Transgender Filipinos face risks from self-medication, experts warn

(First of two parts)

DUMAGUETE CITY, NEGROS OCCIDENTAL, Philippines — For years, Angel, a transgender woman from Negros Oriental, bought contraceptive pills from pharmacies, ordered hormones online and injected herself based on advice from Facebook groups and friends—all without ever consulting a doctor.

“I sometimes experience headaches and shortness of breath, but I never consulted a doctor,” Angel said in Cebuano.

She added: “I didn’t know there were doctors specifically trained in transgender health care until this interview.”

Angel’s experience reflects a growing concern among medical experts, who say many transgender Filipinos, particularly those living outside major urban centers, are resorting to self-medication for gender-affirming hormone therapy because of limited access to qualified health-care providers, exposing themselves to potentially life-threatening complications.

For many transgender individuals, hormone therapy is a crucial step in aligning their physical characteristics with their gender identity and easing gender dysphoria—a condition recognized by the American Psychiatric Association as the psychological distress that may arise from a mismatch between a person’s assigned sex at birth and gender identity.

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“Some people who identify as transgender do experience gender dysphoria, which refers to the psychological distress resulting from an incongruence between one’s sex assigned at birth and one’s gender identity,” the APA states.

Lack of medical guidance

While gender-affirming hormone therapy has become an essential part of transition for many transgender people, access to qualified health-care providers remains limited across much of the Philippines, forcing many to seek information and medications online or through peer networks.

Dr. Vincent Martin Bravo, an endocrinologist based in Dumaguete City who specializes in transgender health care, said one of the biggest challenges facing transgender Filipinos is the lack of access to proper medical guidance.

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“Around half of the transgender individuals who eventually seek professional care are taking medications that are not recommended, such as synthetic contraceptive pills or they are taking the correct medications but at the wrong dosage,” Bravo said in a recent interview.

He added that self-medication is particularly common among transgender individuals considering gender-affirming surgeries.

“Among those interested in procedures such as breast augmentation or sex reassignment surgery, about 93 percent have engaged in self-medication before consulting a health-care provider,” he said.

According to Bravo, available data on transgender health in the Philippines are limited because they only capture individuals who have already accessed medical services. The actual number of transgender people self-medicating nationwide remains unknown.

The situation becomes even more complicated in smaller provinces where access to transgender health-care specialists and laboratory services is scarce. /cb