Purpose: Various problems related to the gender-affirming therapy (GAT) can adversely affect both the physical and mental health of people diagnosed with gender dysphoria (GD). In this study, we aimed to highlight the reasons for loss to follow-up during the gender-affirming hormone therapy (GAHT), which is an important component of GAT.
Methods: People diagnosed with GD who were followed for GAHT between January 2014 and June 2019 (female-to-male: 349; male-to-female: 89) were enrolled. The prepared questionnaire was administered to participants at routine follow-up visits. We arranged tele-interviews for those who did not attend the follow-up visits.
Results: During GAHT process, the health problems most frequently reported by people diagnosed with GD were related to mental health. The most important factors in regular follow-up were the completion of legal procedures in Turkey required for GAT and citizenship alteration, financial barriers, lack of time for clinical visits, and dissatisfaction with health care setting. In addition, we found that the frequency of desire for supervised GAHT and family support were higher in regularly followed people diagnosed with GD. On the contrary, self-initiation of GAHT and mental disorders were more common in people diagnosed with GD lost to follow-up.
Conclusion: The present study provides important information regarding the reasons for loss to follow-up during GAT in Turkey. Elucidation of reasons for loss to follow-up can aid in identifying the gaps in medical care, improve compliance, and outcomes of people diagnosed with GD.
Keywords: barriers to care; gender dysphoria; gender-affirming hormone therapy; stigmatization; transgender.
Copyright 2022, Mary Ann Liebert, Inc., publishers.