Initiation and Maintenance of Low‐Dose Transdermal Testosterone in Non‐Binary Individuals: A Retrospective Audit

ABSTRACT Objective An increasing number of trans individuals, particularly those who are non‐binary, desire lower testosterone doses than those outlined in current guidelines for gender affirmation. These guidelines acknowledge the need for a tailored approach to treatment, especially for non‐binary people. However, existing guidelines for initiation of testosterone assume that trans individuals desire rapid and complete masculinisation through standard dosing. We aimed to assess the initiation and maintenance of low‐dose testosterone in non‐binary individuals treated with transdermal testosterone for ≥ 6 months. Design Retrospective audit. Patients Non‐binary individuals initiating low‐dose transdermal testosterone with ≥ 6 months follow‐up. Intervention Testosterone 1% gel ( 0.5). Conclusions Most non‐binary individuals initiating low‐dose transdermal testosterone continue doses lower than those recommended in current guidelines after 6−12 months of treatment. These hypothesis‐generating findings highlight the need for studies evaluating the influence of low‐dose testosterone on clinical outcomes and safety end‐points.