(P439) Bodies of desire: use of hormones nonprescribed among transgender women in five Brazilian capitals, 2019 - 2021

Background - In order to achieve desired body changes, travestis and transgender women (TGW) resort to a set of gender affirmation procedures, including hormone therapy. The objective of the present study is to analyze experiences of TGW, participants of a multicenter cross-sectional study, on the use of hormones for body change without medical prescription. Methods - We used quantitative and qualitative data from the 'TransOdara Project', carried out between 2019 and 2021, to estimate the prevalence of Sexually Transmitted Infections (STIs) among TGW in five Brazilian Capital Cities. The main outcome was the use of hormones without medical prescription. Descriptive analysis and logistic regression models were performed. For the qualitative analysis, the narratives produced in semi-structured interviews were used. Results - The use of hormones was reported by 40.7% (536/1,317) of the participants. Of the 525 who were able to inform how they had obtained it, 72.6% reported using hormones without a medical prescription. Factors associated with the outcome were considered: young age (OR 2.16; 95% CI: 3.31-3.56), not having access to education (OR 1.82; 95% CI: 1.06-3.13), not having changed names (OR 3.58; 95% CI: 2.23-5.76), 'having full-time sex work as your main occupation' (OR 4.55; 95% CI: 1.88-10.97) or 'having been a sex worker in the past' (OR 1.92; 95% CI: 1.10-3.34). Having suffered discrimination at least once in life for being a TGW was negatively associated with the outcome (OR 0.40; 95%CI: 0.20-0.81). In their narratives, the use of hormones without monitoring appears related to the urgency of gender transition, are use in higher doses than recommended and neglecting potential harms. Conclusion - The use of non-prescribed hormones is high among TGW, especially among younger women, who did not have access to education, who did not change their name and with a history of sex work. To reverse this situation, it is necessary to expand and facilitate access to Primary Health Care services; promote training of health providers to reduce stigma and discriminatory attitudes; widely disseminate the rights guaranteed by law, considering the possibility of rectifying the corporate name, among others.