Over-the-counter contraceptive drugs should not be used in hormone replacement therapy (HRT) for gender transitioning, as they might put the health of transgender people at risk, experts have warned.
There are two types of HRT for gender transition, depending on the age at which users start therapy, according to Nattawut Leelakanok, a lecturer in the Pharmacy Faculty at Burapha University.
For premature HRT, Mr Nattawut suggested the patient consult a physician with their parents before undergoing therapy.
Transgender people who start therapy after hitting puberty need to take both anti-androgen hormones and oestrogen.
However, they should not buy any contraceptive drug over the counter just for its oestrogen content, he cautioned at a recent seminar held by the Pharmacy Council at the Ministry of Public Health in Nonthaburi.
Contraceptives contain at least 20 microgrammes of oestrogen per pill but that is less than the amount recommended for hormone replacement therapy.
Depending on the patient, the proper dosage for HRT 2–6 milligrammes of oestrogen per day.
“That lower amount of oestrogen (in contraceptive pills) might put the patient at risk for cardiovascular disease,” said Mr Nattawut.
However, he estimated that as many as 40% of transgender women used contraceptives as oestrogen substitutes, with some referring to their treatment as a “formula” based on information spread on the internet.
Mr Nattawut said more accurate information on HRT needs to be circulated.
“Transgender women are advised to consult with doctors or chemists before starting their HRT journey,” said Srisombut Nawanoppharatsakul, a lecturer in the Pharmacy Faculty at Silpakorn University.
She said the consultation would help them set a goal for their appearance while decreasing any risks caused by different hormone-responsive abilities.
She also suggested that those who undergo HRT have a hormonal check-up every three months until their oestrogen levels stabilise.
They should check for bone mass, cancerous hormones, and potassium levels, as lower testosterone levels affect the potassium level in the bloodstream.