# Substance and Non-Prescribed Hormone Use Among Transmen

> **NIH NIH R01** · PUBLIC HEALTH INSTITUTE · 2020 · $410,788

## Abstract

Project Summary/Abstract
The proposed study will investigate the trajectories of substance use, prescribed hormone use
(PHU), non-prescribed hormone use (NPHU), and psychological well-being among
transwomen (male-to-female transgender persons) and transmen (female-to-male transgender
persons) who identify their gender other than that assigned at birth. Many trans people seek to
align their physical appearance to match their internal gender identity through taking cross-
gender hormones and surgical procedures. The Standard of Care, World Professional
Association for Transgender Health recommends the initiation of cross-gender hormone and
surgical treatments to those who are transitioning from a gender assigned at birth to a gender
they identify with after comprehensive counseling by mental health professionals. During the
transition, many transwomen/men face a number of difficulties due to transphobia, exposure to
sexual and physical violence, and gender-based discrimination. Hormone therapy and surgical
interventions help transwomen/men to increase health and well-being and assist them to attain
safety. A high prevalence of substance use and NPHU among transwomen/men has been
reported. Transwomen who used NPHs reported more substance use than those who used
only prescribed hormones (PHs). NPH users also showed higher prevalence of depression,
suicidal thoughts, and transphobia, and lower levels of self-esteem. The reported widespread
NPHU is troublesome because NPHU is associated with improper dosage and a lack of
medical monitoring that elevates health risks. Few studies have investigated the trajectories of
substance use and PHU/NPHU in relation to psychosocial factors among transwomen/men.
The Specific Aims of the Study are: 1) To longitudinally describe and understand the
trajectories of substance use, PHU/NPHU, and psychological well-being among transwomen
and transmen in relation to background variables (e.g., gender identity and transition and
fluidity of sexual orientation and sexual partnership); 2) To explore and determine psychosocial
factors and examine the mediating effects of psychosocial factors (e.g., transphobia, self-
esteem, satisfaction with gender transition, social support, and trans community identity) on
health outcomes (e.g., substance use, PHU/NPHU, and psychological well-being); 3) To
compare transwomen and transmen in term of trajectories of substance use, PHU/NPHU, and
psychological outcomes in relation to psychosocial factors and background variables; 4) To
disseminate study findings through presentations and publications and prepare a future health
promotion intervention study for transwomen/men who have been neglected by research
studies. In order to attain the specific aims, we will utilize mixed methods; first conducting
qualitative interviews with transwomen/men, and then a longitudinal study with transwomen
(n=120) and transmen (n=120) recruited in the San Francisco Bay area.

## Key facts

- **NIH application ID:** 9935022
- **Project number:** 5R01DA039971-05
- **Recipient organization:** PUBLIC HEALTH INSTITUTE
- **Principal Investigator:** TOORU NEMOTO
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $410,788
- **Award type:** 5
- **Project period:** 2016-09-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9935022

## Citation

> US National Institutes of Health, RePORTER application 9935022, Substance and Non-Prescribed Hormone Use Among Transmen (5R01DA039971-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9935022. Licensed CC0.

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