at the conference “Queerokratia” in June 2024 in Berlin, which brought together trans, non-binary, and queer people from across Germany. The project team combines expertise in political activism with scientific expertise in gender studies, medicine, medical ethics, pharmacology, and philosophy

Research Team

Flora Baumgartner, Luce deLire, Mirjam Faissner, Resa-Philip Lunau, Lydia Schneider-Reuter, Alva Seltmann, Noma Warnecke

Contact

Diy-project(at)charite.de