Navigating Barriers: Hormone Misuse Among Transgender Women in Mainland China Due to Restrictive Medical and Societal Norms：A Case Report

Background The stringent and challenging procedures required for transgender women to access legitimate gender-affirming medical services in Mainland China often lead them to procure sex hormone medications from unlicensed providers. This situation is exacerbated by pervasive societal biases against transgender individuals, particularly transgender women, who encounter significant hostility. This dynamic underscores the urgent need for reforms to simplify the processes involved in accessing transgender medical services in Mainland China. Case Presentation This article presents a case of hormone misuse by a transgender woman in Mainland China, who experienced breast development, atrophy of male genitalia, diminished testosterone levels, and elevated estradiol and prolactin levels due to self-administered hormone therapy. The individual resorted to purchasing hormones from non-credentialed sources after her parents refused to authorize formal gender-affirming treatment. Despite psychiatric intervention, the patient continued to self-medicate with hormones obtained from these unqualified sources, leading to ongoing genital atrophy. Conclusions There is a compelling need to alleviate the procedural barriers to gender-affirming treatment in China and to revise regulations that require parental consent prior to such treatment. Without these changes, a significant number of transgender individuals will remain unable to access proper medical care, potentially leading to increased instances of hormone therapy misuse among this population.