#GenderAffirmingHormoneTherapy and Health Information on TikTok: Thematic Content Analysis

Background: Transgender and gender diverse people often turn to online platforms for information and support regarding gender-affirming hormone therapy (GAHT); however, analysis of this social media content remains scarce. Objective: We characterized GAHT-related videos on TikTok to highlight the implications relevant to GAHT prescribers. Methods: We used a web scraper to identify TikTok videos posted under the hashtags #genderaffirminghormonetherapy and #genderaffirminghormones as of November 2023. We identified recurrent themes via qualitative content analysis and assessed health education videos with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) scale and a modified Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) test. Results: Out of 69 videos extracted, 71% (49/69) were created by GAHT users, 24.6% (17/69) were created by health care workers, and 21.7% (15/69) were created to provide health education. Themes included physical changes on testosterone, GAHT access, and combating misinformation and stigma surrounding GAHT. Health education videos scored highly on PEMAT-A/V items assessing understandability (mean 88.3%, SD 11.3%) and lower on actionability (mean 60.0%, SD 45.8%). On the CRAAP test, videos scored highly on the relevance, authority, and purpose domains but lower on the currency and accuracy domains. Conclusions: Discussions of GAHT on TikTok build community among transgender and gender diverse users, provide a platform for digital activism and resistance against legislation that limits GAHT access, and foster patient-provider dialogue. Educational videos are highly understandable and are created by reliable sources, but they vary in terms of currency and quality of supporting evidence, and they lack in actionability.